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目的:观察中国人脂联素基因(apM1)与冠心病(CHD)及胰岛素敏感性的关系。方法:对照组136例,冠心病患者281例,又分为单纯CHD患者131例,合并2型糖尿病患者150例,均为无亲缘关系的安徽地区汉族人。用稳态模式胰岛素抵抗指数(HOMA-IR)及胰岛β细胞功能指数(HOMA-β)估测胰岛β细胞胰岛素分泌功能及外周组织胰岛素敏感性。采用聚合酶链反应-单链构象多态性(PCR-SSCP)方法初筛apM1基因后,进行DNA直接测序。结果:apM1基因SNP276基因型GG+CT与TT型相比患CHD的风险增加,风险比值(OR)=2.976,95%可信限1.135-7.804,P=0.027,在固定性别、年龄及体重指数后,偏相关分析表明,GG+CT基因型与HOMA-IR显著正相关(r=0.174,P=0.005)。对照组中GG型或GT型与TT型比较,GG型或GT型的体重指数、腰臀比、体脂百分比、收缩压、空腹胰岛素及HOMA-IR均高于TT型(P<0.05,0.01或0.001),同时,GG型的空腹血糖亦显著升高(P<0.05)。结论:apM1基因SNP276多态性与冠心病及胰岛素敏感性具有相关性。
Objective: To observe the relationship between Chinese adiponectin gene (apM1) and coronary heart disease (CHD) and insulin sensitivity. Methods: The control group of 136 patients with coronary heart disease in 281 cases, 131 patients were divided into simple CHD patients, 150 patients with type 2 diabetes mellitus were unrelated Han people in Anhui Province. The steady-state insulin resistance index (HOMA-IR) and pancreatic β-cell function index (HOMA-β) were used to assess the insulin secretion and insulin sensitivity of pancreatic β cells. The apM1 gene was preliminarily screened by polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) and sequenced directly. Results: The odds ratio (OR) of apM1 gene SNP276 genotype GG + CT compared with TT genotype was 2.76%, 95% confidence interval was 1.135-7.804, P = 0.027. Compared with TT genotype, After partial correlation analysis, GG + CT genotype was positively correlated with HOMA-IR (r = 0.174, P = 0.005). Body weight index, waist-hip ratio, body fat percentage, systolic blood pressure, fasting insulin and HOMA-IR in GG or GT group were higher than those in TT genotype in GG or GT group compared with TT group in control group (P <0.05, 0.01 Or 0.001). Meanwhile, fasting blood glucose of GG type was also significantly increased (P <0.05). Conclusion: The SNP276 polymorphism of apM1 gene is correlated with coronary heart disease and insulin sensitivity.