CAJ | 학술논문

背景:2型糖尿病患者内皮细胞型一氧化氮合酶(endothelial constitutivenitric oxide synthase,ecNOS)的第四内含子的a等位基因(4a等位基因)频率增高且与血管内皮功能减低有关.目的:探讨2型糖尿病和糖耐量正常的2型糖尿病一级亲属ecNOS基因多态和血浆一氧化氮并探讨他们的关系.设计:以诊断为依据,非随机对照试验.地点、对象和方法:正常对照组67例为河北省人民医院健康查体并自愿参加研究者,男33例,女34例;一级亲属组为本院代谢门诊就诊的2型糖尿病患者子女98例,男48例,女50例;糖尿病组为本院老年内分泌科就诊的2型糖尿病患者85例,男40例,女45例.纳入标准:符合1999年WHO 2型糖尿病诊断标准.排除标准:无糖尿病神经病变及血管病变;无血缘关系;无严重高脂血症等.应用PCR扩增技术测定ec-NOS基因型,用硝酸还原酶法测定一氧化氮.主要观察指标:3组研究对象的ecNOS基因型、一氧化氮水平以及空腹胰岛素、总胆固醇、三酰甘油、体质量指数、腰臀比、空腹血糖及血红蛋白.结果:①糖尿病组和一级亲属组与对照组相比a/a+a/b基因型频率和4a等位基因频率呈增高趋势,但差异无显著性意义(P＞0.05).②对照组、一级亲属组、糖尿病携带4a等位基因者的血浆一氧化氮水平[(68.00±15.9),(60.75±17.64),(61.63±18.26)μmol/L]显著低于不带4a等位基因者[(98.30±25.1),(83.70±26.37),(75.15±29.38),t=-3.289,-3.432,P＜0.01,t=-2.432,P＜0.05].结论:2型糖尿病和糖耐量正常的2型糖尿病一级亲属血浆一氧化氮降低存在基因依赖性.
배경:2형당뇨병환자내피세포형일양화담합매(endothelial constitutivenitric oxide synthase,ecNOS)적제사내함자적a등위기인(4a등위기인)빈솔증고차여혈관내피공능감저유관.목적:탐토2형당뇨병화당내량정상적2형당뇨병일급친속ecNOS기인다태화혈장일양화담병탐토타문적관계.설계:이진단위의거,비수궤대조시험.지점、대상화방법:정상대조조67례위하북성인민의원건강사체병자원삼가연구자,남33례,녀34례;일급친속조위본원대사문진취진적2형당뇨병환자자녀98례,남48례,녀50례;당뇨병조위본원노년내분비과취진적2형당뇨병환자85례,남40례,녀45례.납입표준:부합1999년WHO 2형당뇨병진단표준.배제표준:무당뇨병신경병변급혈관병변;무혈연관계;무엄중고지혈증등.응용PCR확증기술측정ec-NOS기인형,용초산환원매법측정일양화담.주요관찰지표:3조연구대상적ecNOS기인형、일양화담수평이급공복이도소、총담고순、삼선감유、체질량지수、요둔비、공복혈당급혈홍단백.결과:①당뇨병조화일급친속조여대조조상비a/a+a/b기인형빈솔화4a등위기인빈솔정증고추세,단차이무현저성의의(P＞0.05).②대조조、일급친속조、당뇨병휴대4a등위기인자적혈장일양화담수평[(68.00±15.9),(60.75±17.64),(61.63±18.26)μmol/L]현저저우불대4a등위기인자[(98.30±25.1),(83.70±26.37),(75.15±29.38),t=-3.289,-3.432,P＜0.01,t=-2.432,P＜0.05].결론:2형당뇨병화당내량정상적2형당뇨병일급친속혈장일양화담강저존재기인의뢰성.
BACKGROUND: Frequency of a allele in the fourth intron(4a allele) of type 2 diabetes endothelial constitutive nitric oxide synthase(ecNOS) increases and relates with decreased vascular endothelial function.OBJECTIVE: To explore ecNOS gene polymorphisms and plasma nitric oxide in type 2 diabetes and in fir st degree relatives of type 2 diabetic mellitus with normal glucose tolerance and to study their relationship.DESIGN: Non-randomly controlled trial based on diagnosis.SETTING, PARTICIPANTS and INTERVENTIONS: Normal controlgroup included 67 healthy volunteers(33 men and 34 women) in Hebei Provincial People' s Hospital; first degree relatives group included 98 off-springs of type 2 diabetes mellirus diagnosed in the out-patient department,including 48 men and 50 women;type 2 diabetes group included 85 patients(40 men and 45 women) in the senile endocrine department. Eligibilitystandards. The patients were diagnosed according to WHO type 2 diabetesdiagnosis standard in 1999. Patients with the following conditions were ex-cluded: diabetic neuropathy and vascular disorder; no blood relationship;and/or severe hyperlipemia. The ecNOS genotype was measured with PCR technique, and nitric oxide was assessedby nitrate reductase method.MAIN OUTCOME MEASURES: ecNOS genotype, nitric oxide level,empty stomach insulin level, total cholesterol, triacylglycerol, body mass index, waist-hip ratio, fasting blood sugar and hemoglobin of three groups.abetes group and first degree relatives group compared with that of control group,in control group, first degree relatives group and diabetes group carrying 4a allele [(68.00 ± 15.9), (0.75 ± 17. 64), and(61.63 ± 18.26) μmol/L] was significantly lower than the groups without 4a allele[(98.30:±:25.1),(83.70±26.37), and(75.15±29.38) (t= -3.289, -3.432, P＜0.01, t= -2.432, P＜0.05)].CONCLUSION: Decrease of plasma nitric oxide level in type 2 diabetes and first degree relatives of type 2 diabetic patients with normal sugar tolerance has gene dependency.