CAJ | 학술논문

严重烧创伤及大手术后患者易发生以高糖血症为表征的糖代谢障碍，又称外科糖尿病，可致感染易感性增加，严重影响预后。临床发现，即使在致伤原因相同及病情相似的患者间，这种糖代谢障碍表现程度亦相差较大，并且对降糖药物的反应上也存在明显个体差异性，目前机制不明。近年来，全基因组关联研究（GWAS）发现基因多态性与糖代谢障碍密切相关，如转录细胞因子7类似物2（TCF7L2）、过氧化物酶体增殖物激活受体γ（PPARγ）等，其中TCF7L2基因多态性被证实与糖代谢障碍关联性最强，而TCF7L2基因多态性与外科糖尿病发病个体化差异是否相关，鲜有报道。本文就 TCF7L2基因多态性与糖代谢障碍的关系作一综述，以期为从遗传学角度研究烧创伤后糖代谢障碍提供新的思路。
엄중소창상급대수술후환자역발생이고당혈증위표정적당대사장애，우칭외과당뇨병，가치감염역감성증가，엄중영향예후。림상발현，즉사재치상원인상동급병정상사적환자간，저충당대사장애표현정도역상차교대，병차대강당약물적반응상야존재명현개체차이성，목전궤제불명。근년래，전기인조관련연구（GWAS）발현기인다태성여당대사장애밀절상관，여전록세포인자7유사물2（TCF7L2）、과양화물매체증식물격활수체γ（PPARγ）등，기중TCF7L2기인다태성피증실여당대사장애관련성최강，이TCF7L2기인다태성여외과당뇨병발병개체화차이시부상관，선유보도。본문취 TCF7L2기인다태성여당대사장애적관계작일종술，이기위종유전학각도연구소창상후당대사장애제공신적사로。
Glycometabolism disorder results from severe burns, trauma or large operations, contributes to the infection and seriously affects the prognosis. There exist significant individual differences about the predispositions to hyperglycemia after severe thermal injury as far as we observed from clinical work. The disease progression may reflect an interation between hereditary factors and environmental challenges, the mechanism of which is still largely unknown. Genome-wide association studies (GWAS) have implicated that polymorphisms in transcription factor 7-like 2 (TCF7L2) is closely associated with type 2 diabetes mellitus (T2DM), constituting the most replicated and strongly risk identified to date. Studies have shown that TCF7L2 variants may caused glycometabolism disorders through impaired insulin secretion and resistance, promoting the conversion from impaired glucose tolerance to T2DM. We suspect whether hyperglycemia after burn and T2DM share the similar pathogenesis mechanism or others. This review focused on understanding of the mechanisms by which TCF7L2 variants affect the risk of glycometabolism disorder.