【摘要】：目的探討PPARγ基因Pro12Ala和C1431T多態(tài)性與妊娠期糖尿病(GDM)發(fā)病的關系。方法選擇2015年6月至2016年2月期間在青島大學附屬醫(yī)院產(chǎn)科門診進行產(chǎn)檢以及住院剖宮產(chǎn)的青島地區(qū)漢族患者260名作為研究對象,采用病例對照的研究方法選取其中的130例妊娠期糖尿病孕婦作為實驗組,平均孕周為(39.3±0.6)周,平均年齡為(28.6±3.1)歲,平均體重指數(shù)為(24.2±3.1);另130例健康孕婦作為對照組,平均年齡為(28.3±3.2)歲,平均孕周為(39.1±0.5)周,平均體重指數(shù)為(24.1±2.6),且兩組孕婦均無高血壓、心臟病等其他妊娠合并癥。測定兩組孕婦血清空腹血糖(FPG)、空腹胰島素(FINS)、甘油三酯(TG)、總膽固醇(TC)及體質(zhì)指數(shù),并計算胰島素抵抗指數(shù)的自然對數(shù)ln(HOMA-IR)。對PPARγ基因的Pro12Ala和C1431T這兩個位點應用聚合酶鏈反應-限制性片段長度多態(tài)性(PCR-RFLP)的方法進行酶切鑒定,最后從中選取部分標本進行送檢測序,以驗證得到的結果是否正確。結果(1)GDM組Ala12等位基因頻率是0.054,顯著低于對照組的0.092,差別有統(tǒng)計學意義;T1431等位基因頻率是0.269,高于對照組的0.246,差別無統(tǒng)計學意義。位點Pro12Ala的基因型頻率χ2=3.345(P0.05),等位基因頻率χ2=1.420(P0.05),位點C1431T的基因型頻率χ2=1.041(P0.05),等位基因頻率χ2=0.181(P0.05),兩個位點基因頻率分布均無統(tǒng)計學意義(見表2.1.1、2.2.1)。(2)GDM組PPARγPro12Ala基因位點中,Pro/Pro基因型甘油三酯及空腹血糖的測量數(shù)值分別為2.85±0.89、3.92±1.06,Pro/Ala和Ala/Ala基因型甘油三酯及空腹血糖的測量數(shù)值分別為2.02±1.23、3.24±0.85,攜帶Ala等位基因的孕婦甘油三酯和空腹血糖水平明顯低于無Ala等位基因的孕婦,差別有統(tǒng)計學意義;Pro/Pro基因型膽固醇、空腹胰島素、胰島素抵抗指數(shù)的測量數(shù)值分別為5.33±1.08、12.95±9.25、2.28±2.36,Pro/Ala和Ala/Ala基因型膽固醇、空腹胰島素、胰島素抵抗指數(shù)的測量數(shù)值分別為5.69±3.86、13.56±2.82、2.76±0.42,這幾種指標在兩種基因型中的分布無統(tǒng)計學差異(P0.05)。而C1431T基因位點中,GDM組C/C型各生化指標的數(shù)值為2.23±0.65、5.28±1.45、3.88±1.37、12.94±3.25、2.42±2.05,C/T+T/T型各生化指標的數(shù)值為2.53±1.78、5.59±3.68、4.11±0.69、13.27±2.96、2.56±0.29,各指標在不同基因型的攜帶者中對GDM的發(fā)病均未發(fā)現(xiàn)有明顯統(tǒng)計學差異(P0.05)。結論PPARγ基因Pro12Ala多態(tài)性可能是抑制GDM的發(fā)病的相關因子,Ala等位基因可能與GDM糖脂代謝紊亂有關;C1431T基因多態(tài)性與GDM發(fā)病以及相關生化指標無明顯相關性。
[Abstract]:Objective to investigate the relationship between Pro12Ala and C1431T polymorphisms of PPAR 緯 gene and (GDM) in gestational diabetes mellitus (GDM). Methods from June 2015 to February 2016, 260 Han nationality patients in Qingdao from June 2015 to February 2016 were selected as the subjects of the study, who underwent birth examination and inpatient cesarean section at the obstetrical outpatient department of affiliated Hospital of Qingdao University. A case-control study was conducted in 130 pregnant women with gestational diabetes mellitus (GDM) as experimental group, with an average gestational age of (39.3 鹵0.6) weeks, mean age of (28.6 鹵3.1) years and average body mass index (BMI) of (24.2 鹵3.1), and 130 healthy pregnant women as control group, with an average age of (28.3 鹵3.2) years. The mean gestational weeks were (39.1 鹵0.5) weeks, and the average body mass index (BMI) was (24.1 鹵2.6) weeks. There were no hypertension, heart disease and other pregnancy complications in the two groups. Serum fasting blood glucose (FPG),) fasting insulin (FINS),) triglyceride (TG),) total cholesterol (TC) and body mass index (BMI) were measured and the natural logarithm of insulin resistance index (HOMA-IR) was calculated. The Pro12Ala and C1431T loci of PPAR 緯 gene were identified by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. Results (1) the frequency of Ala12 allele in GDM group was 0.054, which was significantly lower than that in control group (0.092). The allele frequency of T1431 in GDM group was 0.269, which was higher than that in control group (0.246). The genotype frequency of Pro12Ala was 3.345 (P0.05), the frequency of allele was 1.420 (P0.05), the genotype frequency of C1431T was 1.041 (P0.05), and the frequency of allele was 蠂 2 0.181 (P0.05). There was no significant difference between the two loci (see Table 2.1.12.2.1). (2) in the PPAR 緯 Pro12Ala gene locus of GDM group. The measured values of fasting blood glucose and fasting blood glucose were 2.85 鹵0.89 鹵3.92 鹵1.06g Prop / Ala and 2.02 鹵1.233.24 鹵0.85, respectively. The levels of triglyceride and fasting blood glucose of pregnant women with Ala allele were significantly lower than those of pregnant women without Ala allele. There were significant differences in cholesterol, fasting insulin and insulin resistance index between Pro-Pro-Pro genotype and Ala/Ala genotype (5.33 鹵1.08 鹵12.95 鹵9.25 鹵2.28 鹵2.36) and fasting insulin, respectively. The measured values of insulin resistance index were 5.69 鹵3.86 and 13.56 鹵2.82 鹵2.76 鹵0.42, respectively. There was no significant difference in the distribution of these indexes between the two genotypes (P0.05). In the C1431T gene locus, the values of each biochemical index of C / C type C type in GDM group were 2.23 鹵0.65V 5.28 鹵1.45N 3.88 鹵1.3712.94 鹵3.254.42 鹵2.255C / T, 2.53 鹵1.785.59 鹵3.684.11 鹵0.696.27 鹵2.962.56 鹵0.29, respectively. There was no significant difference in the incidence of GDM among the carriers with different genotypes (P0.05). Conclusion the Pro12Ala polymorphism of PPAR 緯 gene may be a related factor to inhibit the pathogenesis of GDM. The allele of Ala may not be associated with the disorder of GDM glycolipid metabolism. The polymorphism of C1431T gene has no significant correlation with the pathogenesis of GDM and related biochemical indexes.
【學位授予單位】：青島大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R714.256

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