ABCB1基因C3435T多態(tài)性與ICS治療COPD合并OP的相關(guān)性研究
發(fā)布時間：2018-09-03 08:10
【摘要】：目的：探討長期(≥6個月)吸入糖皮質(zhì)激素治療的老年男性COPD患者的骨密度及臨床指標(biāo)的相關(guān)性。 方法：選擇109名COPD患者,其中51名有骨質(zhì)疏松(0P組),58名非骨質(zhì)疏松(NOP組),50名健康對照者(NC組)。測定COPD患者的肺功能,測定實驗組和對照組的骨密度、血清白蛋白(ALB)、血清總蛋白(STP)、丙氨酸氨基轉(zhuǎn)移酶(ALT)、天門冬氨酸氨基轉(zhuǎn)移酶(AST)、血尿素氮(BUN)、血肌(?)(CREA)、血尿酸(SUA)、總膽固醇(TC)、甘油三酯(TC)、高密度脂蛋白膽固醇(HDL-C)、低密度脂蛋白膽固醇(LDL-C)、體重指數(shù)(BMI)、收縮壓(SBP)、舒張壓(DBP)。 結(jié)果：(1)在NC組：體重與L1、L2、L3、L4、L1-L4、股骨頸、股骨大粗降的BMD值呈正相關(guān),BMI與L]、L3、L4、L1-L4的BMD值正相關(guān),且有統(tǒng)計學(xué)意義(P0.05)。(2)在COPD組：年齡與股骨頸、股骨大粗隆的BMD值呈負(fù)相關(guān),體重、BMI與L1、L2、L3、L4、L1-L4、股骨頸、股骨大粗隆的BMD值呈正相關(guān)，有統(tǒng)計學(xué)意義(P0.05)。(3)骨密度測定值比較NC組NOP組OP組(P0.05),有統(tǒng)計學(xué)意義。(4)吸入糖皮質(zhì)激素累積用量(mg)和吸入糖皮質(zhì)激素應(yīng)用時間(月)與L4及L1-L4的13MD值呈負(fù)相關(guān),有統(tǒng)計學(xué)意義(P0.05),L4的BMD更具有顯著性(P0.01)。(5)Logistic回歸分析結(jié)果：昆明地區(qū)老年男性COPD患者并發(fā)骨質(zhì)疏松的危險因素與年齡、日照時間2小時/天、COPD病程(年)、糖皮質(zhì)激素應(yīng)用時間均相關(guān),其保護因素為體重、BMI、減少糖皮質(zhì)激素累計使用量。 結(jié)論：1、(1)昆明地區(qū)老年男性COPD患者并發(fā)骨質(zhì)疏松的危險因素與年齡、日照時間2小時/天、COPD病程(年)、糖皮質(zhì)激素應(yīng)用時間均相關(guān),糖皮質(zhì)激素作為藥物因素增加了骨質(zhì)疏松的風(fēng)險。(2)維持適當(dāng)?shù)捏w重、BMI,減少糖皮質(zhì)激素累計用量對老年男性COPD患者預(yù)防骨質(zhì)疏松的發(fā)生有保護性作用。 2、吸入糖皮質(zhì)激素累積用量(mg)和吸入糖皮質(zhì)激素應(yīng)用時間(月)與L4及L1-L4的BMD值呈負(fù)相關(guān),其中在L4的BMD呈負(fù)相關(guān)作用更具有顯著性意義。 3、昆明地區(qū)漢族老年男性COPD患者吸入常規(guī)劑量的糖皮質(zhì)激素,可顯著減少患者BMD以及增加骨質(zhì)疏松風(fēng)險的發(fā)生。建議該群體應(yīng)定期行骨密度檢查,并預(yù)防性用藥,避免骨質(zhì)疏松的發(fā)生。 目的：探討ARCB1基因C3435T多態(tài)性與吸入糖皮質(zhì)激素治療對老年男性COPD患者的骨量影響是否存在相關(guān)性。 方法：選擇109名長期吸入糖皮質(zhì)激素治療的老年COPD患者,其中：51名為骨質(zhì)疏松(OP組),58名為非骨質(zhì)疏松(NOP組),50名健康對照者(NC組)。采用PCR一RFI提取基因組DNA檢驗ABCB1C3435T多態(tài)性。 結(jié)果：1、ABCBl基因C3435T多態(tài)性與糖皮質(zhì)激素劑量比較結(jié)果：CC基因型吸入糖皮質(zhì)激素累積用量最大及吸入糖皮質(zhì)激素應(yīng)用時間最長(p0.05),差別有統(tǒng)計學(xué)意義。2、(1)昆明地區(qū)老年男性COPD患行并發(fā)骨質(zhì)疏松的危險因索與年齡、日照時間2小時、糖皮質(zhì)激素應(yīng)用時間均相關(guān)(2)昆明地區(qū)老年男性COPD患者并發(fā)骨質(zhì)疏松的保護因索為：體重、BM1.ABCB1基因C3435T、的CC基因型和CT基因型。3、ABCB1基因C3435T的CC基因型在NOP組分布頻率最高,C等位基因分布頻率為63.8%。 結(jié)論1、ABCB1基因C3435T的基因型(CC)和基因型(CT)均保護性因素,即C等位基因為吸入糖皮質(zhì)激素治療老年男性COPD患者合并骨質(zhì)疏松的保護因素。2.ABCB1基因C3435T的分布頻率存在種族上的差異。
[Abstract]:AIM: To investigate the correlation between bone mineral density (BMD) and clinical parameters in elderly male patients with COPD after long-term (> 6 months) inhalation of corticosteroids.
Methods: 109 COPD patients, 51 osteoporosis (0 P group), 58 non-osteoporosis (NOP group) and 50 healthy controls (NC group) were selected. The lung function, bone mineral density (BMD), serum albumin (ALB), total serum protein (STP), alanine aminotransferase (ALT), aspartate aminotransferase (AST) and bone mineral density (BMD) were measured. Blood urea nitrogen (BUN), blood muscle (?) (CREA), blood uric acid (SUA), total cholesterol (TC), triglyceride (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP).
Results: (1) In NC group, body weight was positively correlated with L1, L2, L3, L4, L1-L4, femoral neck, femoral trochanter, BMI was positively correlated with L], L3, L4, L1-L4, BMD was positively correlated with L], L3, L4, L1-L4, and had statistical significance (P 0.05). (2) In COPD group, BMD was negatively correlated with age, femoral neck and trochanter, body weight, BMI was negatively correlated with L1, L2, L3, L4, L1-L4, femoral neck and trochanter. (4) The cumulative dose of inhaled glucocorticoids (mg) and the duration of inhaled glucocorticoids (month) were negatively correlated with the 13MD values of L4 and L1-L4, and the BMD of L4 was more significant (P 0.01). (5) Logisti C regression analysis showed that the risk factors of osteoporosis in elderly male patients with COPD in Kunming were related to age, sunshine duration 2 hours/day, COPD duration (year) and glucocorticoid use time. The protective factors were weight, BMI and reducing the cumulative use of glucocorticoid.
Conclusion: (1) The risk factors of osteoporosis in elderly male patients with COPD in Kunming are related to age, duration of sunshine (2 hours per day), duration of COPD (year) and duration of glucocorticoid use. Glucocorticoid as a drug increases the risk of osteoporosis. (2) Maintaining appropriate body weight, BMI, and reducing the cumulative dose of glucocorticoid are important factors for osteoporosis. Elderly men with COPD have protective effects on preventing osteoporosis.
2. The cumulative dose of inhaled glucocorticoids (mg) and the duration of inhaled glucocorticoids (month) were negatively correlated with the BMD values of L4 and L1-L4, and the BMD values of L4 were negatively correlated.
3. Inhaling conventional doses of glucocorticoids can significantly reduce BMD and increase the risk of osteoporosis in elderly male patients with COPD in Kunming.
Objective: To investigate whether the C3435T polymorphism of ARCB1 gene is associated with the effect of inhaled corticosteroids on bone mass in elderly male patients with COPD.
Methods: 109 elderly COPD patients with long-term inhalation of corticosteroids were selected, 51 of them were osteoporosis (OP group), 58 were non-osteoporosis (NOP group) and 50 were healthy controls (NC group). The ABCB1C3435T polymorphism was detected by PCR-RFI genomic DNA extraction.
Results: 1, ABCBl gene C3435T polymorphism and glucocorticoid dosage comparison results: CC genotype inhaled glucocorticoid maximum cumulative dose and inhaled glucocorticoid use the longest time (p0.05), the difference was statistically significant. 2, (1) Kunming area elderly male COPD risk factors and age of osteoporosis, sunshine time 2 small The protective factors of osteoporosis in elderly male patients with COPD were weight, BM1. ABCB1 gene C3435T, C C genotype and CT genotype.
Conclusion 1. Both genotype (CC) and genotype (CT) of ABCB1 gene C3435T are protective factors, i.e. C allele is a protective factor in elderly male COPD patients with osteoporosis treated with inhaled corticosteroids. 2. The distribution frequency of ABCB1 gene C3435T is racially different.
【學(xué)位授予單位】：昆明醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R563.9
本文編號：2219402
[Abstract]:AIM: To investigate the correlation between bone mineral density (BMD) and clinical parameters in elderly male patients with COPD after long-term (> 6 months) inhalation of corticosteroids.
Methods: 109 COPD patients, 51 osteoporosis (0 P group), 58 non-osteoporosis (NOP group) and 50 healthy controls (NC group) were selected. The lung function, bone mineral density (BMD), serum albumin (ALB), total serum protein (STP), alanine aminotransferase (ALT), aspartate aminotransferase (AST) and bone mineral density (BMD) were measured. Blood urea nitrogen (BUN), blood muscle (?) (CREA), blood uric acid (SUA), total cholesterol (TC), triglyceride (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP).
Results: (1) In NC group, body weight was positively correlated with L1, L2, L3, L4, L1-L4, femoral neck, femoral trochanter, BMI was positively correlated with L], L3, L4, L1-L4, BMD was positively correlated with L], L3, L4, L1-L4, and had statistical significance (P 0.05). (2) In COPD group, BMD was negatively correlated with age, femoral neck and trochanter, body weight, BMI was negatively correlated with L1, L2, L3, L4, L1-L4, femoral neck and trochanter. (4) The cumulative dose of inhaled glucocorticoids (mg) and the duration of inhaled glucocorticoids (month) were negatively correlated with the 13MD values of L4 and L1-L4, and the BMD of L4 was more significant (P 0.01). (5) Logisti C regression analysis showed that the risk factors of osteoporosis in elderly male patients with COPD in Kunming were related to age, sunshine duration 2 hours/day, COPD duration (year) and glucocorticoid use time. The protective factors were weight, BMI and reducing the cumulative use of glucocorticoid.
Conclusion: (1) The risk factors of osteoporosis in elderly male patients with COPD in Kunming are related to age, duration of sunshine (2 hours per day), duration of COPD (year) and duration of glucocorticoid use. Glucocorticoid as a drug increases the risk of osteoporosis. (2) Maintaining appropriate body weight, BMI, and reducing the cumulative dose of glucocorticoid are important factors for osteoporosis. Elderly men with COPD have protective effects on preventing osteoporosis.
2. The cumulative dose of inhaled glucocorticoids (mg) and the duration of inhaled glucocorticoids (month) were negatively correlated with the BMD values of L4 and L1-L4, and the BMD values of L4 were negatively correlated.
3. Inhaling conventional doses of glucocorticoids can significantly reduce BMD and increase the risk of osteoporosis in elderly male patients with COPD in Kunming.
Objective: To investigate whether the C3435T polymorphism of ARCB1 gene is associated with the effect of inhaled corticosteroids on bone mass in elderly male patients with COPD.
Methods: 109 elderly COPD patients with long-term inhalation of corticosteroids were selected, 51 of them were osteoporosis (OP group), 58 were non-osteoporosis (NOP group) and 50 were healthy controls (NC group). The ABCB1C3435T polymorphism was detected by PCR-RFI genomic DNA extraction.
Results: 1, ABCBl gene C3435T polymorphism and glucocorticoid dosage comparison results: CC genotype inhaled glucocorticoid maximum cumulative dose and inhaled glucocorticoid use the longest time (p0.05), the difference was statistically significant. 2, (1) Kunming area elderly male COPD risk factors and age of osteoporosis, sunshine time 2 small The protective factors of osteoporosis in elderly male patients with COPD were weight, BM1. ABCB1 gene C3435T, C C genotype and CT genotype.
Conclusion 1. Both genotype (CC) and genotype (CT) of ABCB1 gene C3435T are protective factors, i.e. C allele is a protective factor in elderly male COPD patients with osteoporosis treated with inhaled corticosteroids. 2. The distribution frequency of ABCB1 gene C3435T is racially different.
【學(xué)位授予單位】：昆明醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R563.9
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，本文編號：2219402
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