血管紧张素转化酶基因多态性与妊娠糖尿病的关系

Correlations of ACE gene polymorphism with gestational diabetes mellitus and pregnancy outcome

摘要:

探讨血管紧张素转化酶基因多态性与妊娠糖尿病（GDM）及妊娠结局的关系。方法采用聚合酶链反应- 限制性片段长度多态性（PCR-RFLP）技术对136 例GDM 孕妇（GDM 组），118 例糖耐量异常孕妇（GIGT 组）及106 例糖耐量正常孕妇（GNGT 组）血管紧张素转化酶插入（I）/ 缺失（D）多态性位点进行分析，随访分析血管紧张素转化酶（ACE）（I/D）基因单核苷酸多态性与相应妊娠结局的关系。结果GDM 组DD 型频率及D等位基因频率高于GNGT组，而I I型低于GNGT 组（ <0.05）。GDM组中ID、DD基因型FPG、Fins、 ACE 及HOMA-IR 均高于I I 型（p <0.05）。GDM 组ID、DD型妊娠结局中胎膜早破、早产儿、新生儿呼吸窘迫综合征、新生儿低血糖及新生儿高胆红素血症例数均高于I I 型（ p<0.05）。DD基因型，D等位基因频率为GDM的危险因素。DD 基因型为妊娠不良结局的危险因素。结论ACE（I/D）基因单核苷酸DD 型是GDM和妊娠不良结局的独立危险因素。

Abstract:

To investigate the relationships of angiotensin converting enzyme (ACE ) gene poly-morphisms with gestational diabetes mellitus (GDM) and pregnancy outcome. Methods Polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) technique was used to analyze insertion (I I) and deletion (D) polymorphism loci in 136 cases of pregnant women with GDM (GDM group), 118 cases of preg-nant women with abnormal glucose tolerance (GIGT group) and 106 pregnant women with normal glucose tolerance(GNGT group). Then the women were followed up, and the correlations between the SNPs of gene and the pregnant outcome were analyzed. Results The frequency of DD genotype and D allele in the GDM group was higher than that in the GNGT group, while the frequency of II genotype was lower than that in the GNGT group ( P< 0.05). The FPG, Fins, ACE and HOMA-IR in the GDM patients with ID or DD genotype were significantly higher than those in the GDM patients with II genotype (P < 0.05). The incidences of premature rupture of membranes, premature birth, neonatal respiratory distress syndrome, neonatal hypoglycemia and neonatal hyperbilirubinemia in the GDM women with ID or DD genotype were significantly higher than those in the GDM women with I I genotype (P < 0.05). DD genotype and the D allele frequency were the risk factors for GDM ( P< 0.05). DD genotype was the risk factor for adverse pregnancy outcome (P < 0.05). Conclusions DD genotype of single nucleotide polymorphism of (I/D) gene is the independent risk factor for GDMand adverse pregnancy outcome.