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目的 探讨 ACE基因插入 /缺失多态性与非胰岛素依赖型糖尿病 (non- insulin- dependentdi-abetes mellitus,NIDDM)患者并发大、微血管病变的关系。方法 采用聚合酶链反应技术检测了 176例NIDDM患者和 5 0名健康个体 ACE基因内含子 16插入 /缺失多态性。结果 对照组与 NIDDM组 ACE基因型及等位基因频率分布相似 (P>0 .0 5 ) ;NIDDM患者 DD型亚组冠心病、脑梗塞的频率分别为 5 4%和 31% ,明显高于 II型亚组的 2 2 % (P<0 .0 1)和 14% (P<0 .0 5 ) ;NIDDM患者 DD型糖尿病肾病的发生率为 5 1% ,明显高于 II型的 31% (P<0 .0 5 )。糖尿病视网膜病变、周围神经病变及任何证据的微血管病变均按 II、DI、DD顺序递增 (P>0 .0 5 )。结论 ACE基因的 D等位基因可增高 NIDDM患者并发大、微血管病变的危险性。
Objective To investigate the relationship between ACE gene insertion / deletion polymorphism and non-insulin-dependent di-abetes mellitus (NIDDM) complicated with large and microvascular lesions. Methods Polymerase chain reaction (PCR) was used to detect the insertion / deletion polymorphism of intron 16 in 176 NIDDM patients and 50 healthy individuals. Results The frequencies of ACE genotypes and alleles in control group were similar to those in NIDDM group (P> 0.05). The frequencies of coronary heart disease and cerebral infarction in DD type subgroup were 54% and 31% respectively in NIDDM patients, which were significantly higher than those in NIDDM patients (P <0.01) and 14% (P <0.05) in type II subgroup; the incidence of DD nephropathy was 51% in NIDDM patients, which was significantly higher than that in type II patients (31% (P <0. 05). Diabetic retinopathy, peripheral neuropathy and any evidence of microangiopathy were increased in the order of II, DI and DD (P> 0.05). Conclusion The D allele of ACE gene may increase the risk of large and microvascular complications in patients with NIDDM.