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目的探讨浙南地区汉族人群肾移植术后糖尿病(PTDM)与自然杀伤细胞免疫球蛋白样受体(KIR)基因多态性的关系。方法选取在温州医科大学附属第一医院器官移植中心行肾移植,且2009年12月至2010年12月期间在本中心随访的146例浙江南部地区汉族肾移植受者入组本研究。采用聚合酶链反应-序列特异性引物技术(PCR-SSP)检测患者KIR基因。两组间KIR基因型频率比较采用χ2检验。结果截至2010年12月,146例肾移植受者中术后1年内共确诊PTDM 45例,作为PTDM组;余101例受者未发现血糖异常,作为正常对照组。PCR-SSP结果显示,KIR 2DL4、3DL2、3DL3和3DP1为框架基因,在两组所有个体中均表达。与正常对照组相比,PTDM组KIR 2DL2、2DS2和2DS4基因型频率增高,其中PTDM组和正常对照组KIR 2DL2基因型频率分别为51.1%和31.7%,差异有统计学意义(χ2=5.004,P<0.05)。与正常对照组比较,PTDM组KIR 2DL1、2DL3、2DL5、2DS1、2DS3、2DS5、3DL1、3DS1和2DP1基因型频率降低,但差异均无统计学意义。结论 KIR 2DL2可能为浙江南部地区汉族人群患PTDM的易感基因。
Objective To investigate the relationship between polymorphism of natural killer cell immunoglobulin-like receptor (KIR) gene and diabetic post-transplant diabetes mellitus (PTDM) in the Han nationality in South Zhejiang. METHODS: A total of 146 renal transplant recipients from Southern Zhejiang were enrolled in this study. Their renal transplantations were performed at the First Affiliated Hospital of Wenzhou Medical University and were followed up from December 2009 to December 2010 in our center. The KIR gene was detected by polymerase chain reaction-sequence specific primer (PCR-SSP). KIR genotype frequencies between the two groups using χ2 test. Results As of December 2010, 45 cases of PTDM were diagnosed in 146 renal transplant recipients within one year after surgery as the PTDM group. No abnormal blood glucose was found in the remaining 101 recipients as the normal control group. PCR-SSP results show that KIR 2DL4, 3DL2, 3DL3 and 3DP1 are framework genes, which are expressed in all individuals in both groups. Compared with the normal control group, the frequencies of KIR 2DL2, 2DS2 and 2DS4 genotypes increased in PTDM group, and the frequencies of KIR 2DL2 genotype in PTDM group and normal control group were 51.1% and 31.7%, respectively (χ2 = 5.004, P <0.05). Compared with the normal control group, the frequency of KIR 2DL1, 2DL3, 2DL5, 2DS1, 2DS3, 2DS5, 3DL1, 3DS1 and 2DP1 genotypes in PTDM group decreased, but the difference was not statistically significant. Conclusion KIR 2DL2 may be a predisposing gene for PTDM in Han population of southern Zhejiang province.