·糖尿病分子生物学和遗传学·

　　【摘要】 目的 探讨IGT者25羟基维生素D3(25-OH-VD3)、维生素D受体(VDR)基因FokI多态性与IR的相关性。 方法 选取IGT者(IGT组)94例及正常对照(NC)组54名，采用PCR-RLFP检测VDR基因FokI多态性，ELISA检测25-OH-VD3，比较各组基因型及等位基因频率。 结果 ⑴与NC组比较，IGT组血清25-OH-VD3较低[(22.05±2.37) vs (32.04± 2.64) ng/ml，P<0.05];⑵与NC比较，IGT组“f”等位基因频率升高(46.8% vs 25.9%，FF:30.9% vs 57.4%;Ff: 46.9% vs 33.3%;ff:22.3% vs 9.3%，P<0.05)。与FF基因型比较，Ff/ff基因型患IGT危险增加(OR=2.613，95%CI=1.239～5.512，P=0.018;OR=4.490，95%CI=1.496～13.473，P=0.010)。与F型比较，携带“f”等位基因患IGT风险增加(OR=2.465，95%CI=1.188～5.116，P=0.023)。Ff、ff基因型与FF型比较，HOMA-IR增高(P<0.05);VDR基因FokI位点ff基因型者较其它两种基因型IR更明显(P<0.01);⑶Logistic回归分析显示，VDR基因FokI ff与IR呈正相关(OR=1.761，95%CI：1.050～2.970，P<0.05)，25-OH-VD3与IR呈负相关(β=-1.187，OR=0.461，95%CI：0.187～0.741，P<0.05)。 结论 血清25-OH-VD3水平与IR呈负相关，VDR基因FokI可能与IGT者IR有关。

　　【关键词】 IGT;胰岛素抵抗;VDR基因多态性

　　【Abstract】 Objectives To explore the association of VDR FokI polymorphism and the levels of serum 25-OH-VD3 with insulin resistance (IR) in patients with impaired glucose tolerance (IGT). Methods 94 subjects with IGT(IGT group) and 54 healthy examinees(NC group) were enrolled. Vitamin D receptor gene FokI polymorphism was detected by PCR-RFLP in all subjects. The levels of 25-hydroxy vitamin D3 were examined by ELISA. The genotype and its frequencies were compared among groups. Results (1) The serum level of 25-OH-VD3 was lower in IGT group than in NC group(22.05±2.37 vs 32.04±2.64, P<0.05).(2) The “f” allele frequencies was significant higher in IGT group than in NC Group (f: 46.8% vs 25.9%; FF: 30.9% vs 57.4%; Ff: 46.9% vs 33.3%; ff: 22.3% vs 9.3%). The patients with Ff or ff genotype had increased risks of IGT than those with FF genotype (OR=2.613,95%CI=1.239～5.512,P=0.018; OR=4.490,95%CI=1.496～13.473,P=0.010). “f” allele had increased risk of IGT as compared with those carrying “F” allele. HOMA-IR was significantly lower in groups with FF genotype than with Ff or ff genotype. (3) Multivariate logistic regression analysis showed polymorphisms of VDR genes were correlative with insulin resistance(OR=1.761,95%CI:1.050～2.970，P<0.05). There was a significantly negative correlation between serum 25(OH)VD3 and HOMA-IR(β=-1.187,OR=0.461,95%CI:0.187～0.741，P<0.05). Conclusions Levels of 25-OH-VD3 and insulin resistance were negatively correlated and polymorphisms of VDR genes may be associated with insulin resistance.

　　【Key Words】 Impaired glucose tolerance(IGT);Insulin resistance(IR);Vitamin D receptor gene FokI polymorphism