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目的 检测老年人 2型糖尿病 (DM2 )患者葡萄糖激酶 (GCK )等位基因频率的变化 ,进而从分子水平探讨 DM及其血管并发症的发病机制。 方法 采用 PCR- SSCP-银染或 EB染色法 ,检测 36～ 76岁 DM2患者 132例和健康对照组 12 8例的 GCK基因。 结果 与健康老年组比较 ,老年 DM2组 Z4等位基因频率明显升高 (49∶ 2 9,P<0 .0 5 ) ,Z等位基因频率则下降 (85∶ 97,P<0 .0 5 ) ,老年 DM2并发血管病变的比例 (6 8% )高于非老年 DM2组 (42 % ,P<0 .0 1) ,且老年 DM2组内含 Z4等位基因个体并发大血管病变的比例高于含 Z等位基因者 (2 8∶ 10 ,P<0 .0 5 )。 结论 Z4等位基因对老年 DM2患者有一定的遗传易感性 ,携 Z4等位基因的老年 DM2患者并发大血管病变比例高。
Objective To investigate the changes of glucokinase (GCK) allele frequencies in elderly patients with type 2 diabetes mellitus (DM2) and to explore the pathogenesis of DM and its vascular complications at the molecular level. Methods PCR-SSCP-silver staining or EB staining was used to detect the GCK genes in 132 DM2 patients aged 36-76 years and 128 healthy controls. Results Compared with healthy elderly group, the frequency of Z4 allele in elderly DM2 group was significantly increased (49:29, P0.05), and the frequency of Z allele decreased (85:97, P0.05 ), The proportion of elderly patients with DM2 complicated with vascular lesions (68%) was higher than that of non-elderly DM2 patients (42%, P <0.01), and the proportion of elderly patients with DM4 Z4 alleles with macrovascular complications was high In the Z allele (2 8:10, P <0.05). Conclusion The Z4 allele has some genetic predisposition to elderly DM2 patients. The elderly patients with DM2 carrying the Z4 allele have a high proportion of macrovascular complications.