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目的观察PPARγ2基因Pro12Ala多态性与罗格列酮(RGZ)治疗2型糖尿病的疗效、血浆内脏脂肪素(visfatin)及瘦素(leptin)水平变化的关系。方法选择218例哈尔滨地区非血缘关系的T2DM患者,使用PCR-RFLP方法检测PPARγ2基因Pro12Ala多态性。应用RGZ(4 mg/d)治疗12周,分别测定治疗前后visfatin、leptin和相关临床指标,并计算胰岛素抵抗指数(HOMA-IR)。结果A等位基因频率为4.4%,其中PP型199例,PA型19例,未发现AA型。RGZ治疗后,PA型FPG、HbA1C较PP型明显下降(P<0.05),PA型HOMA-IR下降更显著(P<0.01);PA型和PP型治疗前后visfatin、leptin水平均明显下降(P<0.01)。结论PPARγ2基因为PA型者对RGZ的治疗反应优于PP型者。PPARγ2基因Pro12Ala多态性可能影响RGZ对T2DM患者的治疗效果。RGZ治疗效果可能与visfatin、leptin水平下降密切相关。
Objective To investigate the effect of Pro12Ala polymorphism of PPARγ2 gene on the efficacy of rosiglitazone (RGZ) on type 2 diabetes mellitus (T2DM) and the changes of plasma visfatin and leptin levels. Methods 218 non-kinded T2DM patients in Harbin were selected and the Pro12Ala polymorphism of PPARγ2 gene was detected by PCR-RFLP. Application of RGZ (4 mg / d) for 12 weeks, before and after treatment were measured visfatin, leptin and related clinical indicators, and calculate the insulin resistance index (HOMA-IR). Results The frequency of allele A was 4.4%. There were 199 PP genotypes and 19 PA genotypes. No AA genotype was found. After treatment with RGZ, the levels of PAG and HbA1C were significantly decreased (P <0.05), but the levels of HOMA-IR in PA were more significantly decreased (P <0.01). The levels of visfatin and leptin in PA and PP before and after treatment were significantly decreased <0.01). Conclusion The PPARγ2 gene of type PA is superior to PP type in response to RGZ. The PPARγ2 gene Pro12Ala polymorphism may affect the therapeutic effect of RGZ on T2DM patients. The therapeutic effect of RGZ may be closely related to the decline of visfatin and leptin levels.