摘要:目的:研究高血壓病患者過氧化物酶體增殖物激活受體(PPAR)γ2基因Pro12Ala多態性與血糖水平之間的關系。方法:納入177名原發性高血壓患者,其中空腹血糖(FBG)lt;5.6 mmol/L組65例, FBG≥5.6 mmol/L組112例,收集一般資料;分別測定空腹及餐后2小時血糖、胰島素;對PPARγ2 基因Pro12Ala多態性與各臨床變量的關系進行研究。結果:FBGlt;5.6 mmol/L組和FBG≥5.6 mmol/L組Pro和Ala等位基因頻率分別為0.333,0.034及0.602,0.031;PP和PA基因型頻率分別為0.299,0.068及0.571,0.062;無AA型純合子。以體重指數(BMI)分層后,BMIlt;25組內,FBG與PPARγ2基因型相關（P=0.029)。以基因型分組比較,PA組空腹血糖水平和胰島素抵抗指數都低于PP組(Plt;0.05)。結論:成都地區高血壓患者PPARγ2基因Pro12Ala多態性與空腹血糖水平相關,且攜帶Ala基因者空腹血糖水平較低,胰島素抵抗較輕,推測該突變可能有減輕高血壓病患者胰島素抵抗,改善糖代謝異常的作用。Abstract: Objective:To study the association between the Pro12Ala polymorphism in peroxisome proliferatorsactivated receptorγ2 ( PPARγ2 ) gene and blood glucose levels in patients with primary hypertension. Methods：The Pro12Ala polymorphism in PPARγ2 was determined by polymerase chain reactionrestriction fragment length polymorphism (PCRRELP) in 177 subjects with primary hypertension of the Han people in Chengdu of China, including 65 subjects with fasting blood glucose (FBG)lt;5.6 mmol/L and 112 subjects with FBG≥5.6 mmol/L; the clinical characteristics including height, weight, OGTT(0h and 2h) of the subjects were detected and the realationship between the Pro12Ala polymorphism and the clinical characteristics were analysed. Results: The allele frequencies in the group with FBGlt;5.6 mmol/L and FBG≥5.6 mmol/L were 0.333, 0.602 for Pro and 0.034, 0.031 for Ala. The genotype frequencies were 0.299, 0.571 for PP and 0.068, 0.062 for PA, and there was no AA. In the group with BMIlt;25, the Pro12Ala polymorphism was associated with FBG （P=0.029). the Ala allele had a negative relationship to the FPG and insulin resistance index (IRI) (Plt;0.05).Conclusion: The data showed that the Pro12Ala polymorphism was associated with FBG., and The allele Ala probably had benefits to glycometabolic disturbance in patients with primary hypertension by declining insulin resistance.
目的 研究成都地區中老年人群體質量指數（BMI）及腹型肥胖對糖尿病患病率及空腹血糖水平的影響。 方法 2007年5月，采用隨機抽樣方法抽取50～80歲中老年人685人進行心血管危險因素調查，其男394人，女291人，年齡（63.3 ± 0.2）歲。 結果 成都地區中老年人群的超重和肥胖所占的比例較大（約44.3%），按BMI分組（BMI＜24 kg/m2；24 kg/ m2≤BMI＜28 kg/ m2；BMI≥28 kg/m2）的糖尿病患病率分別為14.0%、18.7%及23.3%，組間差異有統計學意義（P=0.031）。男女分別按腹型肥胖標準分組（男性切點=85 cm，女性切點=80 cm），男性糖尿病患病率在非腹型肥胖及腹型肥胖組分別為17.9%及18.7%組間差異無統計學意義（P=0.849），女性糖尿病患病率分別為9.7%及18.4%，組間差異有統計學意義（P=0.034）。整個人群中，空腹血糖無隨BMI增加而升高的趨勢（P=0.071）；女性人群中，空腹血糖隨腰圍的增加而升高（P=0.001）；而在男性人群中無此趨勢。在調整相關指標后，logistic回歸分析提示BMI對糖尿病患病率獨立影響，以BMI正常為參照，超重及肥胖的OR值分別為：1.412 [95%CI （0.818，2.437），P=0.215]及2.200 [95%CI（1.034，5.178），P=0.046]。在調整相關指標后，腹型肥胖在女性人群中對糖尿病患病率獨立影響，以非腹型肥胖為參考，腹型肥胖的OR值為：1.394 [95%CI（1.080，3.205），P=0.041]，而在男性人群中無此關系。 結論 成都地區中老年人群超重及肥胖所占的比重較大，BMI可影響糖尿病患病率及空腹血糖水平；腹型肥胖能夠影響女性人群糖尿病患病率及空腹血糖水平，但在男性人群中無此關系。
Objective To explore the relationship between preoperative fasting plasma glucose (FPG) and postoperative pulmonary complications (PPCs) in type 2 diabetic patients undergoing elective thoracoscopic lung resection, and provide a reference for prediction and prevention of PPCs in the clinic. Methods A retrospective analysis was performed on the type 2 diabetic patients who underwent elective thoracoscopic lung resection for the first time in our hospital from January 2017 to March 2021. According to the level of FPG one day before the operation, the patients were divided into three groups: a hypoglycemia group (<6.1 mmol/L), a medium level blood glucose group (≥6.1 mmol/L and <8.0 mmol/L) and a high blood glucose group (≥8.0 mmol/L). Besides, the patients were divided into a PPCs group and a non-PPCs group according to whether PPCs occurred. The risk factors for PPCs were analyzed by logistic regression analysis, and the predictive value of preoperative FPG level on PPCs was estimated by the area under the receiver operating characteristic curve (AUC). Results A total of 130 patients were included, including 75 (57.7%) males and 55 (42.3%) females with an average age of 63.5±9.0 years. Logistic regression analysis showed that compared to non-PPCs patients, the level of preoperative FPG (P=0.023) and smoking history ratio (P=0.036) were higher and the operation time was longer (P=0.004) in the PPCs patients. High FPG level on preoperative day 1 and longer operation time were associated with PPCs risk. Besides, the preoperative FPG of 6.79 mmol/L was the threshold value to predict the occurrence of PPCs [AUC=0.653, 95%CI (0.559, 0.747), P=0.003]. Conclusion There is a certain correlation between preoperative FPG level and postoperative PPCs, which may be used as an index to predict the occurrence of PPCs.