脂联素45 T/G基因多态性对利拉鲁肽治疗2型糖尿病患者的临床疗效

目的：研究脂联素45（APM1-45）T/G基因遗传变异对利拉鲁肽治疗2型糖尿病（T2DM）患者的临床疗效以及对T2DM易感性的影响。方法：选取2017年7月至2019年11月期间海口市第三人民医院收治的T2DM患者共95例作为研究对象，均给予利拉鲁肽进行为期14周的治疗，记录不同基因型患者治疗前后的血糖水平、BMI指数和mRNA相对表达等指标变化，统计不良反应的发生情况。结果：APM1-45（rs2241766）位点在研究人群中的基因分布频率为：TT型46例（48.42%），TG型43例（45.26%），GG型6例（6.32%），三种基因型分布频率符合哈迪温伯格平衡（P=0.328）。治疗后，各组患者的餐后2小时血糖（2h PG）、糖化血红蛋白（HbA1c）、空腹血糖（FPG）和BMI相关指标相比治疗前均下降明显，且存在统计学差异（P<0.05）；TT基因型患者的各项指标与TG/GG基因型患者相比，下降更多，但二者相比不存在统计学差异（P>0.05）。mRNA相对表达方面，相对于TG/GG基因型患者，TT基因型患者的mRNA的相对表达明显偏低，二者差异具有统计学意义（P<0.05）。患者整体不良反应发生情况较少，各组之间无统计学差异。结论：对2型糖尿病患者，利拉鲁肽进行治疗具有明显效果，在显著降低血糖水平、控制体质量的同时，不良反应发生率较低，G等位基因与T2DM易感性存在一定的相关性，而T等位基因携带者对利拉鲁肽的治疗表现出更优的效果。

Effect of adiponectin 45 T/G gene polymorphism on type 2 diabetes treated with liraglutide

AIM: To investigate the effect of genetic variation of calmodulin 45 T/G (APM1-45) gene polymorphism on the clinical efficacy and T2DM patients with type 2 diabetes mellitus treated with liralutide. METHODS: A total of 95 patients with type 2 diabetes admitted to the third people's Hospital of Haikou City from August 2016 to October 2019 were selected as subjects of study. All patients were treated with liraglutide for 14 weeks. And the changes of blood glucose level, BMI index and relative mRNA expression were recorded before and after treatment. Besides record the occurrence of adverse reactions. RESULTS: The distribution frequency of APM1-45 (rs2241766) in the study population was 46 cases of TT type (48.42%), 43 cases of TG type (45.26%), 6 cases of GG type (6.32%). After treatment, the 2h PG, HbAIc, FPG and BMI related indexes of each group decreased significantly compared with those before treatment, and there was statistical difference (P<0.05); the FPG, HbA1c and BMI indexes of TT genotype patients decreased more compared with TG/GG genotype patients, but there was no statistical difference between them (P>0.05). The relative expression of mRNA in TT genotype was significantly lower than that in TG/GG genotype (P<0.05). The overall adverse reactions of patients were less, there was no statistical difference between the groups. CONCLUSION: For type 2 diabetic patients, the treatment of liraglutide alone has obvious effect, and the incidence of adverse reactions is low. There is a certain correlation between G allele and T2DM susceptibility, while T allele carrier has a better effect on the treatment of liraglutide.