Analyzing the correlation of GLP-1R with blood glucose and lipids and its effect on obese patients with type 2 diabetes mellitus
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摘要:
目的 分析胰高血糖素样肽-1受体(GLP-1R)基因多态性对2型糖尿病肥胖患者的影响，以及该受体与血糖、血脂指标的相关性。 方法 选取2022年1月—2023年11月绍兴文理学院附属医院收治的80例2型糖尿病肥胖患者为观察组，同时选取健康人群80例作为对照组。比较2组血糖、血脂指标、基因分布，分析GLP-1R基因多态性与血糖、血脂指标的相关性。使用多因素logistic回归分析研究影响2型糖尿病发生的相关因素。 结果 观察组的总胆固醇、甘油三酯、空腹血糖、糖化血红蛋白水平、rs3765467位点CC基因型和rs2268657位点GG基因型的分布均高于对照组(P＜0.05)。观察组rs3765467位点CC基因型患者的糖化血红蛋白显著高于CT+TT基因型，rs2268657位点GG基因型患者的高密度脂蛋白显著高于GA+AA基因型(P＜0.05)。rs3765467位点CC基因与糖化血红蛋白呈正相关关系(r=0.825，P=0.036)；rs2268657位点GG基因型与高密度脂蛋白呈正相关关系(r=0.812，P=0.023)。GLP-1R rs3765467位点和rs2268657位点是2型糖尿病发生的影响因素(OR=3.414、3.206，均P < 0.05)。 结论 rs3765467位点CC基因与糖化血红蛋白呈正相关关系，rs2268657位点GG基因型与高密度脂蛋白呈正相关关系，GLP-1R rs3765467位点和rs2268657位点是影响2型糖尿病发生的相关因素。 Abstract:Objective To analyze the effect of glucagon-like peptide-1 receptor (GLP-1R) gene polymorphisms on obese patients with type 2 diabetes mellitus and investigate the correlation between this receptor and glycemic and lipid indices. Methods A total of 80 obese patients with type 2 diabetes mellitus admitted to the Affiliated Hospital of Shaoxing University of Arts and Sciences from January 2022 to November 2023 were selected as the observation group, while 80 cases of healthy individuals were selected as the control group. The glycemic and lipid indices, gene distribution, correlation, and multifactorial logistic analysis were compared between the two groups. Results The distribution of total cholesterol, triglycerides, fasting blood glucose, glycosylated hemoglobin levels, rs3765467 locus CC genotype and rs2268657 locus GG genotype were higher in the observation group than those in the control group (P < 0.05). The glycated hemoglobin was significantly higher in patients with CC genotype at rs3765467 locus than CT+TT genotype, and HDL was significantly higher in patients with GG genotype at rs2268657 locus than GA+AA genotype (P < 0.05). The CC gene at locus rs3765467 was positively correlated with glycated hemoglobin (r=0.825, P=0.036), and the GG genotype at locus rs2268657 was positively correlated with HDL (r=0.812, P=0.023). The GLP-1R rs3765467 locus and rs2268657 locus were identified as factors influencing the development of type 2 diabetes mellitus (OR=3.414, 3.206, all P < 0.05). Conclusion The CC gene at locus rs3765467 was positively correlated with glycated hemoglobin, while the GG genotype at locus rs2268657 was positively correlated with HDL. The GLP-1R rs3765467 and rs2268657 loci are associated with the development of type 2 diabetes. -
表 1 2组研究对象血糖、血脂指标比较(x±s)
Table 1. Comparison of blood glucose and lipid indexes between two groups (x±s)
组别 例数 空腹血糖(mmoL/L) 糖化血红蛋白(%) 总胆固醇(mmoL/L) 甘油三酯(mmoL/L) 低密度脂蛋白(mmoL/L) 高密度脂蛋白(mmoL/L) 观察组 80 7.21±1.23 7.15±0.85 5.16±0.83 1.78±0.23 2.89±0.62 1.18±0.23 对照组 80 5.02±0.65 5.23±0.69 4.62±0.91 1.03±0.65 2.78±0.54 1.17±0.25 t值 14.080 15.686 3.921 9.729 1.197 0.263 P值 < 0.001 < 0.001 < 0.001 < 0.001 0.235 0.793 
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表 2 2组研究对象基因位点基因型和等位基因频率分布比较(%)
Table 2. Comparison of genotype and allele frequency distributions between two groups of loci (%)
组别 例数 rs3765467 rs6923761 rs2268657 CC CT TT GG GA AA GG GA AA 观察组 80 50(62.50) 16(20.00) 14(17.50) 62(77.50) 10(12.50) 8(10.00) 55(68.75) 15(18.75) 10(12.50) 对照组 80 37(46.25) 23(28.75) 20(25.00) 55(68.75) 15(18.75) 10(12.50) 42(52.50) 20(25.00) 18(22.50) χ2值 4.231 1.548 4.397 P值 0.039 0.213 0.036
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表 3 观察组不同GLP-1R基因多态性2型糖尿病肥胖患者血糖、血脂比较(x±s)
Table 3. Comparison of blood glucose and lipids in obese type 2 diabetes patients with different GLP-1R gene polymorphisms in the observation group (x±s)
rs3765467 例数 空腹血糖(mmoL/L) 糖化血红蛋白(%) 总胆固醇(mmoL/L) 甘油三酯(mmoL/L) 低密度脂蛋白(mmoL/L) 高密度脂蛋白(mmoL/L) CC 50 6.05±1.21 6.89±1.95 5.02±1.09 2.05±1.65 2.78±0.85 1.45±0.32 CT+TT 30 6.13±1.25 6.12±1.03 4.95±0.98 1.96±1.56 2.76±0.76 1.32±0.22 t值 0.325 2.469 0.338 0.280 0.124 1.962 P值 0.746 0.017 0.737 0.780 0.902 0.053 rs2268657 例数 空腹血糖(mmoL/L) 糖化血红蛋白(%) 总胆固醇(mmoL/L) 甘油三酯(mmoL/L) 低密度脂蛋白(mmoL/L) 高密度脂蛋白(mmoL/L) GG 62 6.06±1.13 6.85±1.86 5.03±1.08 1.98±1.03 2.75±0.76 1.82±0.21 GA+AA 18 6.05±1.09 6.75±1.82 5.01±1.06 2.06±0.87 2.72±0.72 1.20±0.15 t值 0.045 0.272 0.093 0.300 0.167 11.667 P值 0.964 0.787 0.926 0.765 0.868 ＜0.001 rs692376 例数 空腹血糖(mmoL/L) 糖化血红蛋白(%) 总胆固醇(mmoL/L) 甘油三酯(mmoL/L) 低密度脂蛋白(mmoL/L) 高密度脂蛋白(mmoL/L) GG 55 6.02±1.23 6.82±1.25 5.01±1.02 1.95±0.65 2.73±0.62 1.43±0.15 GA+AA 25 6.03±1.14 6.79±1.32 4.95±1.11 1.92±0.48 2.65±0.54 1.39±0.25 t值 0.042 0.117 0.356 0.263 0.688 0.970 P值 0.967 0.908 0.723 0.794 0.495 0.337
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表 4 各变量赋值情况
Table 4. Variable assignment
变量 赋值方法 2型糖尿病发生 发生=1，未发生=0 GLP-1R rs3765467位点 CC基因型=1，其他基因型=0 rs2268657位点 GG基因型=1，其他基因型=0
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表 5 影响2型糖尿病发生的多因素logistic回归分析
Table 5. Multifactorial logistic regression analysis influencing the occurrence of type 2 diabetes
变量 B SE Waldχ2 P值 OR值 95% CI GLP-1R rs3765467位点 1.228 0.427 8.271 0.004 3.414 1.479~7.885 rs2268657位点 1.168 0.411 8.035 0.005 3.206 1.433~7.175
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