[1]朱 琳,陈跃瑜,林延润,等.PCOS 患者MTHFR C677T 基因多态性与胰岛素峰值后移的相关性研究[J].现代检验医学杂志,2023,38(06):54-58+141.[doi:10.3969/j.issn.1671-7414.2023.06.010]
　ZHU Lin,CHEN Yueyu,LIN Yanrun,et al.Relationship between MTHFR C677T Polymorphism and Insulin Peak Shift in Patients with PCOS[J].Journal of Modern Laboratory Medicine,2023,38(06):54-58+141.[doi:10.3969/j.issn.1671-7414.2023.06.010]
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PCOS 患者MTHFR C677T 基因多态性与胰岛素峰值后移的相关性研究()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第38卷
期数:
2023年06期
页码:
54-58+141
栏目:
论著
出版日期:
2023-11-15

文章信息/Info

Title:
Relationship between MTHFR C677T Polymorphism and Insulin Peak Shift in Patients with PCOS
文章编号:
1671-7414（2023）06-054-06
作者:
朱 琳; 陈跃瑜; 林延润; 杨发达
（佛山市南海区妇幼保健院检验科, 广东佛山 528200）
Author(s):
ZHU Lin; CHEN Yueyu; LIN Yanrun; YANG Fada
（Department of Clinical Laboratory ，Nanhai District Maternal and Child Health Hospital of Foshan City，Guangdong Foshan 528200， China）
关键词:
多囊卵巢综合征; 亚甲基四氢叶酸还原酶; 胰岛素释放试验; 胰岛素峰值后移
分类号:
R711.75；Q786
DOI:
10.3969/j.issn.1671-7414.2023.06.010
文献标志码:
A
摘要:
目的 探讨多囊卵巢综合征（polycystic ovary syndrome，PCOS）患者亚甲基四氢叶酸还原酶（methylenetetrahydrofolate reductase，MTHFR）C677T 基因多态性与胰岛素峰值后移的关系，并分析不同基因型对胰岛素功能的影响。方法 选取2022 年1 月～ 2023 年1 月在佛山市南海区妇幼保健院就诊的PCOS 患者191 例，同时进行MTHFR基因C677T 位点、胰岛素释放试验（insulin release test，IRT）和空腹血糖（fasting plasma glucose，FPG）检测。根据IRT 峰值所在的时间点进行分组，峰值在120 或者180min 的患者纳入后移组（n=65），在30 或者60min 的纳入无后移组（n=126）, 比较两组基因型分布和等位基因频率的差异；分析组内不同基因型对FPG, IRT 各时间点血清胰岛素水平、胰岛素抵抗指数(insulin resistance index，IRI) 、胰岛素敏感指数(insulin sensitivity index，ISI) 和胰岛素曲线下面积（area under the curve，AUC）的影响。结果 ①后移组和无后移组MTHFR C677T 三种基因型（CC，CT，TT）的分布为36.92%，40.00%，23.08% 和61.11%，30.16%，8.73%；等位基因（C，T） 的频率为56.92%, 43.08% 和76.19%,23.81%, 差异均有统计学意义(χ2=12.47，15.06；P=0.020，0.000)。②单因素方差分析显示，无后移组三种基因型的空腹胰岛素（fasting insulin ，Fins）和IRI 差异有统计学意义（F=6.569，5.928，P=0.002，0.003）；CT 型、TT 型均高于CC 型[Fins：12.56(9.39，15.49)，12.59(9.56，22.48) vs 8.75(5.43，13.50)；IRI: 2.75(1.96，3.53)，3.16(2.01，4.83) vs1.87(1.28，3.03)]，差异均有统计学意义（t=2.66 ～ 2.93, P=0.004 ～ 0.009）。③后移组三种基因型单因素方差分析显示，Fins 和ISI 差异有统计学意义（F=3.827，3.559，P=0.027,0.034），相比于CC 型，CT 型和TT 型的Fins 升高[13.00(9.29，20.74)，13.92(7.84，18.03) vs 8.67(6.73，10.66)]，而ISI 降低[0.016(0.010，0.023)，0.014(0.011，0.025) vs 0.022(0.018，0.033)], 差异均有统计学意义（t=2.11 ～ 2.51, P=0.015 ～ 0.039）。结论 PCOS 患者MTHFR C677T 基因位点多态性与胰岛素峰值后移有关，基因突变患者Fins 升高。在未发生峰值后移的患者中，基因突变者抵抗程度增加；而在峰值后移的患者中，基因突变者胰岛素敏感性降低。
Abstract:
Objective To investigate the relationship between C677T polymorphism of methylene tetrahydrofolate reductase(MTHFR) and peak shift of insulin in patients with polycystic ovary syndrome（PCOS）,and the insulin function of different genotypes were compared. Methods A total of 191 women with PCOS were recruited from January 2022 to January 2023 at Nanhai District Maternal and Child Health Hospital in Foshan. The polymorphism of MTHFR gene C677T,insulin release test(IRT) and fasting plasma glucose(FPG) were measured.According to the peak time of IRT,the patients were divided into peakshift group(n=65) at 120 or 180min and non-peak-shift group (n=126) at 30 or 60min,differences of genotype distribution and allele frequency between the two groups were analyzed. Comparing FPG，serum insulin level at each time point of IRT, insulin resistance index(IRI), Insulin sensitivity index(ISI) and area under the curve(AUC) between different genotypes in the two groups. Results ① The frequencies of three MTHFR C677T genotypes(CC,CT,TT) in peak-shift group and non-peak-shift group were 36.92%, 40.00%, 23.08% and 61.11%, 30.16%, 8.73%, and the distribution frequency of C and T were 56.92%, 43.08% and 76.19%, 23.81%, and the differences were statistically significant (χ2=12.47, 15.06, P=0.020, 0.000). ② One-way ANOVA showed that there were significant differences in fasting insulin (Fins) and IRI among the three genotypes in the non-post shift group（F=6.569, 5.928, P=0.002, 0.003）. Fins and IRI of CT and TT genotype were higher than those of CC genotype[Fins: 12.56(9.39, 15.49), 12.59(9.56, 22.48) vs 8.75(5.43, 13.50)；IRI: 2.75(1.96, 3.53), 3.16(2.01, 4.83) vs 1.87(1.28, 3.03)], and the differences were statistically significant(t=2.66 ～ 2.93, P=0.004 ～ 0.009). ③ Fins and ISI were significantly different among the three genotypes（F=3.827, 3.559, P=0.027, 0.034）.Compared with CC genotype, Fins of CT genotype and TT genotype increased[13.00(9.29, 20.74), 13.92(7.84, 18.03) vs 8.67(6.73, 10.66)],while ISI decreased[0.016(0.010, 0.023), 0.014(0.011, 0.025)vs 0.022(0.018, 0.033)], the differences were statistically significant（t=2.11 ～ 2.51, P=0.015 ～ 0.039）. Conclusion The polymorphism of MTHFR C677T gene was associated with insulin peak shift in patients with PCOS and Fins was increased in the patients with MTHFR C677T gene mutation.In the patients with no peak insulin shift,the resistance was increased in the patients with the mutation. While in the patients with the peak insulin shift, the insulin sensitivity was decreased.

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备注/Memo

备注/Memo:
基金项目： 佛山市自筹经费类科技创新项目入库培育项目（编号：2220001004289）：PCOS 患者胰岛素峰值后移与MTHFRC677T 基因多态性的相关性研究。
作者简介：朱琳（1985-），女，本科，副主任技师，研究方向：产前筛查与产前诊断方向，E-mail: 422207430@qq.com。
更新日期/Last Update: 2023-11-15