- 學位論文
台灣中部地區第二型糖尿病患者 PPAR基因多型性之分析
Study of the polymorphism of peroxisome proliferator-activated receptors in type 2 diabetic patients in central Taiwan
摘要
過氧化體增殖劑活化接受器（PPARγ），是一個核酸接受器，負 責調節脂肪細胞的分化與胰島素敏感性，研究證實Pro12Ala變異與糖尿病和肥胖有關。因此本研究之目的為探討PPARγ基因多型性在第二型糖尿病患的分佈情況，並評估PPARγ對第二型糖尿病患者體位測量、血液生化值變化之影響。本研究以口服用藥之第二型糖尿病患為研究對象，研究期間共有278位受試者參與，最後完成本研究之受試者為227位（男性132位，女性95位），平均年齡分別為57.1±11.3歲與59.7±12.5歲。研究對象以基因型、身高質量指數的程度、糖化血色素與三酸甘油脂的高低，此四項分組，此四組之基本資料、體位測量在男性與女性皆無顯著差異。結果顯示，台灣中區第二型糖尿病患Pro/Ala與Ala/Ala之盛行率為11.01 %。研究中發現，不論男性或女性之受試者，攜帶Pro/Pro、Pro/Ala與Ala/Ala者與BMI無顯著相關。在血壓方面，雖然沒有統計上之差異，但卻發現女性受試者之舒張壓與攜帶Pro/Pro者或攜帶Pro/Ala之基因型有相關，攜帶Pro/Ala者其舒張壓較攜帶Pro/Pro者為低（78.3±8.2 mmHg vs 84.3±14.3 mmHg）。觀察三種基因型與血液生化值的關係，發現在男性中攜帶Pro/Ala者，其總膽固醇較攜帶Pro/Pro者顯著為低（169.4±40.6 mg/dL vs 202.5±36.6 mg/dL，P＜0.05），而低密度脂蛋白（105.4±34.0 mg/dL vs 124.3±30.4 mg/dL，P＜0.05）亦然，在三酸甘油脂方面，攜帶Pro/Ala者較攜帶Pro/Pro者有較低的趨勢（120.0±50.5 mg/dL vs 150.3±75.6 mg/dL，p =0.06），在女性中則是發現，攜帶Ala/Ala者，其血糖較攜帶Pro/Ala者有較高的趨勢（193.0±32.5 mg/dL vs 142.7±27.5 mg/dL，p =0.06）。本研究結果顯示，PPARγ基因多型性，在台灣中區第二型男性糖尿病患中，具有Pro/Pro基因型者，其總膽固醇與低密度膽固醇值高，以女性而言，具有Ala/Ala基因型者，其血糖有偏高之趨勢。
並列摘要
Peroxisome proliferator-activated receptor gamma（PPARγ）is a nuclear receptor that regulates adipocyte differentiation and insulin sensitivity. Recent research suggests that Pro12Ala variant in PPARγ is associated with diabetes and obesity. The purpose of this study was to investigate whether prevalence of PPARγ polymorphism and assessment the effects on anthropometric measurement and biochemical. Subjects were identified by type 2 diabetic to have take medicine. Two hundred seventy eight patients successfully completed the study. The man with the mean age of 57.1±11.3 y and the women was 59.7±12.7 y. The Patients were assigned to 1 of 4 groups, with genotype, BMI, HbA1c and TG. The 4 group that basic data and anthropometric measurement was no significant. Result shows that prevalence of Pro/Ala and Ala/Ala was 11% in central Taiwan. There were no significant between genotype groups with respect to BMI. The blood pressure was no significant, but the correlation between diastolic blood pressure with homozygous carriers or heterozygous carriers in women subjects. The heterozygous carriers had lower level of diastolic blood pressure compared with wide type carriers（78.3±8.2 mmHg vs 84.3±14.3 mmHg）. In men, the heterozygous carriers had lower level of total cholesterol compared with wide type carriers（169.4±40.6 mg/dL vs 202.5±36.6 mg/dL，P＜0.05）, and the same with low density cholesterol（105.4±34.0 mg/dL vs 124.3±30.4 mg/dL，P＜0.05）. Further, the triglyceride concentration in heterozygous carriers were lower than wide type carriers（120.0±50.5 mg/dL vs. 150.3±75.6 mg/dL，p =0.06）. In women, the homozygous carriers had higher level of fasting blood sugar compared with the heterozygous carriers（193.0±32.5 mg/dL vs 142.7±27.5 mg/dL，p =0.06）.Our result indicates in central Taiwan in man that PPARγ polymorphism was static significant with respect to total cholesterol and low density cholesterol in the heterozygous carriers, and in Women, the homozygous carriers effect of blood sugar.