摘要
目的研究维生素D受体TaqI基因多态性与儿童肾病综合征骨代谢标志物相关性,以期能否根据基因多态性预测儿童骨质疏松症风险,指导药物治疗及评估药物治疗的效果.方法研究对象为2015年5月至2016年11月收住昆明医科大学第一附属医院儿科的70例肾病综合征患儿,维生素D受体TaqI基因多态性检测方法为PCR扩增产物酶切后琼脂糖凝胶电泳检测,骨代谢标志物用生化分析.结果降钙素、25(OH)D3、甲状旁腺激素、钙、磷、碱性磷酸酶在维生素D受体TaqI基因3种基因型(TT,Tt,tt)之间的F值分别为:0.574,2.973,1.947,2.566,0.423,0.242,P值均大于0.05;镁在维生素D受体TaqI基因3种基因型(TT,Tt,tt)之间的F值9.278,P<0.001.在TT基因型患儿中,经骨化三醇治疗2周后与治疗前骨代谢标志物对比,降钙素、25(OH)D3、甲状旁腺激素、镁、磷、碱性磷酸酶t值分别为:0.796,0.290,0.295,0.574,0.830,0.933,P值均大于0.05;钙t值为4.301,P<0.001.在Tt基因型患儿中,经骨化三醇治疗2周后与治疗前骨代谢标志物对比,降钙素、25(OH)D3、甲状旁腺激素、钙、镁、磷、碱性磷酸酶t值分别为:0.722,1.298,1.391,1.511,1.671,1.045,0.368,P>0.05.在tt基因型患儿中,经骨化三醇治疗2周后与治疗前骨代谢标志物对比,降钙素、25(OH)D3、甲状旁腺激素、镁、磷、碱性磷酸酶t值分别为:1.168,1.755,1.787,2.344,1.777,1.808,P值均大于0.05;钙t值为2.458,P<0.005.结论在肾病综合征患儿中,维生素D受体TaqI多态性不能评估骨质疏松风险.TT基因型及tt基因型对骨化三醇治疗的反应性更好,经骨化三醇治疗2周后血清钙较治疗前有明显的升高,骨质疏松症的风险明显减低.
Objective In this paper,we study the relationship between vitamin D receptor TaqIgene polymorphism and bone metabolism disorder in children,snephrotic syndrome,in order to predict children＇s risk of osteoporosisaccording to the genetic polymorphisms,guiding drug treatment and evaluating the effect of drug treatment.Methods The object of the study was the 70 cases of children with nephrotic syndrome in pediatrics in the first affiliated hospital of Kunming Medical University from May 2015 to November 2016.Genotypes of the VDR TaqI gene polymorphism were analyzed using the PCR amplification product enzyme and agarose gel electrophoresis,bone metabolic markers with biochemical analysis.Results The F value of calcitonin（CT）.25（OH） D3（VIT-D）.parathyroid hormone（PTH）.Calcium（Ca）.phosphorus（P）.alkaline phosphatase（ALP） in the three genotypes（TT TT TT） of vitamin D receptor TaqI gene polymorphism were：0.574,2.973,1.947,2.566,0.423,0.242,P〈0.05.The F value of magnesium（Mg） was 9.278,P0.001.In children with TT genotype,after calcitriol treatment2 weeks,the t value of calcitonin.25（OH） D3.parathyroidhormone.magnesium.phosphorus.alkaline phosphatase were：0.796,0.290,0.295,0.574,0.830,0.933,P〈0.05 compared with treatment before.The t value of Ca was 4.301,P0.001.In children with Tt genotype,the t value of calcitonin.25（OH） D3.parathyroid hormone.calcium.magnesium.phosphorus.alkaline phosphatase were：0.722,1.298,1.391,1.511,1.671,1.045,0.368,P〈0.05.In children with tt genotype,the t value of calcitonin.25（OH） D3.parathyroid hormone.magnesium.phosphorus.alkaline phosphatase were：1.168,1.755,1.787,2.344,1.777,1.808,P〈0.05;the t value of Ca was 2.458,the P0.005.Conclusions In children with nephrotic syndrome,vitamin D receptor TaqI gene polymorphism can assess the risk of osteoporosis,tt genotype has lower risk of osteoporosis as compared with Tt genotype and TT genotype.TT genotype and tt genotype have better reactivity of calcitriol therapy.Serum calcium is significantly elevated after 2 weeks＇ treatment of calcitriol.The risk for osteoporosis is significantly reduced.
出处
《昆明医科大学学报》
CAS
2017年第11期69-74,共6页
Journal of Kunming Medical University
基金
云南省科技厅-昆明医科大学应用基础研究联合专项基金资助项目(AFRP2014)
