The Correlation Between Homocysteine As Well As Its Metabolic Enzyme Gene Polymorphism And Diabetic Nephropathy

Objective Investigate the correlation between homocysteine(HCY)as well as its metabolic enzyme gene polymorphism and diabetic nephropathy,explore the susceptibility genes of diabetic nephropathy,provide experimental evidence for the prevention of diabetic nephropathy.Methods In this study,we collected blood samples and clinical data from 295 patients suffering type 2 diabetes,including 112 patients with diabetic nephropathy and 183 patients without diabetic nephropathy,and collected 118 healthy people as a control group.Clinical laboratory biochemical markers and plasma homocysteine levels were detected by conventional biochemical analyzer.We applied multiple PCR to amplify the gene fragment containing the mutation site to be detected,then conducted multiple LDR reaction,detected methylenetetrahydrofolate reductase C677T?A1298C and methionine synthase A2756G gene polymorphism.Use SPSS19.0 software to conduct statistical analysis,and investigate the correlation between HCY as well as its metabolic enzyme gene polymorphism and diabetic nephropathy.Results Compared with the control group,homocysteine concentrations of both diabetic patients without nephropathy and diabetic nephropathy are elevated(P=0.0001),and HCY levels between the two groups also have statistical difference(P=0.008);HCY levels positively correlate with serum creatinine levels,r~2=0.304,P=0.0001;MTHFR C677T mutation,HCY levels of TT homozygotes median are 14.00(11.00~19.60)?mol/L,significantly higher than the non-mutated homozygous CC and CT heterozygotes,TT genotype compared with CC genotype P=0.0001,TT genotype compared with CT genotype P=0.005;HCY levels of MTHFR A1298C,MS A2756G genotypes are not statistically significant,P>0.05;comparing diabetic patients without nephropathy with normal control group,MTHFRC677T genotype and allele frequencies are significantly different(genotype P=0.048,allele P=0.026);multivariate Logistic regression analysis showed that hyperhomocysteinemia is a risk factor for diabetes,OR=1.387(95%CI:1.215~1.583,P=0.0001),and MTHFR C677T genotype also is a risk factor for diabetes,OR=1.555(95%CI:1.085~2.230,P=0.016),but both have not shown any significant correlation with diabetic nephropathy.Conclusion Between plasma HCY levels and diabetic nephropathy,there is some correlation.MTHFR C677T homozygous mutation lead to increased levels of plasma HCY,and may be important genetic factors for diabetes and its chronic complications such as diabetic nephropathy.