摘要
【目的】探讨ERa基因多态性与女性膝骨性关节炎(KOA)经筋分型及中医证型的相关性。【方法】采用病例-对照研究方法,选择2015年1月至2017年12月期间广州中医药大学第三附属医院骨科门诊及住院部收治的180例KOA患者作为病例组;同时,选取180例同时期在本院体检部门进行体检的正常人群作为健康对照组(简称对照组),所有研究对象均为女性。分别采集外周静脉血样,采用MassArray方法对ERa基因的多态性位点PvuⅡ和XbaⅠ进行基因型测定,用SPSS 21.0软件统计基因多态性与KOA经筋分型及中医证型的相关性。【结果】(1)ERa基因XbaⅠ多态性位点的基因型和等位基因频率分布在病例组和对照组有显著性差异(P<0.05),病例组等位基因x频率分布明显高于对照组人群,能显著增加KOA的患病风险(OR=1.45;95%CI,1.05-2.45;P=0.035),X等位基因与KOA患病风险不存在相关性(OR=1.35;95%CI,0.31-1.49;P=0.36)。(2)通过各位点的基因型频率比较发现,PvuⅡ多态性位点与KOA的患病风险不存在相关性(P>0.05);XbaⅠ多态性位点的Xx基因型频率在病例组和对照组中存在显著性差异,能显著增加KOA的患病风险(OR=1.86;95%CI,1.06-3.13;P=0.045)。(3)无条件逻辑回归模型分析发现,在显性模型下,XbaⅠ多态性位点的最小等位基因X与增加KOA患病风险具有相关性(OR=1.51;95%CI,1.15-2.23;P=0.045);PvuⅡ多态性位点与KOA的患病风险无相关性(P>0.05)。(4)分层分析结果显示:ERa基因PvuⅡ和XbaⅠ多态性的基因型与等位基因均与KOA的湿热阻络型和混合型这2个中医证型具有相关性(P<0.05或P<0.01);ERa基因XbaⅠ和PvuⅡ多态性与KOA经筋分型无相关性(P>0.05);XbaⅠ等位基因x与足阳明经筋型和足三阴经筋型具有相关性(P<0.01)。【结论】ERa基因多态性与KOA存在相关性;XbaⅠ多态性的x等位基因可能是其危险因素;pp基因型和xx基因型可能是其易感基因多态性。
Objective To explore the correlation of ERa genetic polymorphisms with classification of muscles along meridian and traditional Chinese medicine(TCM)syndrome types of knee osteoarthritis(KOA)in women patients.Methods The case-control study was adopted.The case group included a total of 180 KOA women outpatients and inpatients admitted in the Third Affiliated Hospital of Guangzhou University of Chinese Medicine from January,2015 to December,2017.Meanwhile,a total of 180 healthy women volunteers taking the physical examination in the same hospital at the same period served as the control group.Peripheral venous blood samples of all subjects were collected.The ERa genotypes of PvuⅡand XbaⅠgene were determined by MassArray method.The correlation of ERa genetic polymorphisms with classification of muscles aolng meridian and TCM syndrome types of women KOA was evaluated by SPSS 21.0.Results(1)The differences of the frequencies of the Era XbaⅠallele and genotype between the case group and control group were significant(P<0.05).The frequency of allele x was higher than that in the control group,indicating that allele x could increase the risk of KOA(OR=1.45,95%CI:1.05-2.45,P=0.035);but allele X had no correlation with the risk of KOA(OR=1.35,95%CI:0.31-1.49,P=0.36).(2)The comparison of genotype frequency showed that the PvuⅡpolymorphism had no correlation with the risk of KOA(P>0.05),but the frequency of Xx genotype of XbaⅠgene in the case group differed from that in the control group,and Xx genotype increased the risk of KOA(OR=1.86,95%CI:1.06-3.13,P=0.045).(3)The results of unconditional Logistic regression model analysis showed that the minor allele X of XbaⅠpolymorphic loci in the dominant model was correlated with the increase of risk of KOA(OR=1.51,95%CI:1.15-2.23,P=0.045);PvuⅡpolymorphic loci had no correlation with the risk of KOA(P>0.05).(4)The results of stratified analysis showed that the genotypes and allele genotypes of PvuⅡand XbaⅠpolymorphism of ERa gene all had correlation with the syndrome type of damp-heat obstructing collaterals and the complicated syndrome type in KOA patients(P<0.05 for P<0.01);PvuⅡand XbaⅠpolymorphism of ERa gene had no correlation with KOA muscle-along-meridian classification(P>0.05);the minor allele x of XbaⅠwas correlated with the foot three Yin muscle-along-meridians(P<0.01).Conclusion The ERa genetic polymorphisms is correlated with the risk of KOA,the minor allele x of XbaⅠis probably the risk factor of KOA,and genotypes pp and xx are probably the polymorphism of susceptibility gene of KOA.
作者
易志勇
韩清民
郭斯印
YZhi-Yong;HAN Qing-Min;GUO Si-Yin(The Third Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510375 Guangdong,China)
出处
《广州中医药大学学报》
CAS
2019年第12期1900-1906,共7页
Journal of Guangzhou University of Traditional Chinese Medicine
基金
广东省中医药局科研项目(编号：20161124)
关键词
膝骨性关节炎
经筋分型
中医证型
基因多态性
相关性分析
knee osteoarthritis
muscle-along-meridian classification
traditional Chinese medicine syndrome types
gene polymorphisms
correlation analysis
作者简介
易志與(1980-),男,医学硕士,主治中医师,E-mail:106652596@qq.com;通讯作者:韩清民(1963-),男,教授,主任医师,E-mail:1338001l307@189.cn。
