Study On The Relationship Between Vitamin D And Its Receptor Gene Polymorphism In Different Syndromes Of Diabetic Nephropathy

Objective Based on renal protective effect of diabetes mellitus of vitamin D, discuss the correlation between vitamin D receptor genotype and the onset of diabetic nephropathy, preliminarily discuss the relationship between different traditional Chinese medicine syndromes of diabetes mellitus and diabetic nephropathy and serum vitamin D levels and vitamin D receptor gene polymorphisms.Methods Select178patients with type2diabetes as experimental group,48normal persons as control group. According to urinary albumin levels, the experimental group are divided into diabetes without nephropathy group, diabetes with microalbuminuria group and diabetes with clinical albuminuria group. According to Chinese medicine classification standards of diabetes in the guiding principle of clinical study on new drug of traditional Chinese medicine,patients are divided hyperactivity of fire due to yin deficiency syndrome, dampness-heat stagnatingin spleen syndrome, deficiency of Qi and Yin syndrome, deficiency of Yin and Yang, blood stasis and fluid stop syndrome, blood stasis in vessel syndrome.Draw boold from the elbow vein in the experimental group and the control group subjects.Use chemiluminescence method to detect serum vitamin D levels and PCR technology to detect the vitamin D receptor gene polymorphisms of Rs731236, Rs11568820, Rs1544410, Rs7975232in peripheral blood mononuclear cells. Analysis of Variance is used to analyse the relationship between serum vitamin D levels and traditional Chinese medicine syndromes of diabetic nephropathy. Chi-square test is used to analyse the relationship between vitamin D receptor gene polymorphisms and traditional Chinese medicine syndromes of diabetes and diabetic nephropathy.Results (1)The serum vitamin D levels of diabetes without nephropathy group, diabetes with microalbuminuria group and diabetes with clinical albuminuria group is lower than control group(P<0.01), the serum vitamin D levels of diabetes with clinical albuminuria group is lower than diabetes without nephropathy group(P<0.05).(2) Rs154440AG genotype and allele A freqency are higher in diabetic nephropathy group than that in diabetes without nephropathy group(P<0.05)and control group(P<0.01), Rs731236CT genotype and allele C freqency are higher than that in diabetes without nephropathy group(P<0.05)and control group(P<0.01)and there is no significant difference in Rs11568820and Rs7975232sites.(3) Rs1544410genotype AG and Rs731236genotype CT is a risk factor for diabetic nephropathy (P=0.009, OR=5.309,95%C.I.:1.465-19.245).(4)In diabetes and diabetic nephropathy patients, deficiency of Yin and Yang, blood stasis and fluid stop syndrome serum vitamin D levels is lower than hyperactivity of fire due to yin deficiency syndrome(P<0.05).(5) In diabetes patients,Rs731236genotype CT and allele C freqency are higher in deficiency of Yin and Yang, blood stasis and fluid stop syndrome than that in the other syndromes (P<0.05); Rs1544410AG genotype and allele A. freqency are higher in deficiency of Yin and Yang, blood stasis and fluid stop syndrome than that in the other syndromes (P<0.05).(6)In diabetic nephropathy patients, Rs731236genotype CT and allele C freqency are higher in deficiency of Yin and Yang, blood stasis and fluid stop syndrome than that in the other syndromes (P<0.05); Rs1544410AG genotype and allele A freqency are higher in deficiency of Yin and Yang, blood stasis and fluid stop syndrome than that in the other syndromes (P<0.05).(7)The proportion of diabetes patients of Yin and Yang, blood stasis and fluid stop syndrome with complication of diabetic nephropathy is higher.Conclusion Vitamin D deficiency is closely related to occurrence and development of type2diabetic nephropathy. Serum vitamin D levels can be used as an important reference index to judge the traditional Chinese medicine syndromes of diabetic nephropathy. Vitamin D receptor genes Rs1544410allele A and Rs731236allele C may be susceptible genes for diabetic nephropathy.Diabetes patients and diabetic nephropathy patients of deficiency of Yin and Yang, blood stasis and fluid stop syndrome Rs1544410allele A and Rs731236allele C proportion is higher. The proportion of diabetes patients of Yin and Yang, blood stasis and fluid stop syndrome with complication of diabetic nephropathy is higher.It shows that the deficiency of Yin and Yang, blood stasis and fluid stop syndrome of diabetes and diabetic nephropathy is associated with Rs1544410allele A and Rs731236allele C.