摘要目的：探讨血清脂联素(adiponectin, APN)基因启动子区域单核苷酸多态性频率与2型糖尿病(type 2 diabetes, T2DM)患者中医证候的关系。方法将符合入选标准的120例T2DM患者按中医辨证分型分为气阴两虚组42例、阴虚燥热组38例、阴阳两虚组40例，另选取50例正常体检者为健康对照组，采用PCR扩增技术筛选脂联素基因(adiponectin gene, aPM1)启动子多态性位点，采用日本日立全自动化生化分析仪测定患者TG、TC、LDL-C、HDL-C，并计算胰岛抵抗指数(insulin resistance index, HOMA-IR)。结果阴虚燥热组患者血清APN水平[(6.98±1.23)μg/ml比(2.55±0.78)μg/ml、(3.48±0.22)μg/ml]高于气阴两虚组及阴阳两虚组(P＜0.05)， TG(4.48±0.87)mmol/L、LDL-C(4.98±0.42)mmol/L、TC(5.36±0.79)mmol/L高于气阴两虚组(3.25±0.75)mmol/L、(4.02±0.69)mmol/L、(3.12±0.52)mmol/L及阴阳两虚组(3.18±0.69)mmol/L、(4.09±0.71)mmol/L、(3.22±0.78)mmol/L(P＜0.05)；不同证型 T2DM 患者血清 HOMA-IR、HDL-C 水平比较，差异均无统计学意义(P＞0.05)。阴虚燥热组aPM1-11377G/C基因型中GG基因型[78.95%(30/38)比42.86%(18/42)、35.00%(14/40)]显著高于气阴两虚组及阴阳两虚组(P＜0.05)，气阴两虚组及阴阳两虚组aPM1-11377G/C基因型中GG基因型高于健康对照组(P＜0.05)。GG基因型血清APN水平[(7.02±1.23)μg/ml比(3.25±0.78)μg/ml、(2.42±0.22)μg/ml， F＝8.123]显著高于GC型及CC型(P＜0.001)，其他指标比较差异无统计学意义(P＞0.05)。结论 T2DM患者阴虚燥热型与 aPM1-11377G/C 基因多态性有关，aPM1-11377G/C 基因多态性可在一定程度上反映T2DM患者中医证候分型，并通过影响患者胰岛素抵抗、动脉斑块及血清APN水平，影响T2DM发生发展。

abstractsObjective To investigate the relationship of serum adiponectin (APN) gene promoter region single nucleotide polymorphism (SNP) frequency and type 2 diabetes mellitus (T2DM).Methods 120 cases of T2DM were divided into Yin Deficiency Syndromes(n=42), Yin hot (n=38), yin and yang (n=40) and 50 cases of normal volunteers were select as the control group. The diponectin gene (aPM1) promoter polymorphisms of each group were detected with polymerase chain reaction amplification (PCR).Results Serum APN Yin hot levels in patients with T2DM (6.98 ± 1.23 μg/ml) were lower than Qi and yin (2.55 ± 0.78 μg/ml) and yang group (3.48 ± 0.22 μg/ml) (P<0.05), and TG, LDL-C, TC (4.48 ± 0.87 mmol/L, 4.98 ± 0.42 mmol/L, 5.36 ± 0.79 mmol/L) were higher than Qi and yin (3.25 ± 0.75 mmol/L, 4.02 ± 0.69 mmol/L, 3.12 ± 0.52 mmol/L) and yang group (3.18 ± 0.69 mmol/L, 4.09 ± 0.71 mmol/L, 3.22 ± 0.78 mmol/L)(P<0.05). Yin hot type aPM1-11377G/C genotype of the GG genotype was significantly higher than the proportion of Qi and yin and yang group (P<0.05), while the yin and yang and yin and yang group aPM1-11377G/C genotype the proportion was higher in GG genotype (P<0.05). GG genotype was significantly lower than serum APN type CG and CC genotype (P<0.05), whereas no significantdifference in other indexes (P>0.05).Conclusion T2DM patients Yin hot type inherent relationship with aPM1-11377G/C polymorphism, aPM1-11377G/C polymorphism may reflect R2DM Disease Syndromes typing a certain extent, and by influence insulin resistance in patients with arterial plaque and serum APN levels, thereby affecting T2DM disease occurrence and progression.