摘要目的 了解过氧化物酶体增殖物激活受体γ2(PPARγ2)基因多态性对血脂异常人群营养干预效果的影响.方法 采取多阶段分层整群随机抽样的方法 ,从南京市3个主城区抽取412例常住汉族高血脂患者,用简单随机抽样方法 将人群分为膳食下预组与对照组.干预组221例给予粗杂粮干预和健康教育,对照组191例仅给予健康教育,从2007年3月至2008年3月,每6个月对两组人群进行1次医学体检,计算体质指数(BMI)、腰臀比(WHR),检测血清总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白且固醇(HDL-C)、空腹血糖(FBG),其后进行PPARγ2基因Pro12Ala多态性检测.结果 干预后干预组、对照组TC水平分别为(4.90±0.86)、(5.16±0.94)mmol/L;TG水平分别为(1.68±0.97)、(2.29±1.10)mmol/L;HDL-C水平分别为(1.35±0.36)、(1.16±0.33)mmol/L,差异均有统计学意义(t值分别为-2.95、-6.01、5.55,P值均<0.01).干预组Pro/Pro基因型的人群BMI[(24.81±3.21)kg/m~2]、WHR(0.88±0.07)、FBG[(5.40 ±1.17)mmol/L]、TC[(4.92±0.87)mmol/L]、TG[(1.68±1.01)mmol/L]均比干预前[分别为(25.39±3.30)ks/m~2、(0.92±0.07)、(6.07±2.17)mmol/L、(5.28 ±0.94)mmol/L、(2.70±1.86)mmol/L]明显降低(t值分别为19.06、16.43、1.98、8.86、-14.32,P值均<0.01),HDL-C[(1.37±0.36)mmol/L]比干预前[(1.13±0.42)mmol/L]明显升高(t=-7.68,P<0.01);Pro/Ala型人群WHR(0.90±0.06)和TG[(1.71±0.59)mmol/L]比干预前[分别为(0.95±0.06)、(2.58±1.12)mmol/L]降低,差异有统计学意义(t值分别为-3.53、-8.05,P值均<0.01).Pro/Pro型的BMI下降幅度[(-1.21 ±1.02)kg/m~2]高于Pro/Ala型[(-0.58±1.85)kg/m~2],差异有统计学意义(t=-6.29,P<0.01).结论 PPARγ2不同基因型人群对粗杂粮膳食干预均有效,其中Pro/Pro型人群多项指标都有明显改善,显示其干预效果好于Pro/Ala型和Ala/Ala型人群.

abstractsObjective To find out the effects of peroxisome proliferator-activated receptor gamma 2(PPARγ2) genetic polymorphism and nutrition intervention to blood lipid abnormal population. Methods 412 hyperlipemia residents of Han group were screened from 3 main districts in Nanjing by multistage stratified cluster random sampling, and separated into nutritional intervention and control group by simple random method. The intervention group (221 individuals) were provided with coarse good grain and health education while only health education was provided for the control group (191 individuals ). Medical examinations ( including body mass index ( BMI ), waist-to-hip ratio ( WHR ) ; total cholesterol ( TC ),triglyceride(TG) ,high density lipoprotein cholesterol(HDL-C) and fasting blood glucose(FBG)) were taken every 6 months between March 2007 and March 2008, and PPARγ2 genetic polymorphism was alsodetected later. ResultsAfter intervention,TC levels of intervention group and control group were (4. 90 ±0. 86) and ( 5.16 ± 0.94) mmol/L respectively ; TG levels were ( 1.68 ± 0.97 ) and (2. 29 ± 1.10) mmol/L respectively; HDL-C levels were ( 1.35 ± 0. 36 ) and ( 1.16 ± 0. 33 ) mmol/L respectively, all of the differences were significant in statistics (t values were - 2. 95, - 6. 01,5.55 respectively, P < 0. 01 ). The levels of BMI ( ( 24. 81 ± 3.21 ) kg/m~2 ), WHR ( 0. 88 ± 0. 07 ), FBG ( ( 5.40 ± 1.17 ) mmol/L ), TC( (4. 92±0. 87 ) mmol/L ) and TG ( ( 1.68±1.01 )mmol/L)decreased significantly (t values were 19. 06,16. 43,1.98,8. 86, - 14. 32 respectively, P <0.01 ) compared to the levels before intervention ( BMI(25.39 ±3.30 ) kg/m~2, WHR ( 0. 92±0. 07 ), FBG ( 6. 07±2. 17 ) mmol/L, TC ( 5.28±0. 94 ) mmoL/L and TG(2. 70 ±1.86) mmol/L), while HDL-C ( 1.37±0. 36 ) mmol/L increased significantly compared to the level before intervention (1.13±0. 42) mmol/L(t = -7. 68, P < 0. 01 ) in the individuals with Pro/Pro of intervention group. WHR (0. 90 ±0. 06 ) and TG ( ( 1.71±0. 59) mmol/L) decreased significantly compared to the levels before intervention ( WHR (0. 95±0. 06 ) and TG (2. 58±1.12 ) mmol/L) ( t values were-3.53 and -8. 05 respectively,P <0. 01 ) in the ones with Pro/Ala. Moreover, susceptibility of change for BMI in Pro/Pro genotype carriers( ( -1.21 ± 1.02)kg/m~2) was significantly greater than that in Pro/Ala genotype carriers ( ( - 0. 58 ± 1.85 ) kg/m~2, t = - 6. 29, P <0. 01 ). ConclusionSeveral indices of individuals with Pro/Pro improved obviously after nutrition intervention, which showed that effects of intervention to these people were better than those with Pro/Ala and Ala/Ala.