内科

目的探讨慢性阻塞性肺疾病（COPD）患者Gc基因多态性与游离态25羟维生素D的关系。方法检测120例吸烟COPD患者（COPD患者组）和107例吸烟非COPD患者（非COPD患者组）的血清总25羟维生素D、VDBP及白蛋白水平，进行Gc基因多态性分析，分析不同Gc基因型研究对象游离态25羟维生素D水平。结果COPD患者FEV1、FEV1/FVC低于非COPD患者、CAT评分高于非COPD患者、6分钟步行试验距离短于非COPD患者，差异均有统计学意义（P＜0.05）。COPD患者总25羟维生素D水平低于非COPD患者、VDBP水平高于非COPD患者、游离态25羟维生素D水平低于非COPD患者，差异均有统计学意义（P＜0.05）。COPD患者Gc基因1F1F基因型频率高于非COPD患者，22基因型频率低于非COPD患者，差异有统计学意义（P＜0.05）；COPD患者和非COPD患者1F1S、1F2、1S2、1S1S基因型频率比较差异无统计学意义（P＞0.05）。不同基因型COPD患者及非COPD患者游离态25羟维生素D水平比较差异具有统计学意义（P＜0.01）；纯合子1F1F型患者及非患者的游离态25羟维生素D水平低于其他基因型（P＜0.05）；22型患者及非患者的游离态25羟维生素D水平高于其他基因型（P＜0.05）。1F1F型和22型患者及非患者的游离态25羟维生素D水平比较差异有统计学意义（P＜0.05）。结论COPD患者的游离态25羟维生素D水平较低，不同Gc基因型患者游离态25羟维生素D水平存在差异，Gc基因可能通过影响25羟维生素D水平参与COPD的发生发展，检测游离态25羟维生素D水平可能比单纯测定总维生素D水平对判断COPD患者病情更有临床价值。

【Abstract】ObjectiveTo explore the relationship between Gc gene polymorphism and free 25hydroxyvitamin D in patients with chronic obstructive pulmonary disease. MethodsA total of 120 smokers with COPD (COPD group) and 107 smokers with non COPD (non COPD group) were enrolled as the research objects, the levels of serum total 25hydroxyvitamin D, VDBP and albumin of all the subjects were measured, Gc gene polymorphism analysis was performed， and the level of free 25hydroxyvitamin D in different Gc genotype subjects were analyzed. ResultsThe FEV1、FEV1/FVC in patients with COPD were significantly lower than those in objects with non COPD, scores of CAT in patients with COPD were significantly higher than those in objects with non COPD, 6minute walk distance in patients with COPD were significantly shorter than that in objects with non COPD (P＜0.05). The levels of total and free 25hydroxyvitamin D in patients with COPD were significantly lower than those in objects with non COPD, and the level of ADBP in patients with COPD was significantly higher than that in objects with non COPD (P＜0.05).The frequency of 1F1F genotype of Gc gene in patients with COPD was significantly higher than that in objects with non COPD, and the frequency of 2-2 genotype of Gc gene in patients with COPD was significantly lower than that in objects with non COPD (P＜0.05); no statistical significance was found between patients with COPD and objects with non COPD in the frequency of 1F1S,1F2,1S2,1S1S genotype of Gc gene (P＞0.05). There was significant difference in the level of free 25hydroxyvitamin D among difference genotype of Gc gene in patients with COPD and objects with non COPD (P＜0.05); the levels of free 25hydroxyvitamin D of 1F1F genotype in patients with COPD and objects with non COPD were significantly lower than those of others genotype (P＜0.05); and the levels of free 25hydroxyvitamin D of 2-2 genotype in patients with COPD and objects with non COPD were significantly higher than those of others genotype (P＜0.05). There was significant difference in the levels of free 25hydroxyvitamin D between 1F1F and 2-2 genotype in patients with COPD and objects with non COPD (P＜0.05). ConclusionsPatients with COPD has lower levels of free 25hydroxyvitamin D, there is differences in free 25hydroxyvitamin D among different Gc genotypes patients with COPD, Gc gene may participate in the genesis of COPD by regulating the level of 25hydroxyvitamin D, and the detection of free 25 hydroxyvitamin D may be more valuable than the simple determination of total vitamin D