C-reactive Protein-717C>T Genetic Polymorphism Associates with Esophagectomy-induced Stress Hyperglycemia
C-reactive Protein-717C>T Genetic Polymorphism Associates with Esophagectomy-induced Stress Hyperglycemia
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DOI：
10.1007/s00268-010-0456-x
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发表时间：
2010-05-01
影响因子：
2.6
通讯作者：
Ogawa, Jun-ichi
中科院分区：
文献类型：
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作者：
Motoyama, Satoru;Miura, Masatomo;Ogawa, Jun-ichi
应激性高血糖是指在疾病期间出现的短暂高血糖，通常仅限于既往无糖尿病证据的患者。遗传学对手术引起的高血糖的影响仍然只是部分understood.研究参与者是日本患者治疗胸段食管癌根治性食管切除术在秋田大学医院在2003年和2007年之间。我们确定了食管切除术引起的应激性高血糖症（手术过程中血糖升高30 mg/dl）和C反应蛋白（CRP）、肿瘤坏死因子（TNF）-α、-β、干扰素-γ、转化生长因子-β 1、白细胞介素（IL）-1 β、IL-2、IL-4、IL-6、IL-6受体、IL-10、IL-12 β、脂联素和过氧化物酶体增殖物激活受体-γ。28例（46%）患者在手术期间血糖水平升高超过30 mg/dl。在检测的基因多态性中，CRP-717 C> T与食管切除术期间应激性高血糖显著相关。多因素Logistic回归分析显示，CRP-717 T/T基因型患者发生手术诱导高血糖的风险显著高于CRP-717 C/T基因型患者。CRP-717 C > T基因多态性可能是胸段食管癌患者术后应激性高血糖的预测因子。
Stress hyperglycemia refers to the transient hyperglycemia seen during illness and is usually restricted to patients without previous evidence of diabetes. The influence of genetics on surgery-induced hyperglycemia remains only partially understood.The study participants were Japanese patients treated for thoracic esophageal cancer with curative esophagectomy at Akita University Hospital between 2003 and 2007. We determined the associations between esophagectomy-induced stress hyperglycemia (a parts per thousand yen30 mg/dl increases in blood glucose during surgery) and genetic polymorphisms for C-reactive protein (CRP), tumor necrosis factor (TNF)-alpha, -beta, interferon-gamma, transforming growth factor-beta 1, interleukin (IL)-1 beta, IL-2, IL-4, IL-6, IL-6 receptors, IL-10, IL-12 beta, adiponectin, and peroxisome proliferator-activated receptor-gamma.In 28 (46%) patients, blood glucose levels increased more than 30 mg/dl during surgery. Among the genetic polymorphisms tested, CRP -717C > T was significantly associated with stress hyperglycemia during esophagectomy. Multivariate logistic regression revealed that patients with the CRP -717T/T genotype had a significantly greater risk of developing surgery-induced hyperglycemia than those with the CRP -717C/T genotype. Stress hyperglycemia was also significantly associated with postoperative infectious complications and duration of intensive care unit stay.It is suggested that CRP -717 C > T genetic polymorphism may be a predictive factor for stress hyperglycemia in patients receiving esophagectomy for thoracic esophageal cancer.