[1]赵红燕,李蓉.糖尿病个体化医疗的研究进展[J].国际内分泌代谢杂志,2017,37(03):174-177.[doi:10.3760/cma.j.issn.1673-4157.2017.03.008]
 Zhao Hongyan,Li Rong..Progress of personalized medicines of diabetes mellitus[J].International Journal of Endocrinology and Metabolism,2017,37(03):174-177.[doi:10.3760/cma.j.issn.1673-4157.2017.03.008]
点击复制

糖尿病个体化医疗的研究进展()
分享到:

《国际内分泌代谢杂志》[ISSN:1673-4157/CN:12-1383/R]

卷:
37
期数:
2017年03期
页码:
174-177
栏目:
综述
出版日期:
2017-05-20

文章信息/Info

Title:
Progress of personalized medicines of diabetes mellitus
作者:
赵红燕李蓉
400042 重庆医科大学附属第一医院内分泌科
Author(s):
Zhao Hongyan Li Rong.
Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400042, China
关键词:
糖尿病 个体化医疗 基因组学
Keywords:
Diabetes mellitus Personalized medicine Genomics
DOI:
10.3760/cma.j.issn.1673-4157.2017.03.008
摘要:
糖尿病领域的个体化医疗是在传统医学基础上结合基因组学、生物学标志检测等对糖尿病进行精确诊断和分层并指导治疗。基因检测可明确单基因突变糖尿病的病因如青少年起病的成人型糖尿病(MODY)、新生儿糖尿病(NDM)、线粒体基因突变糖尿病。应用生物学标志物如胰岛素抗体、C肽等可指导糖尿病精确分层并评估预后。而细胞色素P450 2C9(CYP2C9)、有机阳离子转运蛋白(OCTs)、过氧化物酶体增殖物活化受体γ(PPARγ)相关基因变异对降糖药物的影响为患者选择降糖方案提供了参考。虽然个体化医疗在糖尿病领域还不能达到精确诊断及治疗,但未来将成为糖尿病领域的发展新趋势。
Abstract:
Personalized medicine in the field of diabetes which based on the combination of traditional medicine,genomics and biological markers, means the precise diagnosis and guidance for the treatment of diabetes. Genetic testing could identify monogenetic diabetes, such as maturity-onset diabetes of the young(MODY), neonatal diabetes mellitus(NDM)and mitochondrial gene mutation diabetes. Biological markers such as insulin antibody and C peptide contribute to the accurate stratification and prognosis evaluation of diabetes. And the effect of cytochrome P450 2C9, organic cation transporters and peroxisome proliferator activated receptor γ related gene polymorphism provide reference for the choice of hypoglycemic treatment. Although personalized medicine in the field of diabetes can not be accurate diagnosis and treatment, it will become a new trend in the future.

参考文献/References:

[1] 王欣. “精准”糖尿病为时尚早[J].中国医院院长,2015,(12):42-42.
[2] Pearson ER, Starkey BJ, Powell RJ,et al. Genetic cause of hyperglycaemia and response to treatment in diabetes[J].Lancet,2003,362(9392):1275-1281.DOI:10.1016/S0140-6736(03)14571-0.
[3] 梁黎, 王春林. 青少年发病的成人型糖尿病诊治进展[J].中华实用儿科临床杂志,2015,(20):1528-1531. DOI:10.3760/cma.j.issn.2095-428X.2015.20.003.
[4] 周庆菊, 李蓉. MODY2的认识及诊疗进展[J].国际内分泌代谢杂志,2016,36(3):180-183. DOI:10.3760/cma.j.issn.1673-4157.2016.03.009.
[5] Steele AM, Shields BM, Wensley KJ,et al. Prevalence of vascular complications among patients with glucokinase mutations and prolonged, mild hyperglycemia[J].JAMA,2014,311(3):279-286. DOI:10.1001/jama.2013.283980.
[6] Pearson ER, Flechtner I, Njølstad PR,et al. Switching from insulin to oral sulfonylureas in patients with diabetes due to Kir6.2 mutations[J].N Engl J Med,2006,355(5):467-477.DOI:10.1056/NEJMoa061759.
[7] Wang S, Wu S, Zheng T,et al. Mitochondrial DNA mutations in diabetes mellitus patients in Chinese Han population[J].Gene,2013,531(2):472-475. DOI:10.1016/j.gene.2013.09.019.
[8] Suzuki S, Hinokio Y, Ohtomo M,et al. The effects of coenzyme Q10 treatment on maternally inherited diabetes mellitus and deafness, and mitochondrial DNA 3243(A to G)mutation[J]. Diabetologia,1998,41(5):584-588.DOI:10.1007/s001250050950.
[9] Insel RA, Dunne JL, Atkinson MA,et al. Staging presymptomatic type 1 diabetes: a scientific statement of JDRF, the Endocrine Society, and the American Diabetes Association[J].Diabetes Care,2015,38(10):1964-1974. DOI:10.2337/dc15-1419.
[10] Balasubramanyam A, Nalini R, Hampe CS,et al. Syndromes of ketosis-prone diabetes mellitus[J].Endocr Rev,2008,29(3):292-302. DOI:10.1210/er.2007-0026.
[11] 周智广. 1型糖尿病的精准医疗距离我们有多远[J].中华内科杂志,2016,55(1):4-5. DOI: 10.3760/cma.j.issn.0578-1426.2016.01.002.
[12] 张弛. 酮症倾向糖尿病的异质性及分型诊断研究[D].中南大学,2005.
[13] Kuhtreiber WM, Washer SL, Hsu E, et al. Low levels of C-peptide have clinical significance for established type 1 diabetes[J].Diabet Med,2015,32(10):1346-1353. DOI:10.1111/dme.12850.
[14] Thunander M, Törn C, Petersson C,et al. Levels of C-peptide, body mass index and age, and their usefulness in classification of diabetes in relation to autoimmunity, in adults with newly diagnosed diabetes in Kronoberg, Sweden[J].Eur J Endocrinol,2012,166(6):1021-1029. DOI:10.1530/EJE-11-0797.
[15] Bo S, Gentile L, Castiglione A,et al. C-peptide and the risk for incident complications and mortality in type 2 diabetic patients: a retrospective cohort study after a 14-year follow-up[J].Eur J Endocrinol,2012,167(2):173-180. DOI:10.1530/EJE-12-0085.
[16] Jones AG, McDonald TJ, Shields BM,et al. Markers of β-cell failure predict poor glycemic response to GLP-1 receptor agonist therapy in type 2 diabetes[J]. Diabetes Care,2016,39(2):250-257. DOI:10.2337/dc15-0258.
[17] Surendiran A, Pradhan SC, Agrawal A,et al. Influence of CYP2C9 gene polymorphisms on response to glibenclamide in type 2 diabetes mellitus patients[J].Eur J Clin Pharmacol,2011,67(8):797-801. DOI:10.1007/s00228-011-1013-8.
[18] Zhou K, Donnelly L, Burch L,et al. Loss-of-function CYP2C9 variants improve therapeutic response to sulfonylureas in type 2 diabetes: a Go-DARTS study[J].Clin Pharmacol Ther,2010,87(1):52-56. DOI:10.1038/clpt.2009.176.
[19] 李明, 尹丽敏. 浙江沿海汉族人群CYP2C9基因多态性与甲苯磺丁脲代谢活性关系[J]. 中国药物与临床, 2010,10(2):140-143. DOI:10.3969/j.issn.1671-2560.2010.02.006.
[20] Dujic T, Zhou K, Donnelly LA,et al. Association of organic cation transporter 1 with intolerance to metformin in type 2 diabetes: a GoDARTS study[J].Diabetes,2015,64(5):1786-1793. DOI:10.2337/db14-1388.
[21] Tarasova L, Kalnina I, Geldnere K,et al. Association of genetic variation in the organic cation transporters OCT1, OCT2 and multidrug and toxin extrusion 1 transporter protein genes with the gastrointestinal side effects and lower BMI in metformin-treated type 2 diabetes patients[J].Pharmacogenet Genomics,2012,22(9):659-666. DOI:10.1097/FPC.0b013e3283561666.
[22] Tzvetkov MV, Vormfelde SV, Balen D,et al. The effects of genetic polymorphisms in the organic cation transporters OCT1, OCT2, and OCT3 on the renal clearance of metformin[J].Clin Pharmacol Ther,2009,86(3):299-306. DOI:10.1038/clpt.2009.92.
[23] Zhou K, Donnelly LA, Kimber CH, et al. Reduced-function SLC22A1 polymorphisms encoding organic cation transporter 1 and glycemic response to metformin: a GoDARTS study[J].Diabetes,2009,58(6):1434-1439. DOI:10.2337/db08-0896.
[24] 郭瑜. OCT1、MATE1基因多态性与中国2型糖尿病患者二甲双胍疗效的相关性研究[D].中南大学,2013.
[25] Becker ML, Visser LE, van Schaik RH,et al. Interaction between polymorphisms in the OCT1 and MATE1 transporter and metformin response[J].Pharmacogenet Genomics,2010,20(1):38-44. DOI:10.1097/FPC.0b013e328333bb11.
[26] Kang ES, Park SY, Kim HJ,et al. Effects of Pro12Ala polymorphism of peroxisome proliferator-activated receptor gamma2 gene on rosiglitazone response in type 2 diabetes[J].Clin Pharmacol Ther,2005,78(2):202-208.DOI:10.1016/j.clpt.2005.04.013.
[27] Li Q, Chen M, Zhang R,et al. KCNJ11 E23K variant is associated with the therapeutic effect of sulphonylureas in Chinese type 2 diabetic patients[J].Clin Exp Pharmacol Physiol,2014,41(10):748-754. DOI:10.1111/1440-1681.12280.

相似文献/References:

[1]郑少雄.罗格列酮和心血管风险——近期文献解读[J].国际内分泌代谢杂志,2007,(04):231.
[2]凌厉,朱本章.胰岛素类似物安全性研究进展[J].国际内分泌代谢杂志,2007,(04):234.
[3]李颖,刘东方.餐后1小时血糖升高的意义及干预[J].国际内分泌代谢杂志,2007,(04):235.
[4]崔巍,施秉银.内质网应激介导β细胞生存/死亡的研究进展[J].国际内分泌代谢杂志,2007,(04):256.
[5]杨叶虹,胡仁明.SELDI-TOF-MS技术及其在糖尿病研究中的应用[J].国际内分泌代谢杂志,2007,(04):261.
[6]高妍.针对华人糖尿病特点优化降糖方案[J].国际内分泌代谢杂志,2007,(04):269.
[7]杨志霞,郭莹辉,杨永生,等.胰岛素泵和多次皮下注射治疗糖尿病的比较[J].国际内分泌代谢杂志,2007,(04):273.
[8]周建英,马向华.胃旁路术减肥同时改善糖代谢的机制[J].国际内分泌代谢杂志,2007,(04):285.
[9]李翠柳,朱大龙.破译肠道代谢信息,驱动治疗革新[J].国际内分泌代谢杂志,2014,(06):383.[doi:10.3760/cma.j.issn.1673-4157.2014.06.006]
 Li Cuiliu*,Zhu Dalong..Deciphering metabolic messages from the gut drives therapeutic innovation[J].International Journal of Endocrinology and Metabolism,2014,(03):383.[doi:10.3760/cma.j.issn.1673-4157.2014.06.006]
[10]袁捷 姜云生 杜彦丽 王肃.1型糖尿病对小鼠早孕时期子宫肌层结构和细胞增殖的影响[J].国际内分泌代谢杂志,2015,(01):6.[doi:10.3760/cma.j.issn.1673-4157.2015.01.002]
 Yuan JieJiang YunshengDu YanliWang Su.Effects of type 1 diabetes on the muscularis structure and cell proliferation of uterine in mice during early pregnancy[J].International Journal of Endocrinology and Metabolism,2015,(03):6.[doi:10.3760/cma.j.issn.1673-4157.2015.01.002]

备注/Memo

备注/Memo:
基金项目:国家临床重点专科建设项目(2011)
更新日期/Last Update: 2017-05-20