免疫遗传学研究对儿童尿石症发病率的预测能力

SH.A. YUSUPOV, L.R. KHAKIMOVA
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摘要

目的:探讨乌兹别克儿童尿石症(UL)发生的遗传多态性。方法:研究于2012 - 2019年在撒马尔罕国立医科大学儿童外科专科医院进行。在第一阶段,对652例住院患者的病史进行回顾性分析。在第二阶段,200名1 - 17岁的儿童被纳入研究,其中100人被诊断为UL(主要组),100人组成没有UL的对照组(住院接受小手术干预,如包皮环切术或疝修补术)。对维生素D受体(VDR)、IL-1β和IL-18基因进行免疫遗传学研究。结果:VDR和IL-1β基因多态性在UL易感性中起重要作用。在各研究组中,VDR基因(Fok-1)的F/ F + F/ F基因型与UL的相关性有统计学意义,主组的相关性是对照组的1.3倍(p=0.033;χ2 = 4.56)。IL-1β基因C/C等位基因在主组和对照组的检出率显著高于对照组(p=0.027;χ2 = 7.23;df = 2)。各遗传模式IL-18 (+105A/C)基因多态性频率分布在主、对照组间差异无统计学意义(p>0.05;χ2 = 3.93;df = 2)。结论:VDR和IL-1β基因多态性标记物分布的研究确定了免疫遗传学方法在乌兹别克人群儿童UL易感性检测中的作用,提示免疫遗传学因素在乌兹别克人群儿童UL易感性中具有重要意义,可在临床前阶段预测该疾病。因此,为了乌兹别克儿童UL的早期诊断,在复杂的检查程序中包括FokI基因型和VDR和IL-1β基因多态性检测是合理的。
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PREDICTIVE ABILITY OF IMMUNOGENETIC STUDIES FOR INCIDENCE OF UROLITHIASIS IN CHILDREN
Objective: To determine the genetic polymorphism associated with the development of urolithiasis (UL) in children of the Uzbek population. Methods: The study was conducted in the Specialized Children's Surgical Hospital of the Samarkand State Medical University between 2012 and 2019. In the first stage, a retrospective analysis of the case histories of 652 admitted patients was undertaken. In the second stage, 200 children aged 1 to 17 years were enrolled in the study, of which 100 were diagnosed with UL (main group), and 100 comprised the control group without UL (hospitalized for minor planned surgical interventions, such as circumcision or hernia repair). Immunogenetic studies of the vitamin D receptor (VDR), IL-1β, and IL-18 genes were carried out. Results: The obtained results indicate that polymorphism of the VDR and IL-1β genes plays an important role in susceptibility to UL. In the study groups, a statistically significant association of F/f+f/f genotypes of the VDR gene (Fok-1) with UL was found, which was 1.3 times more frequent in the main group than in the control one (p=0.033; χ2 =4.56). The C/C allele of the IL-1β gene was significantly more frequently detected in the main vs. control group (p=0.027; χ2 =7.23; df=2). The distribution of frequency of IL-18 (+105A/C) gene polymorphism for all models of inheritance was not statistically significantly different in the main and control groups (p>0.05; χ2 =3.93; df=2). Conclusion: : The role of the immunogenetic method in the detection of susceptibility to UL development was determined in the study of the distribution of polymorphic markers of the VDR and IL-1β genes, indicating the significance of the immunogenetic factors for the predisposition to UL in children of the Uzbek population which may predict the disease at its preclinical stage. Therefore, in the interests of the early diagnosis of UL in children of the Uzbek population, it is reasonable to include testing for FokI genotype and polymorphism of VDR and IL-1β genes in the complex program of examination.
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