Effects of TLR-9(1237 T/C)gene polymorphism on recurrent infection in patients with diabetic foot
10.12092/j.issn.1009-2501.2025.07.010
- VernacularTitle:TLR-9(1237 T/C)基因多态性对糖尿病足患者复发感染的影响
- Author:
Jing HU
1
;
Di ZHANG
;
Erlin CHENG
Author Information
1. 新疆医科大学第一附属医院伤口治疗门诊,乌鲁木齐 830054,新疆
- Publication Type:Journal Article
- Keywords:
toll-like receptor 9;
single nucleotide polymorphism;
diabetic foot;
recurrent infection
- From:
Chinese Journal of Clinical Pharmacology and Therapeutics
2025;30(7):950-960
- CountryChina
- Language:Chinese
-
Abstract:
AIM:To investigate the effect of Toll-like receptor 9(TLR-9)gene rs5743836(1237 T/C)single nucleotide polymorphism on recurrent infec-tion in patients with diabetic foot(DF).MEHTODS:A total of 128 DF patients admitted to our hospital from June 2020 to June 2022 were collected and di-vided into an infected group(n=53)and a non-in-fected group(n=75)according to the presence or absence of recurrent infection.The general data and TLR-9 gene polymorphism were compared be-tween the two groups.The genotypes and allele frequencies of TLR-9(1237 T/C)gene polymor-phism were detected and compared between the two groups.Logistic regression was used to analyze the correlation between TLR-9 gene 1237 T/C poly-morphism and recurrence of DF patients.RESULTS:There were significant differences between the two groups in invasive operation,course of antibiotic use and peripheral vascular disease of both lower limbs(P＜0.05).The wild type TT homozygote pro-duced two fragments of 108 bp and 27 bp in length,the variant CC homozygote produced three fragments of 60 bp,48 bp and 27 bp in length,and the heterozygous TC produced four fragments of 108 bp,60 bp,48 bp and 27 bp in length.The TLR-9(1237 T/C)gene identity was 100％.The genotype frequencies met the Hardy-Weinberg genetic equi-librium(P＞0.05).There were significant differences in CC gene frequency,TC gene frequency,TT gene frequency,C gene distribution and T gene distribu-tion between the two groups(P＜0.05).Logistic re-gression analysis showed that TLR-9 CC genotype increased the risk of recurrent infection in DF pa-tients in the co-dominant model(OR=5.357,95％CI:1.901-15.100).After adjusting for sex,age and smoking(OR=5.341,95％CI:1.874-15.015,P＜0.01),the C allele significantly increased the risk of recur-rent infection in DF patients(OR=2.328,95％CI:1.874-15.015,P＜0.01).1.078-5.936),and the differ-ence was statistically significant(P＜0.01).The TT genotype and CC+TC genotype of TLR-9 were not significantly associated with smoking history,Wag-ner grade,peripheral neuropathy,retinopathy,hy-pertension,osteoporosis and lower extremity arte-riosclerosis obliterans in DF patients(P＞0.05).There were significant differences in the course of DM,DF,levels of HbAlc,LDL-C,CRP and PCT be-tween patients with CC genotype and patients with TT+TC genotype(P＜0.05).CC genotype,DM dura-tion ≥9 years,DF duration ≥5 months,HbAlc＜5.00％,LDL-C≥3.03 mmol/L,CRP≥23.25 mg/mL,PCT≥0.87 ng/mL were risk factors for recurrent infec-tion in DF patients(P＜0.05).HbAlc,LDL-C,CRP and PCT all showed interaction with TLR-9(1237 T/C)gene.The risk of recurrent infection in DF patients with abnormal HbAlc,LDL-C,CRP and PCT levels and TLR-9(1237 T/C)gene polymorphism interac-tion combination was 2.659 times higher than that in DF patients without the above combination,and the difference was statistically significant(P＜0.05).CONCLUSION:CC genotype and C allele of TLR-9 gene 1237 T/C are independent risk factors for re-current infection in DF patients.
