Abstract: Objective To investigate the relationship between TLR₄ gene polymorphism and LEAD in patients with T2DM-PTB. Methods We recruited 87 cases with T2DM-PTB patients complicated with LEAD and 68 cases with T2DM-PTB from Infectious Hospital of Heilongjiang Province between September 2013 and June 2015. The basic information of both T2DM-PTB patients complicated with LEAD and T2DM-PTB patients were collected. Meanwhile, peripheral blood was collected in order to undergo gene polymorphism analysis. DNA was extracted by genomic DNA extraction kits and genotyping was accomplished by using Real-time PCR (Taqman probe method). Three TLR₄ gene loci (rs 7873784, rs1927911, rs1927914) were tested. Results Allele distribution of TLR₄ gene SNPs locus in the observation group and the control group: The G allele of rs7873784 were 91.38% (159/174) and 91.18% (124/136) in the two groups, and the C allele were 8.62% (15/174) and 8.82% (12/136) in the two groups, respectively. There was no significant difference between the two groups (χ²=0.00,P=0.950); The T allele of rs1927911 in two groups were 59.20% (103/174) and 61.76% (84/136), respectively, and the C allele were 40.80% (71/174) and 38.24% (52/136), respectively. There was no significant difference between the two groups (χ²=0.21,P=0.646); The T allele of rs1927914 in two groups were 59.77% (104/174) and 64.71% (88/136), respectively, and the C allele were 40.23% (70/174) and 35.29% (48/136), respectively. There was no significant difference between the two groups (χ²=0.79,P=0.374). Genotype distribution of TLR₄ gene SNP locus in the observation group and the control group: The GG genotypes of rs7873784 were 82.76% (72/87) and 82.35% (56/68) in two group, and the GC genotype of the two groups were 17.24% (15/87) and 17.65% (12/68), respectively. The difference between the two groups was not statistically significant (χ²=0.00,P=0.947). The TT genotypes of rs1927911 were 32.18% (28/87) and 35.30% (24/68) in two groups, the CT genotype of the two groups were 54.02% (47/87) and 52.94% (36/68), and the CC genotype of the two groups were 13.80% (12/87), 11.76% (8/68), respectively. The difference between the two groups was not statistically significant (χ²=0.24,P=0.887). The TT genotypes of rs1927914 were 33.33% (29/87) and 42.65% (29/68) in two groups, the CT genotypes of two groups were 52.87% (46/87) and 44.12% (30/68), and the CC genotypes of two groups were 13.80% (12/87), 13.23% (9/68), respectively. The difference between the two groups was not statistically significant (χ²=1.49,P=0.475). Rs7873784 gene locus of TLR₄: compared with wild homozygous genotype GG, the adjusted OR value of GC genotype was 0.90 (95%CI:0.39-2.06, P=0.80). Rs1927911 gene locus of TLR₄: compared with wild homozygous genotype TT, the adjusted OR values of CT genotype and CC genotype were 1.00 (95%CI:0.51-1.97, P=1.00) and 1.29 (95%CI:0.46-3.66, P=0.63), respectively. Rs1927914 gene locus of TLR₄: compared with wild homozygous genotype TT, the adjusted OR values of CT genotype and CC genotype were 1.27 (95%CI:0.64-2.51, P=0.49) and 1.24 (95%CI:0.47-3.27, P=0.67), respectively. There was no significant difference between the 3 genotypes at different loci (P>0.05). Conclusion The polymorphisms of rs7873784, rs1927911 and rs1927914 in TLR₄ gene are not associated with LEAD in T2DM-PTB patients.

Key words: Tuberculosis, pulmonary, Diabetes mellitus, type 2, Comorbidity, Toll-like receptor 4, Diabetic angiopathies, Causality