血清胎球蛋白A水平与糖尿病下肢血管病变的关系

发布时间：2018-07-02 19:23

本文选题：2型糖尿病 + 胰岛素抵抗　；参考：《新疆医科大学》2017年硕士论文

【摘要】：目的:研究正常对照组(A组)、2型糖尿病非下肢血管病变组(B组)和2型糖尿病下肢血管病变组的血清胎球蛋白A(Fetuin-A)的水平与胰岛素抵抗、血脂、血糖、踝肱指数(Ankle brachial index,ABI)的相关性,并探讨ABI的影响因素。方法:选取2015年3月至2016年12月在我院体检中心、内分泌科住院及门诊病人,根据血糖、糖化血红蛋白、糖耐量试验及ABI指标等将患者分为3组:正常对照组(A组),共30例,糖尿病非下肢血管病变组(B组),共31例,糖尿病下肢血管病变组(C组),共35例。测量血压(BP)、体重(BW)、身高(H),计算体重指数(BMI),同时,空腹取血测定其血糖(GLU)、糖化血红蛋白(Hb Alc)、甘油三酯(TG)、胆固醇(TC)、高密度脂蛋白胆固醇(HDL)、低密度脂蛋白胆固醇(LDL)。采用酶联免疫吸附法(ELISA)测定血清胎球蛋白A的水平。结果:(1)一般情况,96例患者中,男52例,女44例,平均年龄59.65士4.23岁。A组(30例)、B组(31例)、C组(35例)的年龄、性别、病程、身高及DBP无统计学差异(P0.05),体重、BMI及SBP及ABI具有统计学意义(P0.05)。(2)B组和C组的CRP、FPG、PPG、HbA1c、HOMA-IR、TG、TC、LDL、HDL均高于A组,除TG外与正常对照组比较,差异均有统计学意义(P0.05),C组高于A组,除HbA1c外,两者差异均有统计学意义(P0.05))。(3)Fetuin-A水平在A、B、C三组中分别为(389.75±79.1)、(513.77±75.51)(456.92±75.53),且差异均具有统计学意义(P0.05)。(4)相关分析结果显示,在A组中,Fetuin-A与年龄呈负相关,且有统计学意义(P0.05)。在B组中,Fetuin-A与体重、BMI、PPG、Hb A1c、HOMA-IR、TG成正相关,与HDL成负相关,且有统计学意义(P0.05)。在C组中,Fetuin-A与年龄、HDL呈负相关,与体重、BMI、ABI、CRP、PPG、HbA1c、HOMA-IR、TG成正相关,且有统计学意义(P0.05)。(5)在C组中随着ABI的逐渐降低,血清Fetuin-A水平逐渐下降,且有显著性差异(P0.05)。多元线性逐步回归分析显示:Fetuin-A、HDL及SBP是ABI的独立影响因素。结论:2型糖尿病非下肢血管病变组和2型糖尿病下肢血管病变组与正常对照组相比,存在明显的IR和较高水平的血清胎球蛋白A,提示高水平的血清胎球蛋白A参与了糖尿病胰岛素抵抗的发展,促进了糖尿病的发生。血清胎球蛋白A在2型糖尿病下肢血管病变患者中随着ABI值降低,水平逐渐降低,提示低水平的血清胎球蛋白A预示着糖尿病下肢血管的病变,胎球蛋白A可能参与血管钙化。
[Abstract]:Objective: to study the correlation between serum fetuin-A (Fetuin-A) levels and insulin resistance, blood lipid, blood glucose, ankle-brachial index (Ankle brachial) in patients with type 2 diabetes mellitus (group B) and patients with type 2 diabetes mellitus (group B). The influencing factors of ABI were discussed. Methods: according to blood glucose, glycosylated hemoglobin, glucose tolerance test and ABI index, the patients were divided into 3 groups: normal control group (group A). There were 31 cases in diabetic group (group B) and 35 cases in group C (group C). Blood pressure (BP), body weight (BW), height (H), body mass index (BMI), blood glucose (GLU), glycosylated hemoglobin (TG), cholesterol (TC), high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) were measured. The level of serum fetal globin A was determined by enzyme linked immunosorbent assay (Elisa). Results: (1) the average age, sex and course of disease were 59.65 卤4.23 years old in group A (30 cases), 31 cases in group B (31 cases) and 35 cases in group C (35 cases). There was no significant difference in height and DBP (P0.05). There were significant differences in body weight,). (and). (between group B and group C (P0.05). The HDL-C of). (group B and group C were significantly higher than those of group A, except TG, the difference was statistically significant (P0.05), except for HbA1c, HbA1c, HbA1c, HbA1c, HbA1c, HbA1c, HbA1c, HbA1c, HbA1c, HbA1c, HbA1c, HbA1c, HbA1c, HbA1c, HbA1c. The level of Fetuin-A was (389.75 卤79.1), (513.77 卤75.51) (456.92 卤75.53) in group C (P0.05). (3), and the correlation analysis showed that Fetuin-A was negatively correlated with age in group A (P0.05). In group B, Fetuin-A was positively correlated with HbA1cHMA-IRTG, and negatively correlated with HDL (P0.05). In group C, Fetuin-A was negatively correlated with age and serum Fetuin-A was significantly lower than that in group C (P0.05), and the serum Fetuin-A level was significantly lower than that in group C (P0.05). Multivariate linear stepwise regression analysis showed that: Fetuin-Atrol HDL and SBP were independent influencing factors of ABI. Conclusion compared with the normal control group, the non-lower extremity vascular lesion group of type 2 diabetes mellitus and the lower limb vascular disease group of type 2 diabetes mellitus are different from those of the normal control group. There is obvious IR and high level of serum fetal globin A, which suggests that the high level of serum fetal globin A is involved in the development of insulin resistance in diabetes mellitus and promotes the development of diabetes mellitus. The level of serum fetal globin A in patients with type 2 diabetic lower extremity vascular disease decreased with the decrease of ABI value, suggesting that the low level of serum fetal globin A may be involved in vascular calcification of the lower extremity of diabetes mellitus.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R587.2;R543

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