血清FGF-21、Adropin水平与糖尿病肾脏病的相关性研究

发布时间：2018-02-28 14:21

本文关键词： 糖尿病肾脏病糖尿病 2型尿白蛋白排泄率 FGF-21 Adropin　出处：《遵义医学院》2017年硕士论文　论文类型：学位论文

【摘要】：目的:观察2型糖尿病及糖尿病肾脏病患者血清成纤维细胞生长因子21(FGF-21)、Adropin水平,探讨FGF-21、Adropin与糖尿病肾脏病之间的关系。方法:选择T2DM患者114例,按尿白蛋白排泄率(AER)分为单纯2型糖尿病组(T2DM)、微量白蛋白尿组(mic-DKD)、大量白蛋白尿组(mac-DKD)。同期选取36例糖耐量受损患者作为糖耐量异常组(IGT),42例健康人群作为正常对照组。测定各组研究对象空腹静脉血糖(FPG)、糖化血红蛋白(HbA1c)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)、血肌酐(SCr)、空腹胰岛素(FIns)、餐后2h胰岛素(2hINS)水平及AER,收集身高、体重、腰围(WC)、收缩压(SBP)、舒张压(DBP)等资料,计算体重指数(BMI)、肾小球滤过率(eGFR)、尿白蛋白与肌酐比值(ACR)、稳态模型胰岛素抵抗指数(HOMA-IR)、稳态模型胰岛素分泌指数(HOMA-β)。采用酶联免疫吸附测定(ELISA)法测定血清FGF-21、Adropin水平。结果:1.微量白蛋白尿组和大量白蛋白尿组WC、SBP、DBP、FPG、HbA1c、HOMA-IR、FGF21均高于正常对照组,差异均有统计学意义(P0.05)。单纯2型糖尿病组、微量白蛋白尿组及大量白蛋白尿组HDL-C、HOMA-β、eGFR、adropin均低于正常对照组,差异均有统计学意义(P0.05)。2.Adropin与SBP、DBP、FPG、HbA1c、TG、AER、ACR、FGF21呈负相关(P0.05)。3.FPG、HbA1c、Adropin是DKD患者24h尿白蛋白的独立危险因素。结论:FGF21可能与DKD有关,但影响DKD发生发展的具体机制尚不明确;2型糖尿病患者血清Adropin水平降低可能参与DKD的发生发展。
[Abstract]:Objective: to observe the level of serum fibroblast growth factor 21FGF-21 adropin in patients with type 2 diabetes mellitus and diabetic kidney disease, and to explore the relationship between FGF-21 adropin and diabetic kidney disease. According to the urinary albumin excretion rate (AER), the patients were divided into three groups: type 2 diabetes mellitus group (T2DMN), microalbuminuria group (mic-DKDN), and large albuminuria group (mac-DKDN). In the same period, 36 patients with impaired glucose tolerance were selected as impaired glucose tolerance group and 42 healthy persons as normal control group. The levels of fasting venous blood glucose (FPG), HbA1cn, triglyceride (TGN), total cholesterol (TC), high density lipoprotein (HDL-C), low density lipoprotein (LDL-C), serum creatinine (creatinine), fasting insulin (FInsn), 2 h postprandial insulin (2hINS) and AER2 h postprandial were measured. Weight, waist circumference, systolic blood pressure (SBP), diastolic blood pressure (DBP), etc. Body mass index (BMI), glomerular filtration rate (GFR), urinary albumin / creatinine ratio (ACRA), homeostasis model insulin resistance index (HOMA-IRN) and homeostasis model insulin secretion index (Homa 尾) were calculated. Serum FGF-21 Adropin levels were measured by Elisa. In microalbuminuria group and large albuminuria group, the levels of HbA1cHbA1cHbA1cHbA1-IRFGF21 were higher than those in the normal control group. The difference was statistically significant (P 0.05). The levels of HDL-Con HOMA- 尾 eGFRadropin in type 2 diabetes mellitus group, microalbuminuria group and large albuminuria group were lower than those in normal control group. There was a negative correlation between P0.05N. 2.Adropin and SBPnDBPfGN HbA1cFGF21 in DKD patients. 3. FGF21 was an independent risk factor for 24 hours urinary albumin in patients with DKD. Conclusion: FGF21 may be related to DKD, and it may be associated with HbA1C / FGF21 / ACRFGF21, which is a significant risk factor for 24 hours urinary albumin in patients with DKD (P < 0. 05, P = 0. 05, P = 0. 05, P = 0. 05, P = 0. 05). However, the mechanism of affecting the occurrence and development of DKD is not clear. The decrease of serum Adropin level may be involved in the pathogenesis and development of DKD in patients with type 2 diabetes mellitus.
【学位授予单位】：遵义医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R587.2;R692.9

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