血清FABP4、irisin以及CMPF与糖脂代谢关系的临床研究

发布时间：2018-02-28 13:43

本文关键词： 脂肪细胞型脂肪酸结合蛋白 irisin 3-羧-4-甲-5-丙基呋喃戊酮酸 2型糖尿病胰岛β细胞功能　出处：《南方医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：背景最近几年来,越来越多的研究表明,肥胖与细胞因子中的FABP4密切有关,而且肥胖相关的胰岛素抵抗也与FABP4有着紧密的关联。Irisin是新近发现的一种细胞因子,在体内和体外的研究中发现,运动诱导irisin的大量分泌,在一定程度上改善胰岛素抵抗。然而,脂肪细胞因子FABP4与irisin之间又有怎样的关联呢?另外,CMPF在2型糖尿病一级亲属这一高危人群中的血清浓度尚不清楚,并且关于CMPF与人体胰岛β细胞分泌功能的研究尚少。因此,本研究旨在探讨血清irisin和FABP4之间的关联,以及不同糖代谢状态下CMPF的浓度和其与糖脂代谢和胰岛β细胞分泌功能之间的关联。目的1.探讨在社区人群中血清FABP4和irisin水平,与糖脂代谢的关联以及两者的相关性;2.检测在2型糖尿病患者的血清中细胞因子FABP4与irisin的水平,探讨这两个指标之间的关联;3.探讨不同糖代谢状态下CMPF的浓度和其与糖脂代谢和胰岛β细胞分泌功能之间的关联。方法招募上海市奉贤区40-60岁近半年内体检身体健康志愿者111名,其中男性56名,女性55名。另招募上海市奉贤区新诊断T2DM患者99名,糖尿病前期患者99名,T2DM—级亲属99名,糖耐量正常者99名。按照2003年ADA的诊断标准来诊断糖尿病前期和T2DM。采用酶联免疫吸附试验ELISA法检测血清中细胞因子FABP4、CMPF及irisin的表达水平。结果1.血清FABP4浓度与性别相关(r=0.348,P0.001),女性明显高于男性。矫正性别后的偏相关分析提示血清FABP4水平与舒张压(r=0.270,P=0.005)、体脂百分比(r=0.251,P=0.012)呈正相关,与骨骼肌质量(r=-0.335,P=0.001)、irisin(r=-0.203,P=0.033)呈负相关。2.与糖耐量正常组相比较,血清CMPF浓度在糖尿病前期(P=0.019)、新诊断T2DM组(P0.001)和T2DM—级亲属组(P0.001)显著升高。双相关分析表明血清CMPF水平与体重指数(r=-0.129,P=0.037)、甘油三酯(r=-0.203,P=0.001)、早相胰岛素分泌指数(r=-0.150,P=0.015)、晚相胰岛素分泌指数(r=-0.127,P=0.041)呈负相关。结论1.在我国40-60岁中年社区人群中,血清irisin水平与FABP4呈独立相关。血清irisin表达水平与糖脂代谢以及肾功能好坏的关系十分密切。新诊断T2DM患者血清irisin与FABP4呈独立负相关,提示irisin可能具有拮抗FABP4的作用。2.血清CMPF水平在糖尿病前期、T2DM及T2DM—级亲属中浓度明显升高。血清CMPF水平与胰岛β细胞分泌功能呈独立相关,随着CMPF水平的升高β细胞分泌功能逐渐下降。因此,本研究表明血清CMPF浓度与糖代谢紊乱相关,CMPF浓度的升高可能是导致高血糖及β细胞功能障碍的相关因素。
[Abstract]:Background in recent years, more and more studies have shown that obesity is closely related to FABP4 in cytokines, and obesity related insulin resistance is closely related to FABP4. Irisin is a newly discovered cytokine. In vivo and in vitro, it has been found that exercise induces a large amount of irisin secretion and improves insulin resistance to some extent. However, what is the relationship between the adipocyte factor FABP4 and irisin? In addition, the serum concentration of CMPF in first-degree relatives of type 2 diabetes is not clear, and there are few studies on the relationship between CMPF and 尾 -cell secretion in human pancreatic islets. Therefore, the purpose of this study is to explore the relationship between serum irisin and FABP4. And the relationship between the concentration of CMPF and the glucose and lipid metabolism and the secretion function of islet 尾 cells under different glucose metabolism. Objective 1. To explore the levels of serum FABP4 and irisin in community population. The relationship between glucose and lipid metabolism and the correlation between them. 2. The levels of cytokines FABP4 and irisin in the serum of patients with type 2 diabetes mellitus were detected. To explore the correlation between these two indexes. To study the concentration of CMPF in different glucose metabolism state and its relationship with glucose and lipid metabolism and 尾 -cell secretory function. Methods physical examination was conducted in Fengxian District of Shanghai within nearly half a year of 40-60 years old. 111 healthy volunteers, Among them, 56 were males and 55 were females. 99 newly diagnosed T2DM patients were recruited from Fengxian District of Shanghai, 99 relatives of pre-diabetic patients with T2DM- grade, 99 subjects with normal glucose tolerance were diagnosed as prediabetic and T2DMaccording to the diagnostic criteria of ADA in 2003. The expression levels of cytokine FABP4CMPF and irisin in serum were detected by enzyme linked immunosorbent assay (ELISA). 1. Serum FABP4 concentration and sex. The results of partial correlation analysis showed that the serum FABP4 level was positively correlated with diastolic blood pressure (DBP) 0.270, and the percentage of body fat was 0.251% (P < 0.012). There was a negative correlation with the skeletal muscle mass, ru -0.335P ~ (0.001) and ~ (0.203) ~ (P ~ (0.033)). 2. Compared with the normal glucose tolerance group, there was a negative correlation between the two groups, and compared with the normal glucose tolerance group, there was no significant difference between the two groups. Serum CMPF level was significantly higher in prediabetic patients than in newly diagnosed T2DM group (P 0.001) and T2DM-grade relatives group (P 0.001). Double correlation analysis showed that serum CMPF level and body mass index (BMI) were 0.129%, 0.129% and 0.037%, triglyceride level -0.203P0.001, early phase insulin secretion index (r = -0.150), late phase insulin secretion, and late phase insulin secretion, respectively. Conclusion 1. In the middle aged community population of 40-60 years old, there is a negative correlation between r and 0.127 (P = 0.041). Serum irisin level was independently correlated with FABP4, serum irisin expression level was closely related to glycolipid metabolism and renal function. Serum irisin was negatively correlated with FABP4 in newly diagnosed T2DM patients. The results suggest that irisin may antagonize FABP4. 2. Serum CMPF level is significantly increased in prediabetic patients with T2DM and T2DM- grade relatives. Serum CMPF level is independent of islet 尾 -cell secretory function. As the level of CMPF increased, 尾 -cell secretory function decreased gradually. Therefore, this study suggests that the increase of serum CMPF concentration and glucose metabolism disorder may be the related factors of hyperglycemia and 尾 -cell dysfunction.
【学位授予单位】：南方医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R587.1

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