新诊断2型糖尿病颈动脉内中膜厚度与血清脂联素、Chemerin的相关性研究

发布时间：2018-03-07 00:31

  本文选题：糖尿病　切入点：糖尿病大血管病变　出处：《山西医科大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的:近年来,随着人们生活与饮食结构显著改变,肥胖、糖尿病等威胁人类健康的非传染疾病越来越多。2型糖尿病(T2DM)患者常伴有高血糖、肥胖等多种心血管疾病的危险要素,这些因素综合作用加速动脉粥样硬化进程,严重影响患者身心健康。在T2DM患者中,绝大多数属于超重或者肥胖[1]。其中脂肪细胞分泌的脂肪细胞因子有可能是肥胖与糖尿病两者潜在联系的分子基础。脂联素(adiponectin,ADP),趋化因子Chemerin等脂肪细胞因子参与糖类和脂质代谢途径,促进糖尿病大血管病变的发生、发展。本文探讨新诊断T2DM患者颈动脉内中膜厚度与内脏型肥胖及脂肪细胞因子ADP,Chemerin和同型半胱氨酸(homocysteine,hcy)的关系。方法:收集2013年3月至2014年10月于山西省人民医院内分泌科住院及门诊就诊的60例新诊断T2DM患者,并选择20例体检正常者作对照组。依据颈动脉超声测得的颈动脉内中膜厚度(Carotid artery intima media thickness,CIMT)值将入选的新诊断T2DM患者分2组,CIMT增厚组(CIMT0.9mm)28例及CIMT正常组(CIMT≤0.9mm)32例,采集空腹静脉血,测定Chemerin、ADP、hcy、TG、TC、LDL-C、Hb A1c和空腹胰岛素(fasting insulin,Flns)等相关指标。分析新诊断2型糖尿病患者CIMT与BMI,腰围,腰臀比(waist-hip ratio,WHR),血清Chemerin,ADP,hcy等的关系。结果:1.新诊断T2DM患者的腰围,WHR,Chemerin及hcy水平高于对照组,ADP低于对照组;CIMT增厚组腰围,腰臀比,Chemerin,hcy水平高于CIMT正常组,而ADP水平低于CIMT正常组。2.血清Chemerin与腰围,腰臀比,糖化血红蛋白,胰岛素抵抗指数(homeostasis model of assessment-insulin resistence,HOMA-IR)呈正相关。3.血清hcy水平与BMI,腰围,WHR,Hb A1c,HOMA-IR呈正相关。4.血清ADP水平与体质指数,腰围,WHR,糖化血红蛋白,胰岛素抵抗指数呈负相关。5.新诊断T2DM组CIMT影响因素的多元逐步回归分析。以CIMT为因变量,BMI,腰围,腰臀比,TC,TG,LDL,HDL,Hb A1c,FPG,HOMA-IR,Chemerin,hcy,ADP为自变量,在校正年龄、性别后,用多元逐步回归分析筛选变量,发现CIMT与ADP呈负相关,与腰围,TG,LDL,Hb A1c,FPG,Chemerin,hcy呈正相关,与其余指标无显著相关。结论:T2DM合并糖尿病大血管病变的患者血清趋化素Chemerin及hcy水平明显升高,ADP水平下降。腹型肥胖时,Chemerin水平升高,ADP水平下降可能通过不同途径参与T2DM大血管病变的发生和发展,联合测定Chemerin及脂联素水平可能对糖尿病大血管病变的预测有重要价值。
[Abstract]:Objective: in recent years, with the significant changes in people's life and diet structure, obesity, diabetes and other non-communicable diseases threatening human health, more and more type 2 diabetes mellitus T2DM) patients are often accompanied by hyperglycemia, obesity and other cardiovascular disease risk factors. The combined effects of these factors accelerate the progression of atherosclerosis and seriously affect the physical and mental health of patients with T2DM. Most of them are overweight or obese [1] .Adipose cytokines secreted by adipocytes may be the molecular basis of the potential link between obesity and diabetes. Adiponectin, Chemerin and other adipocytokines are involved in carbohydrates. And lipid metabolism pathways, Promote the development of diabetic macroangiopathy, The relationship between carotid intima-media thickness (IMT) and visceral obesity, adipocyte factor (ADP- Chemerin) and homocysteine homocysteine (homocysteine) in newly diagnosed T2DM patients was investigated. Methods: from March 2013 to October 2014, the patients were collected in Shanxi Provincial people's Hospital. 60 newly diagnosed T2DM patients in secretory department and outpatient department, Twenty normal subjects were selected as control group. The newly diagnosed T2DM patients were divided into 2 groups according to carotid artery artery intima media thicknessCIMT, 28 patients with CIMT thickening group and 32 patients with CIMT normal group with CIMT 鈮，

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