初诊2型糖尿病伴腹型肥胖与血胰高糖素样肽1相关性研究

发布时间：2018-04-18 00:30

  本文选题：2型糖尿病 + 血胰高糖素样肽1　； 参考：《安徽医科大学》2017年硕士论文

【摘要】：研究目的2型糖尿病(type 2 diabetes mellitus,T2DM)的发病机制目前仍然不明确,随着研究的深入,胰高糖素样肽1(Glucagon-like peptide 1,GLP-1)与T2DM的关系逐渐受到关注。近年来,多数研究主要集中在外源性GLP-1(即胰高糖素样肽1类似物或受体激动剂)对T2DM血糖的控制、体重和肥胖的改善方面。然而初诊T2DM内源性GLP-1水平及其与腹型肥胖的关系目前尚无定论。故本研究通过检测初诊T2DM伴腹型肥胖患者内源性血GLP-1水平,以及所有入组患者的空腹血糖、血脂、糖化血红蛋白、C肽、胰高糖素、肝肾功能等指标,探讨初诊T2DM伴腹型肥胖与GLP-1的相关性以及影响GLP-1水平的因素。研究方法本课题的研究对象均选自于2015年2月至2016年2月在安徽医科大学第三附属医院内分泌科住院的初诊T2DM患者,共计102例,其中男性60例,女性42例,年龄在29-76岁之间。T2DM诊断标准均符合1999年世界卫生组织诊断标准。腹型肥胖符合2007年《中国成人血脂异常防治指南标准》中的诊断标准(即男性腰围≥90cm,女性腰围≥85cm)。按腰围不同分为腹型肥胖组(AO组)59例、非腹型肥胖组(NA0组)43例。所有患者测量身高、体重、腰围,并于次日清晨抽取空腹静脉血,测定糖化血红蛋白、空腹血糖、血尿酸、总胆固醇、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、极低密度脂蛋白胆固醇、谷丙转氨酶、谷草转氨酶、谷氨酰胺转肽酶、碱性磷酸酶、肌酐、尿素氮、C肽、血胰高糖素、GLP-1。研究结果1.NA0组血GLP-1水平明显高于AO组,差异有统计学意义(P0.05);AO组腰围、体重指数、血尿酸、血糖、C肽、胰高糖素、总胆固醇、甘油三酯、极低密度脂蛋白胆固醇、谷丙转氨酶、谷草转氨酶均明显高于NAO组,差异均有统计学意义(P0.05),而两组其他指标差异无统计学意义(P0.05)。2.GLP-1与各指标Pearson相关分析结果显示:血GLP-1与腰围、体质指数、血糖、糖化血红蛋白A1c、总胆固醇均呈负相关(r值分别为-0.518,-0.230,-0.221,-0.591,-0.632),差异均有统计学意义(P0.05),与C肽呈正相关(r值为0.244),差异有统计学意义(P0.05),而与甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、极低密度脂蛋白胆固醇、血尿酸、胰高糖素等指标无相关性(P0.05)。3.以血GLP-1为因变量,以腰围、体质指数、血糖、糖化血红蛋白A1c、总胆固醇为自变量,进行回归分析,结果显示腰围、总胆固醇、血糖、糖化血红蛋白A1c为血清GLP-1水平的独立影响因素(β值分别为-0.452,-0.311,0.237,-0.398;P0.05)。研究结论1.初诊T2DM伴腹型肥胖血GLP-1水平明显低于非腹型肥胖T2DM。2.腰围、总胆固醇、血糖、糖化血红蛋白A1c与GLP-1具有相关性,是影响其水平的因素。
[Abstract]:Objective the pathogenesis of type 2 diabetes mellitus type 2 diabetes mellitusus T2DMis is still unclear. With the further study, the relationship between 1(Glucagon-like peptide 1 and T2DM has been paid more and more attention.In recent years, most studies have focused on the effects of exogenous GLP-1 (glucagon like peptide-1 analogues or receptor agonists) on T2DM blood glucose control, weight and obesity improvement.However, the level of endogenous GLP-1 in newly diagnosed T2DM and its relationship with abdominal obesity are still unknown.Therefore, the levels of endogenous GLP-1 in newly diagnosed T2DM patients with abdominal obesity, fasting blood glucose, blood lipid, glycosylated hemoglobin C peptide, glucagon, liver and kidney function were measured.To investigate the correlation between newly diagnosed T2DM with abdominal obesity and GLP-1 and the factors influencing the level of GLP-1.Methods the subjects of this study were 102 newly diagnosed T2DM patients, including 60 males and 42 females, who were hospitalized in the Endocrinology Department of the third affiliated Hospital of Anhui Medical University from February 2015 to February 2016.The diagnostic criteria of. T2DM between 29-76 years old were in accordance with the 1999 WHO diagnostic criteria.Abdominal obesity was in accordance with the diagnostic criteria in 2007 (male waist 鈮，

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