sfrp5与2型糖尿病合并大血管病变相关性研究

发布时间：2018-04-23 02:13

本文选题：sfrp5 + 脂联素　；参考：《川北医学院》2017年硕士论文

【摘要】：目的:脂联素和分泌型卷曲相关蛋白5(secreted frizzled related protein,sfrp5)是近年来研究较热的脂肪因子,在2型糖尿病等疾病的发生发展过程中起着重要作用。本研究通过测定正常人及2型糖尿病患者血浆脂联素和sfrp5的水平探究其与2型糖尿病及2型糖尿病合并大血管病变的相关性。方法:1.本研究共纳入2015年11月-2016年7月在川北医学院附属医院内分泌科门诊及住院部就诊的81例2型糖尿病患者(女38例,男43例),平龄:52.15±11.91岁。根据有无血管病变分为单纯2型糖尿病组(n MVC)和2型糖尿病合并大血管病变组(MVC)。并根据大血管病变程度将MVC分为三个亚组。另于川北医学院附属医院体检中心随机选取健康体检者80例为正常对照组(NC组)。2.采用酶联免疫吸附法(ELISA)测定各组空腹血浆脂联素和sfrp5浓度,同时采集各组体重指数、空腹血糖、糖化血红蛋白、甘油三酯、胆固醇、高密度脂蛋白、低密度脂蛋白等一般临床指标。3.应用SPSS19.0统计软件对所有数据进行分析,正态分布的资料以±s表示,非正态分布资料通过对数转换后进行分析。多组间比较采用方差分析。相关分析采用spearman相关分析。多因素分析采用多元逐步回归分析。以logistic回归分析2型糖尿病合并大血管病变的主要影响因素。均以P0.05为差异有统计学意义。结果:1.各组间sfrp5比较:NC与n MVC、MVC任意两两比较均有统计学意义,且呈逐渐降低趋势(F=34.957,P=0.000);各组间脂联素比较:NC与n MVC、MVC任意两两比较均有统计学意义,且呈逐渐降低趋势(F=48.317,P=0.000)。2.各亚组间sfrp5比较:M1与M2、M3任意两两比较均有统计学意义,且呈逐渐降低趋势(F=6.783,P=0.000);各亚组间脂联素比较:M1与M2、M3任意两两比较均有统计学意义,且呈逐渐降低趋势(F=5.067,P=0.003)。3.以sfrp5为因变量,以脂联素、BMI、TG、TC、HDL-C、LDL-C、FBG、Hb A1c为自变量,进行多元线性逐步回归显示:脂联素、LDL-C、Hb A1c是血浆sfrp5的显著影响因素(R2=0.621,P0.05)。4.以脂联素为因变量,以sfrp5、BMI、TG、TC、HDL-C、LDL-C、FBG、Hb A1c为自变量,进行多元线性逐步回归显示:sfrp5、LDL-C、Hb A1c是血浆脂联素的显著影响因素(R2=0.614,P0.05)。5.以2型糖尿病是否合并大血管病变为因变量,以sfrp5、BMI、TG、TC、HDL-C、LDL-C、FBG、Hb A1c为自变量,进行logistic回归分析,结果表明sfrp5、BMI、TG、HDL-C进入方程,表明他们是2型糖尿病合并大血管病变的重要影响因素。结论:1.血浆sfrp5、脂联素均与肥胖、血糖、血脂异常、大血管病变相关,或许可作为临床上对于肥胖、2型糖尿病、血脂异常、动脉粥样硬化的诊断、治疗及预后提供一些依据,但其作用机制尚未十分清楚,需进一步完善相关基础实验探究其作用机制。2.sfrp5与脂联素呈显著正相关,可能是由于二者均有脂肪细胞分泌,当脂肪细胞功能紊乱时,二者分泌均出现异常;同时,二者在发挥生物学作用时,可能为协同作用。
[Abstract]:Objective: adiponectin (adiponectin) and secretory crimp associated protein (5(secreted frizzled related protein frp5) are hot fat factors and play an important role in the development of type 2 diabetes. In this study, plasma adiponectin and sfrp5 levels were measured in normal subjects and patients with type 2 diabetes to explore their correlation with type 2 diabetes and type 2 diabetes with macroangiopathy. Method 1: 1. From November 2015 to July 2016, 81 patients with type 2 diabetes mellitus (38 female and 43 male), aged 52.15 卤11.91 years, were enrolled in the Department of Endocrinology, Department of Endocrinology, affiliated Hospital of North Sichuan Medical College. The patients were divided into two groups: type 2 diabetes mellitus group (n MVC) and type 2 diabetes mellitus complicated with macrovascular disease group. MVC was divided into three subgroups according to the degree of macrovascular disease. In addition, 80 healthy subjects were randomly selected as normal control group (NC group) in the center of medical examination center of affiliated hospital of North Sichuan Medical College. Fasting plasma adiponectin and sfrp5 levels were measured by Elisa. Body mass index, fasting blood glucose, glycosylated hemoglobin, triglyceride, cholesterol, high density lipoprotein were collected. Low density lipoprotein and other general clinical indicators. The data of normal distribution is expressed as 卤s, and the data of non-normal distribution is analyzed by the transformation of numbers. ANOVA was used to compare the two groups. Correlation analysis was performed by spearman correlation analysis. Multivariate stepwise regression analysis was used. The main influencing factors of type 2 diabetes with macroangiopathy were analyzed by logistic regression analysis. All with P0.05 as the difference was statistically significant. The result is 1: 1. There was a significant difference in sfrp5 comparison between each group (% NC) and n MVC (n MVC), and there was a trend of decreasing gradually (P < 0. 000), and there was a significant difference in adiponectin comparison between each group (% NC) and n MVCMVC (arbitrary pairwise comparison), and there was a decreasing trend of FN (48.317P0. 000) 路2.The ratio of adiponectin in each group was 48.317P0. 000 ~ 0. 000 and the ratio of adiponectin to n MVCMVC was significantly lower. The comparison of sfrp5 between M2M3 and M2M3 had statistical significance, and showed a decreasing trend (F = 6.783), and adiponectin was significantly higher than that of M2M3 (P < 0.01), and showed a decreasing trend of F5.067P0. 003N 路3.The ratio of adiponectin between the two subgroups was statistically significant in comparison with that of M2M3, and there was a trend of decrease in F5. 067P0. 003p0. 3 in each subgroup. The multivariate stepwise regression analysis showed that adiponectin (sfrp5) was a significant influencing factor for plasma sfrp5, and HDL-CnLDL-CU HbA1c was an independent variable. It was found that adiponectin was a significant factor affecting plasma sfrp5 (R20.621P0.05N. 4). With adiponectin as dependent variable, and sfrp5BMITGN TGG (TGN) HDL-CU LDL-CU FBGU HbA1c as independent variable, multivariate linear stepwise regression analysis showed that: sfrp5, LDL-CmHbA1c was a significant factor affecting plasma adiponectin (R20.614, P0.05. 5), and a multivariate linear stepwise regression analysis was carried out to show that: sfrp5HbA1c was a significant influence factor of plasma adiponectin. Taking type 2 diabetes mellitus with macrovascular disease as dependent variable, using sfrp5 BMITGN TGGN HDL-CnLDL-CnLDL-C FBGG HbA1c as independent variable, logistic regression analysis was carried out. The results showed that sfrp5BMITGN HDL-C entered the equation, indicating that they were important factors in type 2 diabetes mellitus with macroangiopathy. Conclusion 1. Plasma sfrp5 and adiponectin are all associated with obesity, blood glucose, dyslipidemia, macroangiopathy, which may provide some evidence for diagnosis, treatment and prognosis of obesity type 2 diabetes mellitus, dyslipidemia and atherosclerosis. However, the mechanism of adiponectin is not very clear. It is necessary to further improve the basic experiment to find out the positive correlation between the mechanism. 2. Sfrp5 and adiponectin, which may be due to both adipocytes secreting adipocytes, when the function of adipocytes is disordered. At the same time, they may be synergistic when they play a biological role.
【学位授予单位】：川北医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R587.2

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