白细胞与2型糖尿病关系的研究

发布时间：2018-04-27 05:18

本文选题：白细胞 + 超重　；参考：《山东大学》2015年硕士论文

【摘要】：目的：研究白细胞与2型糖尿病之间的关系,探讨白细胞分别与腰围、甘油三酯、高血压、超重的交互作用对2型糖尿病(T2DM)的影响。方法：抽取349例来自兰山区2个镇卫生院、2个社区卫生服务中心老年人的查体资料和门诊资料,采用以社区为基础的病例对照研究方法,以182例T2DM患者为病例组,以167例无T2DM者为对照组,观察身高、体重、腰围、白细胞、中性粒细胞、淋巴细胞、血糖、血尿素氮、肌酐、尿酸、总胆固醇、甘油三脂、尿蛋白、尿酸碱度、尿糖等指标。定量资料采用均数±标准差表示,计数资料采用频数(%)表示。应用单因素和多因素Logistic分析方法,分析白细胞计数及其分类与糖尿病关系。应用多元Logistic回归调整潜在的混杂因素及估计比值比(OR)。用相加模型分析白细胞分别与腰围、甘油三酯、高血压、超重的交互作用T2DM的影响。结果：经单因素logistic回归分析显示白细胞总数、淋巴细胞和中性粒细胞数每增加一个单位,患糖尿病的危险性分别增加1.25、1.50和1.30倍。将白细胞总数、淋巴细胞数、中性粒细胞数按三分位数划分后进行分析,结果显示,它们同T2DM患病危险性皆显著正相关。利用多因素logistic回归调整性别、年龄、高血压、BMI、腰围、尿素、肌酐、总胆固醇、甘油三脂、高密度脂蛋白、低密度脂蛋白、谷草转氨酶、谷丙转氨酶、尿酸碱度、尿蛋白多个潜在混杂变量后,对于白细胞总数、淋巴细胞数、中性粒细胞数每增加一个单位,患糖尿病的危险性分别增加1.18、1.27和1.23倍。将白细胞总数、淋巴细胞数、中性粒细胞数按三分位数划分后进行分析,T2DM患病危险性OR及其95%信限,白细胞分别为：1.52(0.83-2.80)、2.72(1.42-5.19)；淋巴细胞数分别为：1.10(0.61-1.98)、1.45(0.78-2.71)；中性粒细胞数分别为：1.52(0.86-2.82)、2.13(1.15-3.95)。白细胞与腰围、甘油三酯、高血压、超重之间单因素分析显示无论调整混杂因素前和后,两因素同时存在的效应皆大于各因素单独存在时效应之和,表明两因素之间在糖尿病患病中存在正相加模型交互作用。协同指数(S)分别为：1.91、3.46、1.30、3.61；交互效应超额相对危险度(RERI)分别为：2.30、9.31、1.86、3.41；归因交互效应百分比(AP)为：39.48%、66.03%、20.50%、59.67%。用多元logistic回归调整性别、年龄、高血压、腰围、血尿素氮、血肌酐、总胆固醇、甘油三脂、高密度脂蛋白、低密度脂蛋白、谷草转氨酶、谷丙转氨酶、尿蛋白、尿酸碱度后,白细胞与腰围、甘油三酯、高血压、超重对糖尿病仍具有正交互作用。调整上述各混杂因素后,S分别为：1.76、3.10、1.12、2.73；RERI分别为1.55、6.98、0.82、1.08；AP分别为：33.78%、61.74%、9.38%、39.89%。结论：白细胞总数、淋巴细胞数、中性粒细胞数无论其原始值还是其三分位数皆与T2DM的患病危险性显著相关,白细胞与T2DM患病之间的关系并不完全依赖于其它因素。腰围、甘油三酯、高血压、超重是糖尿病发生的危险因素,白细胞与这些因素在糖尿病发病中存在明显的正相加模型交互作用,使糖尿病患病危险性明显增加。
[Abstract]:Objective : To study the relationship between leukocyte count and type 2 diabetes mellitus . The effects of leukocyte count , blood glucose , blood urea nitrogen , creatinine , uric acid , total cholesterol , blood urea nitrogen , creatinine , uric acid , total cholesterol , triglyceride , urinary protein , urine pH and urine sugar were analyzed by multivariate logistic regression analysis .
The number of lymphocytes was 1.10 ( 0.61 - 1.98 ) and 1.45 ( 0.78 - 2.71 ) , respectively .
The number of neutrophil count was 1.52 ( 0.86 - 2.82 ) , 2.13 ( 1.15 - 3.95 ) . The single - factor analysis between white blood cell and waist circumference , triglyceride , hypertension and overweight showed that both factors were more effective than those before and after adjustment of confounding factors , indicating that there was a positive additive model interaction between the two factors . The synergistic index ( S ) was 1.91 , 3.46 , 1.30 , 3.61 , respectively .
The relative risk of interaction effect ( RERI ) is 2.30 , 9.31 , 1.86 , 3.41 , respectively .
The percentage of attribution interaction ( AP ) was 39.48 % , 66.03 % , 20.50 % , 59.67 % . After adjustment of sex , age , hypertension , waist circumference , blood urea nitrogen , serum creatinine , total cholesterol , triglyceride , high density lipoprotein , low density lipoprotein , aspartate aminotransferase , glutamic pyruvic transaminase , urinary protein and urine pH value , the relationship between white blood cell and waist circumference , triglyceride , hypertension and overweight was positive . After adjusting the above confounders , S was 1.76 , 3.10 , 1.12 , 2.73 , respectively .
RERI was 1.55 , 6.98 , 0.82 , 1.08 , respectively .
Conclusion : The total number of white blood cells , the number of lymphocytes , the number of neutrophils , the number of neutrophils , the number of neutrophils and the number of neutrophils in the patients with T2DM are significantly associated with the risk of diabetes , and the relationship between white blood cell and T2DM is not entirely dependent on other factors . The waist circumference , triglyceride , hypertension and overweight are the risk factors of diabetes . The leukocyte and these factors have obvious positive additive model interaction in the pathogenesis of diabetes , which can increase the risk of diabetes .

【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R587.1

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