2型糖尿病患者感染幽门螺杆菌对胰岛素抵抗及脂联素分泌的影响

发布时间：2018-05-05 01:20

本文选题：糖尿病 + 胰岛素抵抗　；参考：《蚌埠医学院》2017年硕士论文

【摘要】：目的:研究幽门螺杆菌(H.pylori)感染2型糖尿病(T2DM)患者对其胰岛素敏感性的影响,并分析这种影响与脂联素分泌水平变化有无相关性,进一步探讨H.pylori感染是否为T2DM发生及发展的危险因素,并预期根除H.pylori治疗是否可改善胰岛素抵抗程度并延缓T2DM进展。方法:收集2015年12月-2016年12月期间于我院住院的新发T2DM患者136例作为研究对象,根据14C尿素呼气试验结果分为H.pylori+组和H.pylori-组,并记录受试者的年龄、性别、身高、体重,测定血清空腹血糖(FPG)、空腹胰岛素(FINS)、糖化血红蛋白(HbA1c)、总胆固醇(total cholesterol,TC)、甘油三酯(triglyceride,TG)、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)、脂联素等指标,计算体质指数(BMI)及稳态模型胰岛素抵抗指数(HOMA-IR),比较两组各项指标的差异并进行统计学分析,另外对可能影响研究结果的因素(年龄及BMI)进行亚组分析,根据年龄及BMI进行分组,比较各亚组间HOMA-IR及脂联素水平有无统计学差异。结果:H.pylori+组和H.pylori-组间除TC、LDL-C、FINS、HOMA-IR差异有统计学意义(P(27)0.05),其余临床及实验室指标差异均无统计学意义(P(29)0.05),H.pylori+组患者的低密度脂蛋白胆固醇、总胆固醇、空腹胰岛素及胰岛素抵抗指数均较H.pylori-组偏高。亚组分析中,对年龄及BMI进行分层后,除了年龄350岁同时BMI324.0 kg/m2亚组中胰岛素抵抗指数在H.pylori+组与H.pylori-组差异无统计学意义之外,其余各亚组H.pylori+组胰岛素抵抗指数均高于H.pylori-组,且差异有统计学意义(P(27)0.05),而各亚组脂联素分泌水平无统计学差异(P(29)0.05)。结论:H.pylori感染增加T2DM患者胰岛素抵抗程度,但H.pylori感染对脂联素分泌水平无影响,故H.pylori感染导致的高胰岛素抵抗与脂联素无相关性,针对H.pylori进行治疗可能改善胰岛素抵抗进而延缓T2DM发生及发展。
[Abstract]:Objective: to study the effect of H. pylori infection on insulin sensitivity in patients with type 2 diabetes mellitus (T2DM), and to analyze whether this effect is related to the level of adiponectin secretion. To further explore whether H.pylori infection is a risk factor for the occurrence and development of T2DM, and to predict whether the eradication of H.pylori treatment can improve the degree of insulin resistance and delay the progression of T2DM. Methods: 136 newly diagnosed T2DM patients who were hospitalized in our hospital from December 2015 to December 2016 were divided into H.pylori group and H.pylori- group according to 14C urea breath test results. The age, sex, height, weight of the subjects were recorded. The levels of serum fasting blood glucose (FPG), fasting insulin (Fin), glycosylated hemoglobin (HbH1), total cholesterol (TC), triglyceride-triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), low-density lipoprotein cholesterol (LDL-LDL), adiponectin, etc., were measured. Body mass index (BMI) and homeostasis model insulin resistance index (HOMA-IRI) were calculated. The differences between the two groups were compared and statistically analyzed. In addition, the factors (age and BMIs) that might influence the results of the study were subgroup and grouped according to age and BMI. HOMA-IR and adiponectin levels were compared between subgroups. Results there was significant difference in HOMA-IR between H. pylori group and H.pylori group except TCL-LDL-CnsFINSMA-IR. There was no significant difference in other clinical and laboratory indexes between two groups. There was no significant difference in low density lipoprotein cholesterol (LDL-C) and total cholesterol (TC) between the two groups, and there was no significant difference in the clinical and laboratory indexes between the two groups, and there was no significant difference between the two groups in terms of low density lipoprotein cholesterol (LDL-C) and total cholesterol (TC). Fasting insulin and insulin resistance index were higher than H.pylori- group. In the subgroup analysis, after stratification of age and BMI, the insulin resistance index of H.pylori group was higher than that of H.pylori-group, except that the insulin resistance index of BMI324.0 kg/m2 subgroup was no significant difference between H.pylori group and H.pylori- group. There was significant difference in adiponectin secretion between the two subgroups, but there was no significant difference in adiponectin secretion between the two subgroups. Conclusion the infection of H. pylori increases the degree of insulin resistance in patients with T2DM, but the level of adiponectin is not affected by H.pylori infection, so the high insulin resistance caused by H.pylori infection has no correlation with adiponectin. Treatment of H.pylori may improve insulin resistance and delay the onset and development of T2DM.
【学位授予单位】：蚌埠医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R587.1

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