阿托伐他汀对中老年2型糖尿病合并高脂血症患者脂联素、瘦素水平及其比值的影响

发布时间：2018-05-12 07:58

本文选题：糖尿病 + 2型　；参考：《安徽医科大学》2017年硕士论文

【摘要】：目的通过酶联免疫吸附测定(Enzyme linked immunosorbent assay,ELISA)方法,在受试者用药前后,分别检测血清脂联素(adiponectin,APN)、瘦素(leptin,LEP)水平,并计算其比值,进而评价中老年2型糖尿病(Type 2 diabetes mellitus,T2DM)合并高脂血症患者给予阿托伐他汀治疗后血清APN、LEP及其比值的变化。方法于2015年6月至2016年3月期间,收集安徽省立医院干部病房及内分泌科住院患者及体检中心体检的50~90岁受试者的临床资料,经过排除标准筛选,共140例纳入研究,男54例,女66例,年龄50~86岁,平均年龄(64.7±9.4)岁。其中包括100例T2DM合并高脂血症患者和40例同期体检的健康中老年人。所有入选者均询问高血压、糖尿病等相关病史,测量患者血压,了解现服用药物情况,收集一般资料,包括姓名、性别、年龄等,并通过测量其身高、体重,从而计算体质量指数(Body mass index,BMI)。100例入选患者中,因失访及未遵医嘱按时进行治疗等原因排除共20例,有效研究病例共80例,设为观察组,另40例入选健康中老年人设为对照组。对照组直接抽取空腹静脉血,观察组给予阿托伐他汀10 mg/d,连服12周,于用药前后分别于空腹时抽取静脉血,两组均采用全自动生化分析仪测定空腹血糖(Fasting plasma glucose,FPG)、糖化血红蛋白(Hemoglobin A1c,Hb Alc)、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)等指标,使用ELISA法测定APN、LEP,并计算脂联素与瘦素比值(adiponectin/leptin,A/L)。将以上所测指标在观察组治疗前和对照组之间及观察组治疗前后进行相关统计学分析。结果(1)观察组治疗前和健康对照组组间比较:对比观察组治疗前和健康对照组的年龄、性别、体重等一般资料,两组间差异无统计学意义(P0.05),观察组治疗前TC(t=-2.309,P0.05)、TG(t=-11.050,P0.001)和LDL-C(t=-2.185,P0.05)水平均高于对照组,HDL-C(t=4.535,P0.001)水平低于对照组,APN水平低于对照组(t=27.006,P0.001),LEP水平高于对照组(t=-12.415,P0.001),A/L水平低于对照组(t=8.861,P0.001)(2)观察组治疗前后血脂、APN、LEP及其比值变化:用药12周后,患者TG(t=11.124,P0.001)、TC(t=24.816,P0.001)、LDL-C(t=21.508,P0.001)明显降低,HDL-C明显升高(t=-12.011,P0.001),APN略有升高,但差异无统计学意义(P=0.064),LEP水平略有降低,但差异无统计学意义(P=0.068),但A/L明显升高(t=-2.741,P0.05)。结论1.中老年T2DM合并高脂血症患者与中老年健康人群相比较,TC、TG、LDL-C水平较高,HDL-C水平较低,APN水平较低,LEP水平较高,A/L水平较低。2.中老年T2DM合并高脂血症患者经阿托伐他汀治疗后可明显降低TC、TG、LDL-C水平,升高HDL-C水平,并能够升高A/L水平,但对APN、LEP的影响不明显。
[Abstract]:Objective to detect the serum levels of adiponectin (APNN) and leptin (leptinophane) by enzyme linked immunosorbent assay (Elisa), and to calculate the ratio of leptin in serum before and after treatment. To evaluate the changes of serum APNL P and its ratio in elderly patients with type 2 diabetes mellitus (type 2 diabetes mellitusus T2DM) and hyperlipidemia after treatment with Atto vastatin. Methods from June 2015 to March 2016, the clinical data of 50 ~ 90 year old subjects in cadre ward, endocrine department and physical examination center of Anhui Provincial Hospital were collected and selected by exclusion criteria. A total of 140 cases (54 males) were included in the study. 66 females, aged 50 to 86 years, with an average age of 64.7 卤9.4 years. These included 100 T2DM patients with hyperlipidemia and 40 healthy adults who underwent physical examination at the same time. All participants were asked about their history of hypertension and diabetes, measured their blood pressure, were informed about their current drug use, collected general information, including name, sex, age, etc., and measured their height, weight, etc. Thus, the body mass index BMI.100 patients were included in the study, 20 patients were excluded for reasons of missing visit and not following the doctor's instructions, 80 cases were effectively studied as the observation group, and 40 cases were selected as the control group. In the control group, fasting venous blood was extracted directly. The observation group was given Atto vastatin 10 mg / d for 12 weeks, and venous blood was taken before and after treatment. In both groups, fasting plasma glucose levels, hemoglobin A1cU HbAlcCU, total cholesterol total cholesterolen TCU, triglyceride-triglyceride TGG, high density lipoprotein cholesterol high density lipoprotein cholesterolHDL-Cand low density lipoprotein cholesterol (LDL-C) were measured by automatic biochemical analyzer, and the results were compared with those of the control group, and were used for the determination of fasting blood glucose, hemoglobin A 1cn, HbAlc, total cholesterol, triglyceride, high density lipoprotein cholesterol, low density lipoprotein cholesterol and low density lipoprotein cholesterol. The ELISA method was used to determine APNN LEP and the adiponectin / leptin ratio was calculated. The above indexes were statistically analyzed between the observation group and the control group before treatment and before and after treatment in the observation group. Results 1) comparison between the observation group and the healthy control group before treatment: the general data of age, sex, body weight were compared between the observation group and the healthy control group before treatment. There was no significant difference between the two groups (P 0.05). Before treatment, the levels of TCctti-2.309P0.05P0.05P0.001 and LDL-CtU -2.185P0.05) in the observation group were higher than those in the control group (HDL-Ct4.535P0.001) lower than that of the control group (P 0.001LEP). The levels of TCntU -2.309P0.001LLEP in the observation group were higher than those in the control group before and after treatment. The levels of plasma APA / L in the observation group were lower than those in the control group before and after treatment. Changes of LEP and its ratio in APNU: 12 weeks after treatment, The level of HDL-C increased slightly, but the difference was not statistically significant (P 0.064), but there was no significant difference between the two groups, but A / L was significantly higher than 2.741% (P 0.05), but there was no significant difference between the two groups in the level of APN (P 0.064, P 0.001, P 0.001), but there was no significant difference between the two groups in the level of APN, but there was no significant difference between the two groups in terms of the level of APN, but A / L was significantly higher than that of the control group (P < 0.05). Conclusion 1. The level of TGG LDL-C in middle aged and elderly patients with hyperlipidemia was higher, HDL-C was lower, APNs were lower, T2DM levels were higher than those in middle and old people with hyperlipidemia, and the levels of A- / L were lower than those of healthy controls. In the middle-aged and elderly patients with T2DM combined with hyperlipidemia, Atto vastatin treatment significantly decreased the level of TGG LDL-C, increased the level of HDL-C, and increased the level of A / L, but the effect on APNL was not obvious.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R587.1;R589.2

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