T2DM患者骨密度与sLR11基因多态性及相关危险因素的研究

发布时间：2018-05-18 16:09

本文选题：T2DM + 骨质疏松　；参考：《延边大学》2017年硕士论文

【摘要】：目的:研究和探讨延边地区2型糖尿病(Type 2 diabetes mellitus,T2DM)患者骨密度与可溶性低密度脂蛋白受体 11(soluble low-density lipoprotein recptor family member 11,sLR11)基因多态性及相关危险因素的分析,为T2DM患者骨质疏松症的预防及治疗提供理论依据。方法:选取2012年～2016年在延边医院内分泌科住院治疗的T2DM患者124例,根据所选研究对象骨密度值将其分为3组,骨量正常组(48例)、骨量减低组(53例)及骨质疏松组(23例)。通过超声骨密度检测仪测定右足踝部骨密度,利用LDR-PCR技术进行SNP分型及测序,运用Hard-Weinberg平衡定律,确定样本群体代表性。计量资料数据用M(P25,P75)、均数士标准差(x±s),组间均数比较用秩和检验、单因素方法分析,多因素分析采用二元Logistic分析,P0.05有统计学意义。结果:1.延边地区T2DM患者在骨量正常组、骨量减低组、骨质疏松组等位基因A、T,基因型AA、AT、TT分布差异无统计学意义。但与骨量正常组比较,骨量减低组及骨质疏松组等位基因T有上升趋势;在显性模式下,与骨量正常组相比较,骨量减低组及骨质疏松组基因型AA有下降趋势;隐性模式下,与骨量正常组比较,骨量减低组基因型TT有上升趋势。延边地区T2DM患者三组基因型间比较BMD水平差异无统计学意义。2.T2DM患者女性BMD 水平低于男性;年龄大于50岁者低于年龄小于50岁者;吸烟者BMD水平低于不吸烟者;BMI正常者BMD水平低于超重组及肥胖组;颈动脉内膜增厚组、颈动脉粥样硬化斑块组BMD水平低于颈动脉正常组;病程大于10年者BMD水平低于病程小于5年,差异有统计学意义,P0.05。汉族与朝鲜族BMD水平之间差异无统计学意义。3.T2DM患者BMD水平与LDL-C、HbA1c呈负相关。T2DM患者OP的影响因素有LDL-C、HbA1c、病程、BMI、年龄。结论:1.sLR11基因rs3824968基因多态性可能与延边地区T2DM骨质疏松无相关性。2.T2DM患者BMD与吸烟、年龄、性别、动脉粥样硬化、病程长密切相关。3.T2DM患者BMD与LDL-C、HbA1c密切相关。4.T2DM患者BMI是BMD的保护因素。
[Abstract]:Objective: to investigate the polymorphism of bone mineral density (BMD) and soluble low density lipoprotein receptor (11(soluble low-density lipoprotein recptor family member 11s LR11) gene in type 2 diabetes mellitus patients with type 2 diabetes mellitus (T2DM) in Yanbian area. To provide theoretical basis for the prevention and treatment of osteoporosis in patients with T2DM. Methods: 124 T2DM patients who were hospitalized in the Department of Endocrinology in Yanbian Hospital from 2012 to 2016 were divided into 3 groups according to the BMD of the selected subjects: 48 cases of normal bone mass group, 53 cases of osteopenia group and 23 cases of osteoporosis group. The bone mineral density of right foot and malleolus was measured by ultrasonic bone density detector. SNP typing and sequencing were carried out by LDR-PCR technique. The representative sample population was determined by Hard-Weinberg equilibrium law. The metrological data were measured by MKP25, P75, and the standard deviation of mean value was x 卤s.There was statistical significance in the comparison of mean between groups by rank sum test, single factor analysis and multivariate Logistic analysis (P0.05). The result is 1: 1. There was no significant difference in the distribution of allele ACTT and genotypes of T2DM in normal bone mass group, low bone mass group and osteoporosis group in Yanbian area. However, the allele T of bone mass reduction group and osteoporosis group showed an upward trend compared with that of normal bone mass group; in dominant mode, compared with normal bone mass group, genotype AA of bone mass decreased group and osteoporosis group showed a tendency to decrease; in recessive mode, there was a decrease trend in genotype AA of bone mass reduction group and osteoporosis group. Compared with the normal bone mass group, the TT genotype of the decreased bone mass group showed an increasing trend. There was no significant difference in BMD level among the three groups of T2DM patients in Yanbian area. 2. The BMD level of female patients with T2DM was lower than that of males, and that of patients older than 50 years was lower than that of those aged less than 50 years old. The level of BMD in smokers was lower than that in non-smokers with normal BMD, and the level of BMD in carotid intima-thickening and carotid atherosclerotic plaques was lower than that in normal carotid. The level of BMD was lower in patients with more than 10 years duration than that in 5 years, and the difference was statistically significant (P 0.05). There was no significant difference in BMD level between Han nationality and Korean nationality. 3. The level of BMD in T2DM patients was negatively correlated with HbA1c of LDL-C2DM. The influencing factors of op in T2DM patients were LDL-C2DM HbA1c, course of disease and age. Conclusion: 1. The rs3824968 polymorphism of sLR11 gene may not be associated with osteoporosis of T2DM in Yanbian area. 2.The BMD of T2DM patients is closely related to smoking, age, sex, atherosclerosis and long course of disease. 3. BMD in T2DM patients is closely related to BMI HbA1c in LDL-C2DM patients. 4. BMI in T2DM patients is the protective factor of BMD.
【学位授予单位】：延边大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R580

【参考文献】