2型糖尿病患者血清胎球蛋白A与颈动脉斑块的相关性

发布时间：2018-05-23 18:05

本文选题：2型糖尿病 + 血清胎球蛋白A　；参考：《苏州大学》2015年硕士论文

【摘要】：目的:探讨2型糖尿病(T2DM)患者血清中胎球蛋白A(Fetuin-A)与颈动脉粥样斑块的相关性。方法:根据彩色多普勒超声仪检查双侧颈动脉的结果,将60例2型糖尿病患者分为T2DM合并颈动脉粥样斑块组(A组,30例)、T2DM无颈动脉粥样斑块组(B组,30例);同期门诊健康体检者28例为正常对照组(C组)。测量血压、身高、体重、空腹血糖(FPG)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、胰岛素(FINS)、糖化血红蛋白(Hb Alc)、超敏C反应蛋白(hs CRP),并计算体重指数(BMI)、胰岛素抵抗指数(HOMA-IR)。采用双抗体夹心酶联免疫吸附实验(ELISA)检测所有受试者血清Fetuin-A浓度。结果:①三组方差分析结果显示A、B组血清Fetuin-A水平均低于C组[(0.65?0.26)g/l、(1.05?0.39)g/l vs(1.57?0.58)g/l](P0.01),A组血清Fetuin-A水平明显低于B组(P0.01)。②单因素相关分析结果显示,血清Fetuin-A水平与HDL-C、FINS呈正相关(r=0.218,P0.05;r=0.468,P0.05),与FBG、Hb A1C、CRP、WHR呈负相关(r=-0.343,P0.01;r=-0.505,P0.01;r=-0.544,P0.01;r=-0.353,P0.01)。③多元线性逐步回归分析表明,FINS、Hb A1c是血清Fetuin-A水平的独立影响因素(β分别为-0.411、0.227,P0.05)。结论:①2型糖尿病合并颈动脉斑块患者血清Fetuin-A水平较2型糖尿病无颈动脉斑块患者低,提示血清Fetuin-A水平下降可能促进了2型糖尿病患者颈动脉粥样斑块的早期形成,监测其水平或有助于糖尿病大血管并发症的早期发现。②相关分析显示Fetuin-A水平与炎症指标hs CRP呈负相关,提示或是炎症状态导致了Fetuin-A水平的下降,从而导致了2型糖尿病患者颈动脉粥样硬化的发生发展。③2型糖尿病无颈动脉斑块组血清Fetuin-A水平低于正常对照组,且血清Fetuin-A水平与血糖、血脂均相关,提示良好的血糖、血脂控制,或可使血清Fetuin-A水平升高,有利于延缓甚至减少2型糖尿病及其大血管并发症的发生、发展。
[Abstract]:Objective: to investigate the relationship between fetuin-A and carotid atherosclerotic plaque in patients with type 2 diabetes mellitus (T2DM). Methods: according to the results of color Doppler ultrasound examination of bilateral carotid artery, 60 patients with type 2 diabetes mellitus were divided into two groups: T2DM with carotid atherosclerotic plaque group (n = 30) and control group (n = 30) with T2DM without carotid atherosclerotic plaque group (n = 30). Measuring blood pressure, height, weight, Fasting blood glucose (FPG), total cholesterol (TCC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), insulin (FINS), glycosylated hemoglobin (HbAlcn), hypersensitive C-reactive protein (hsCRPN), body mass index (BMI), insulin resistance index (HOMA-IRN) were calculated. The serum Fetuin-A concentration of all subjects was determined by double antibody sandwich enzyme linked immunosorbent assay (Elisa). Results the results of ANOVA showed that the level of serum Fetuin-A in group A was lower than that in group C (0.65 ~ 0.26g / g / l vs(1.57?0.58)g/l). The level of serum Fetuin-A in group A was significantly lower than that in group B (P 0.01g / l vs(1.57?0.58)g/l), and the level of serum Fetuin-A in group A was significantly lower than that in group B (P 0.01). There was a positive correlation between serum Fetuin-A level and HDL-CCAFINS. The linear regression analysis showed that the serum Fetuin-A level was positively correlated with the levels of HDL-Cnn 0.218P0.05P0.05, and negatively correlated with the serum Fetuin-A levels (尾 = -0.4110.227P0.01r-0.505P0.01r-0.544P0.01P0.01P0.01p0.01. the regression analysis showed that FINSHAB A1c was an independent factor of serum Fetuin-A level (尾 = -0.4110.227P0.05). Conclusion the level of serum Fetuin-A in patients with type 12 diabetes mellitus complicated with carotid plaque is lower than that in patients with type 2 diabetes without carotid artery plaque, suggesting that the decrease of serum Fetuin-A level may promote the early formation of carotid atherosclerotic plaque in type 2 diabetes mellitus patients. 2 correlation analysis showed that the level of Fetuin-A was negatively correlated with the inflammatory marker hs CRP, suggesting that the inflammatory state led to the decrease of Fetuin-A level. As a result, the level of serum Fetuin-A in type 32 diabetic patients without carotid plaque was lower than that in normal control group, and the serum Fetuin-A level was correlated with blood glucose and blood lipids, indicating good blood glucose. The control of blood lipid may increase the level of serum Fetuin-A, which can delay or even reduce the occurrence and development of type 2 diabetes mellitus and its macrovascular complications.
【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R587.1

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