短期CSII强化治疗对初诊2型糖尿病患者血清Betatrophin水平的影响

发布时间：2018-05-28 21:05

本文选题：2型糖尿病 + Betatrophin　；参考：《江苏大学》2017年硕士论文

【摘要】：目的Betatrophin是新发现的一种分泌蛋白,近年来一些临床及基础研究发现,在胰岛素抵抗(IR)状态下,Betatrophin表达显著增高。本研究首次观察了初诊2型糖尿病(T2DM)患者经短期持续性胰岛素皮下输注(CSII)强化治疗前后,血清Betatrophin水平的变化,以进一步探讨其与胰岛素抵抗(IR)、2型糖尿病的相关性。方法本研究总共招募120例研究对象,其中初诊T2DM患者(T2DM组)60例,年龄、性别及体重指数(BMI)相匹配的正常对照组(NC组)60例。所有受试者均采用统一的标准测定人体基本参数、口服葡萄糖耐量试验(OGTT)、胰岛素释放试验、糖化血红蛋白(Hb A1c)、血糖、血脂、胰岛素抵抗指数(HOMA-IR)、胰岛β细胞功能指数(HOMA-β)及Betatrophin等基线指标。初诊T2DM组的受试者均接受为期2周的CSII强化治疗,于停用CSII 24h后复测上述指标;血清Betatrophin的测定均采用酶联免疫吸附法(ELISA)。结果(1)与NC组相比较,初诊T2DM组患者基线的Hb A1c、空腹血糖(Glu0)、OGTT 2h血糖(Glu120)、HOMA-IR、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)均显著增高(P(27)0.05或P(27)0.01),而空腹胰岛素(Ins0)、高密度脂蛋白胆固醇(HDL-C)及HOMA-β则呈显著下降(P(27)0.05或P(27)0.01)。(2)初诊T2DM组患者基线血清Betatrophin水平显著高于正常对照组,差异具有统计学意义(P(27)0.01)。(3)相关分析结果显示,初诊T2DM组患者基线血清Betatrophin水平与Glu0、Glu120、Hb A1c、及HOMA-IR呈显著正相关(P(27)0.05)。(4)经2周CSII强化治疗后,初诊T2DM组患者Glu0、OGTT 30min血糖(Glu30)、OGTT 1h血糖(Glu60)、Glu120、OGTT 3h血糖(Glu180)、TG、TC、HDL-C、LDL-C及HOMA-IR均显著低于治疗前(P(27)0.05或P(27)0.01);而OGTT 30min胰岛素(Ins30)、OGTT 1h胰岛素(Ins60)、OGTT 2h胰岛素(Ins120)、OGTT 3h胰岛素(Ins180)、OGTT 30min C肽(C-P30)、OGTT 1h C肽(C-P60)、OGTT 2h C肽(C-P120)、OGTT 3h C肽(C-P180)及HOMA-β均显著高于治疗前,差异有统计学意义(P(27)0.05或P(27)0.01)(5)初诊T2DM组患者经2周CSII强化治疗后血清Betatrophin水平显著高于治疗前,[448.83(229.89-719.68)vs.393.79(168.51-577.63)pg/m L,P(27)0.05]。(6)相关结果显示,初诊T2DM组患者CSII治疗前血清Betatrophin水平与治疗前后空腹血糖差值(△Glu0)、OGTT 1h血糖差值(△Glu60)、及胰岛素抵抗指数差值(△HOMA-IR)呈显著负相关(P(27)0.05);与OGTT 30min胰岛素差值(△Ins30)、OGTT 1h胰岛素差值(△Ins60)、OGTT 2h胰岛素差值(△Ins120)、OGTT 30min C肽差值(△C-P30)、OGTT 1h C肽差值(△C-P60)、OGTT 2h C肽差值(△C-P120)、OGTT 3h C肽差值(△C-P180)均呈显著正相关(P(27)0.05)。初诊T2DM组患者治疗前后血清Betatrophin水平差值(△Betatrophin)与治疗前后空腹C肽差值(△C-P0)及治疗前后空腹胰岛素差值(△Ins0)均呈正相关(P(27)0.05)。(7)在初诊T2DM组,以△Betatrophin为因变量,△Glu0、△C-P0、△Ins0、△HOMA-IR为自变量建立多元线性逐步回归模型,结果显示△C-P0(β=172.03,P=0.016)最终进入方程(R2=0.103,P(27)0.05)。结论(1)与正常对照组相比较,初诊T2DM组患者血清Betatrophin水平显著升高,且其与胰岛素抵抗(IR)、糖脂代谢等指标具有显著相关性。(2)经过短期CSII强化治疗后,初诊T2DM组患者血清Betatrophin水平显著升高,治疗前后Betatrophin差值(△Betatrophin)与治疗前后空腹C肽差值(△C-P0)及治疗前后空腹胰岛素差值(△Ins0)呈显著正相关;且△C-P0是△Betatrophin的独立影响因素。(3)Betatrophin与胰岛素抵抗(IR)密切相关,提示其可能在2型糖尿病的发生发展中发挥了重要作用。
[Abstract]:Objective Betatrophin is a newly discovered secretory protein. In recent years, some clinical and basic studies have found that the expression of Betatrophin is significantly higher in the state of insulin resistance (IR). This study was the first to observe the level of serum Betatrophin in patients with newly diagnosed type 2 diabetes (T2DM) before and after short-term continuous subcutaneous insulin infusion (CSII). To further explore its correlation with insulin resistance (IR) and type 2 diabetes. Methods a total of 120 subjects were recruited in this study, of which 60 cases of first diagnosed T2DM patients (group T2DM), age, sex and body mass index (BMI) matched the normal control group (group NC), all of the subjects were determined by a unified standard to determine the basic parameters of the human body. Oral glucose tolerance test (OGTT), insulin release test, glycated hemoglobin (Hb A1c), blood glucose, blood lipid, insulin resistance index (HOMA-IR), islet beta cell function index (HOMA- beta) and Betatrophin and other baseline indicators. The subjects in the first diagnosed T2DM group were treated with CSII intensive treatment for 2 weeks, and the above indexes were remeasured after the discontinuation of CSII 24h. Serum Betatrophin was measured by enzyme linked immunosorbent assay (ELISA). Results (1) compared with group NC, the baseline Hb A1c, Glu0, OGTT 2H blood glucose (Glu120), HOMA-IR, triglyceride (TG), total cholesterol, low density lipoprotein cholesterol (27) 0.05 or 0.01 (27) 0.01) were found in the first diagnosed group. Ins0, high density lipoprotein cholesterol (HDL-C) and HOMA- beta were significantly decreased (P (27) 0.05 or P (27) 0.01). (2) the baseline serum Betatrophin level in the first diagnosed T2DM group was significantly higher than that in the normal control group. The difference was statistically significant (P (27) 0.01). (3) the correlation analysis showed that the baseline serum Betatrophin level of the patients in the first diagnosis group and Glu0, G Lu120, Hb A1c, and HOMA-IR have significant positive correlation (P (27) 0.05). (4) after 2 weeks of CSII intensive treatment, Glu0, OGTT 30min glucose (Glu30) in the first diagnosed T2DM group were significantly lower than before the treatment (27) 0.05 or 27 (27) 0.01). Ins60, OGTT 2H insulin (Ins120), OGTT 3H insulin (Ins180) and OGTT 30min C peptide (C-P30) were significantly higher than those before treatment. The difference was statistically significant (27) 0.05 or (27) 0.01) (5) after 2 weeks of intensive treatment Significantly higher than before treatment, [448.83 (229.89-719.68) vs.393.79 (168.51-577.63) pg/m L, P (27) 0.05]. (6) related results showed that the serum Betatrophin level before treatment in the early diagnosis group was significantly negatively correlated with the difference value of fasting blood glucose (delta Glu0) before and after treatment (delta Glu0), and the difference value of insulin resistance index (delta) (delta). 27) 0.05); the difference between OGTT 30min insulin (delta Ins30), OGTT 1H insulin difference (delta Ins60), OGTT 2H insulin difference value (delta Ins120), OGTT 30min C peptide difference value (delta) difference value (delta) difference value (27) 0.05). The difference of serum Betatrophin level (delta Betatrophin) was positively correlated with the difference value of fasting C peptide (delta C-P0) before and after treatment and the difference of fasting insulin (delta Ins0) before and after treatment (P (27) 0.05). (7) in the first diagnosed T2DM group, Delta Betatrophin as the dependent variable, Delta Glu0, Delta C-P0, Delta Ins0, Delta HOMA-IR was a multivariate linear stepwise regression model, and the result was obvious. The indication Delta C-P0 (beta =172.03, P=0.016) finally entered the equation (R2=0.103, P (27) 0.05). Conclusion (1) compared with the normal control group, the serum Betatrophin level of the first diagnosed T2DM group was significantly higher, and it had a significant correlation with insulin resistance (IR), glycolipid metabolism and so on. (2) after short-term CSII intensive treatment, the serum Betatro in the newly diagnosed T2DM group The level of Phin was significantly higher, and the difference of Betatrophin (delta Betatrophin) before and after treatment was positively correlated with the difference value of the fasting C peptide (delta C-P0) before and after treatment and the difference of fasting insulin (delta Ins0) before and after treatment; and delta C-P0 was an independent factor of Delta Betatrophin. (3) Betatrophin is closely related to insulin resistance (IR), suggesting that it may be in type 2 diabetes. The disease has played an important role in the development and development of the disease.
【学位授予单位】：江苏大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R587.1

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