新诊断2型糖尿病患者血清鸢尾素与网膜素-1水平变化的相关研究

发布时间：2018-06-01 21:08

  本文选题：2型糖尿病 + 鸢尾素　； 参考：《山西医科大学》2017年硕士论文

【摘要】：目的:糖尿病属常见的内分泌疾病,发病机制复杂,与环境、遗传等有关,是由胰岛素分泌和(或)作用障碍导致的代谢紊乱,可致心、眼、肾及神经等部位的病变,严重时可威胁生命。随生活水平提高,患病人数逐年增多,影响患者生存质量,成为主要的公共卫生问题,因此,糖尿病的早期筛查显得尤为重要。本研究旨在探讨新诊断2型糖尿病患者血清鸢尾素(irisin)及网膜素(omentin-1)的变化,为糖尿病的早期诊断提供一定指导。方法:1.研究对象:选取2015年12月至2016年5月于我院内分泌科确诊的新诊断T2DM患者60例为实验组,同期选择年龄、性别相匹配的健康者60例为对照组。2.临床资料收集:记录所有受试者的年龄、身高、体质量、收缩压(SBP)、舒张压(DBP),测定空腹血糖(FPG)、空腹胰岛素(FINS)、餐后2小时血糖(2h PG)、糖化血红蛋白(Hb A1c)、血脂等指标,血清omentin-1、irisin采用酶联免疫吸附法(ELISA)测定。结果:1.两组一般临床观察指标的比较:两组间性别、年龄、BMI、SBP、DBP水平差异无统计学意义(P0.05),T2DM组的FPG、2h PG、FINS、Hb A1c、HOMA-IR、TG、TC、LDL-C水平均明显高于NGT组(P0.05或P0.01),omentin-1、irisin、HOMA-β、HDL-C水平明显低于NGT组(P0.05或P0.01)。2.irisin、omentin-1与各指标的相关分析:spearman相关分析结果显示,irisin与FPG、2h PG、Hb A1c、FINS、HOMA-IR、LDL-C呈负相关(sr=-0.183,P=0.046)、(sr=-0.182,P=0.047)、(sr=-0.242,P=0.008)、(rs=-0.186,P=0.041)、、(sr=-0.248,P=0.006)、(sr=-0.199,P=0.029),与HDL-C呈正相关(sr=0.261,P=0.004);omentin-1与FPG、2h PG、Hb A1c、FINS、HOMA-IR、LDL-C呈负相关(sr=-0.233,P=0.010)、(sr=-0.310,P=0.001)、(sr=-0.415,P=0.000)、(sr=-0.266,P=0.003)(sr=-0.271,P=0.003)、(sr=-0.239,P=0.009),与HDL-C呈正相关(sr=0.270,P=0.003);irisin与omentin-1呈正相关(sr=0.227,P=0.013)。3.回归分析:多元逐步回归分析显示,Hb A1c是血清irisin的相关因素(P0.01),Hb A1c、HDL-C是血清omentin-1的相关因素(P0.01或P0.05),Logistic回归分析显示血清irisin、omentin-1是影响糖代谢的保护因素(OR:0.522,95%CI:0.293~0.930,P=0.027)、(OR:0.934,95%CI:0.891~0.979,P=0.005)。结论:1.新诊断2型糖尿病患者的血清irisin、omentin-1水平较正常糖耐量者明显降低,提示irisin、omentin-1可能与2型糖尿病有关。2.血清irisin、omentin-1与FPG、2h PG、Hb A1c、FINS、HOMA-IR、LDL-C呈负相关,与HDL-C呈正相关;irisin与omentin-1呈正相关,提示irisin、omentin-1可能与胰岛素抵抗、脂代谢有关,并存在相互调节作用。3.血清irisin、omentin-1是影响糖代谢的保护因素,多元逐步回归显示Hb A1c是血清irisin的相关因素,Hb A1c、HDL-C是血清omentin-1的相关因素,提示血清irisin、omentin-1受糖脂代谢影响,其水平下降可能是糖尿病发生、发展的原因之一。
[Abstract]:Objective: diabetes is a common endocrine disease, which has complex pathogenesis and is related to environment and heredity. It is a metabolic disorder caused by insulin secretion and / or dysfunction, which can cause heart, eye, kidney and nerve diseases. When it is serious, it can be life-threatening. With the improvement of living standards, the number of patients increases year by year, which affects the quality of life of patients and becomes the main public health problem. Therefore, the early screening of diabetes is particularly important. The purpose of this study was to investigate the changes of serum irisin (Iris) and omentin-1 (omentin-1) in newly diagnosed type 2 diabetic patients, and to provide guidance for early diagnosis of diabetes mellitus. Method 1: 1. Participants: from December 2015 to May 2016, 60 patients with newly diagnosed T2DM were selected as experimental group, and 60 healthy persons with matched age and sex were selected as control group. Clinical data were collected: the age, height, body mass, systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FPG), fasting insulin (Fin), 2 h postprandial blood glucose (2 h) PGN, HbA1cU, blood lipid were recorded. Serum omentin-1 irisin was determined by enzyme linked immunosorbent assay (Elisa). The result is 1: 1. Comparison of general clinical observation indexes between two groups: sex between two groups, 骞撮緞,BMI,SBP,DBP姘村钩宸�寮傛棤缁熻�″�︽剰涔�(P0.05),T2DM缁勭殑FPG,2h PG,FINS,Hb A1c,HOMA-IR,TG,TC,LDL-C姘村钩鍧囨槑鏄鹃珮浜嶯GT缁，

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