女性2型糖尿病患者绝经后性激素水平与血脂及内脏脂肪面积的关系

发布时间：2018-06-17 18:07

本文选题：2型糖尿病 + 绝经后女性　；参考：《山东中医药大学》2017年硕士论文

【摘要】：目的1、分析女性2型糖尿病患者绝经后性激素水平变化的特点;2、分析女性2型糖尿病患者绝经后血脂、内脏脂肪面积变化的特点;3、探索女性2型糖尿病患者绝经后性激素水平与血脂、内脏脂肪面积的相关性。方法所有病例资料均来源于2015年3月1日至2016年12月31日山东省立医院内分泌科病房,共收集符合课题要求的女性2型糖尿病绝经后患者147例,其中绝经时间1-5年者为A组,共26例;绝经时间6-10年者为B组,共30例;绝经时间大于10年者为C组,共91例。收集并登记患者信息:一般资料(包括住院号、年龄、糖尿病病程、既往史、月经情况、血压、BMI等)、相关生化指标(包括血糖、血脂、性激素、肝功、肾功等)、内脏脂肪面积、皮下脂肪面积。对三组病例进行回顾性研究,采用单因素方差分析、多元线性回归分析等方法分析绝经后不同阶段性激素、血脂、内脏脂肪面积的变化特点及性激素与血脂、内脏脂肪面积的相关性。结果1、三组研究对象各指标比较随着绝经时间的增加,三组研究对象冠心病患病率、脑血管病患病率逐渐升高,差异无统计学意义(P=0.080,0.081),脂肪肝患病率逐渐下降,差异无统计学意义(P=0.483)。随着绝经时间的增加,三组研究对象年龄、收缩压、肌酐显著升高(P=0.000,0.021,0.004),谷丙转氨酶显著下降(P=0.007),总胆固醇先升高再下降(P=0.045)。三组研究对象间糖尿病病程、舒张压、身高、体重、BMI、促卵泡刺激素、促黄体生成素、雌二醇、睾酮、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、甘油三酯、内脏脂肪面积、皮下脂肪面积、空腹血糖、糖化血红蛋白、空腹C肽、胰岛素抵抗指数、谷草转氨酶、谷氨酰胺转肽酶、碱性磷酸酶、尿酸差异无统计学意义(P0.05)。2、三组研究对象多元线性回归分析校正混杂因素后,总胆固醇与空腹血糖(β=0.246,P=0.002)、促卵泡刺激素(β=0.173,P=0.032)独立正相关;总胆固醇与空腹血糖(β=0.254,P=0.001)、促黄体生成素(β=0.238,P=0.003)独立正相关;性激素与高密度脂蛋白胆固醇无关;低密度脂蛋白胆固醇与空腹血糖(β=0.225,P=0.006)、促卵泡刺激素(β=0.169,P=0.037)独立正相关;低密度脂蛋白胆固醇与空腹血糖(β=0.234,P=0.004)、促黄体生成素(β=0.222,P=0.006)独立正相关;性激素与甘油三酯无关;内脏脂肪面积与BMI(β=0.695,P=0.000)、睾酮(β=0.189,P=0.009)、胰岛素抵抗指数(β=0.166,P=0.018)独立正相关;性激素与皮下脂肪面积无关。3、根据睾酮中位数将研究对象分为两组比较高睾酮组低密度脂蛋白胆固醇、内脏脂肪面积显著高于低睾酮组(P=0.045,0.001);高密度脂蛋白胆固醇低于低睾酮组,差异无统计学意义(P=0.440);总胆固醇、甘油三酯、皮下脂肪面积高于低睾酮组,差异无统计学意义(P=0.108,0.169,0.055)。结论(1)女性2型糖尿病患者随着绝经年限的增加,总胆固醇先升高再降低;(2)女性2型糖尿病患者绝经后总胆固醇、低密度脂蛋白胆固醇随着促卵泡刺激素、促黄体生成素的升高而升高;内脏脂肪面积随着睾酮的升高而升高;(3)女性2型糖尿病患者绝经后高睾酮组低密度脂蛋白胆固醇、内脏脂肪面积显著高于低睾酮组。
[Abstract]:Objective 1 to analyze the characteristics of postmenopausal sex hormone changes in postmenopausal women with type 2 diabetes; 2, analyze the characteristics of postmenopausal blood lipids and visceral fat area changes in women with type 2 diabetes mellitus; 3, explore the correlation between postmenopausal sex hormone levels in women with type 2 diabetes and the area of visceral fat and visceral fat. All of the cases were derived from 201 In the Department of endocrinology of the Shangdong Province-owned Hospital from March 1st to December 31, 2016, 147 cases of postmenopausal women with type 2 diabetes mellitus were collected, of which 1-5 years of menopause were group A, 26 cases were A, 6-10 years for menopause were group B, 30 cases were in group C for more than 10 years, and 91 cases were collected and registered patient information: 1 Data (including hospital number, age, course of diabetes, past history, menstruation, blood pressure, BMI, etc.), related biochemical indexes (including blood sugar, blood lipid, sex hormone, liver function, kidney work, etc.), visceral fat area, subcutaneous fat area. A retrospective study on three groups of cases, analysis of single factor ANOVA, multiple linear regression analysis, and so on. The changes of sex hormones, blood lipid, visceral fat area and the correlation between sex hormone and blood fat and visceral fat area after different stages. Results 1, the three groups of subjects compared with the increase of menopause time, three groups of subjects with coronary heart disease rate, cerebrovascular disease rate gradually increased, the difference was not statistically significant (P=0.080,0.081 The prevalence rate of fatty liver decreased gradually, the difference was not statistically significant (P=0.483). With the increase of menopause time, three groups of subjects age, systolic pressure, creatinine increased significantly (P=0.000,0.021,0.004), alanine aminotransferase significantly decreased (P=0.007), total cholesterol increased first and then decreased (P=0.045). The course of diabetes, diastolic pressure and body pressure between the three groups of subjects were between the subjects. High, weight, BMI, follicle stimulating hormone, luteinizing hormone, estradiol, testosterone, high density lipoprotein cholesterol, low density lipoprotein cholesterol, triglyceride, visceral fat area, subcutaneous fat area, fasting blood sugar, glycosylated hemoglobin, fasting C peptide, islopanin resistance index, glutamine transaminase, glutamine transpeptidase, alkaline phosphatase, urine There was no significant difference in acid difference (P0.05).2. After multivariate linear regression analysis of the three groups, the total cholesterol was independent positive correlation with fasting blood glucose (beta =0.246, P=0.002) and follicle stimulating hormone (beta =0.173, P=0.032), and total cholesterol was independently and positively correlated with fasting blood glucose (beta =0.254, P=0.001) and luteinizing hormone (beta =0.238, P=0.003). Sex hormones are not related to high-density lipoprotein cholesterol; low density lipoprotein cholesterol is independent positively associated with fasting blood glucose (beta =0.225, P=0.006), follicle stimulating hormone (beta =0.169, P=0.037), low density lipoprotein cholesterol (LDL) and fasting blood glucose (beta =0.234, P=0.004), luteinizing hormone (beta =0.222, P=0.006) independent positive correlation; sex hormone and triglyceride The area of visceral fat was independent of BMI (beta =0.695, P=0.000), testosterone (beta =0.189, P=0.009), and insulin resistance index (beta =0.166, P=0.018); sex hormones were not related to the area of subcutaneous fat.3, and the subjects were divided into two groups of high testosterone group low density lipoprotein cholesterol according to the median of testosterone, and the area of visceral fat was significantly higher than that of low testosterone. Group (P=0.045,0.001); high density lipoprotein cholesterol was lower than low testosterone group, the difference was not statistically significant (P=0.440), total cholesterol, triglyceride, subcutaneous fat area was higher than low testosterone group, the difference was not statistically significant (P=0.108,0.169,0.055). Conclusion (1) female type 2 diabetes patients with the increase of menopause, total cholesterol first increase and then drop (2) the total cholesterol and low density lipoprotein cholesterol increased with the increase of follicle stimulating hormone and luteinizing hormone in women with type 2 diabetes, and the area of visceral fat increased with the increase of testosterone; (3) the area of low density lipoprotein cholesterol in postmenopausal women with type 2 diabetic patients was significantly higher than that in the high testosterone group and the area of visceral fat was significantly higher than that of the patients with type 2 diabetes. Low testosterone group.
【学位授予单位】：山东中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R587.1

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