高胰岛素水平导致肥胖相关机制研究

发布时间：2018-06-25 07:05

本文选题：糖尿病 + 高胰岛素血症　；参考：《郑州大学》2015年硕士论文

【摘要】：目的:肥胖是导致2型糖尿病(Type 2 Diabetes Mellitus,T2DM)及心脑血管疾病的重要危险因素,老年2型糖尿病患者因生活、饮食条件的不同,血糖控制情况有所差异,血糖控制的好坏可以间接的通过糖化血糖蛋白来表示。基础胰岛素水平与肥胖存在一定的联系,那么胰岛素水平的高低与肥胖之间是否存在着关联?血糖控制的好坏对胰岛素水平高低导致肥胖有什么相关性?本研究旨在通过观察2型糖尿病患者空腹胰岛素水平对肥胖的影响及血糖控制欠佳时胰岛素水平与肥胖的相关分析。方法:对2014年1月至2014年6月年在郑州大学第一附属医院老年内分泌科和内分泌科住院的278例老年糖尿病患者测糖化血红蛋白(Hb A1c),按其数值高低分为血糖控制正常组G1组(Hb A1c≤6.5%)和血糖控制较差组G2组(6.5%Hb A1c≤8.5%);测空腹胰岛素水平,按空腹胰岛素是否大于7.1u U/m L分为血糖控制正常高胰岛素水平组(G1 High Insulin,G1HI)、血糖控制正常低胰岛素水平组(G1 Low Insulin,G1LI)、血糖控制较差高胰岛素水平组(G2 High Insulin,G2HI)和血糖控制较差低胰岛素水平组(G2 High Insulin,G2HI)四组。测量患者身高、体重并计算体质指数(Body Mass Index,BMI),BMI=体重(千克)/身高(米)的平方。进行高胰岛素水平组和低胰岛素水平组BMI相比较;四组中两两组之间BMI进行比较,分析胰岛素与肥胖的关系及不同血糖水平胰岛素与肥胖关系。结果:1.278例2型糖尿病患者中男性151例,女性127例,平均年龄男性(68.9±6.4)岁,女性(67.3±7.3)岁,G1组BMI(25.58±4.11)kg/m2,G2组BMI(27.89±3.69)kg/m2;G1组空腹胰岛素(8.31±6.26)u U/m L,G2组空腹胰岛素(7.96±4.51)u U/m L;G1组糖化血红蛋白(6.09±3.48)%,G2组糖化血红蛋白(7.47±0.56)%;2.高胰岛素水平组较低胰岛素水平组BMI明显增高(P0.05),G1HI组较G1LI组BMI明显增高(P0.05),G2HI组较G2LI组BMI明显增高(P0.05)。3.G1组、G2组间空腹胰岛素与BMI的Pearson相关分析,G1和G2组空腹胰岛素与BMI成相关,G2组相关性更高(G1组r=0.64;G2组r=0.716)。结论:老年糖尿病患者体内基础胰岛素水平越高,越容易引起肥胖的发生,而血糖控制越差基础胰岛素越高,更容易引起肥胖的发生。目的:高胰岛素水平容易导致肥胖的发生,引起2型糖尿病、心脑血管病等慢性疾病,胰岛素通过何种机制引肥胖发生国内的文献鲜有提出,本文主要探讨高胰岛素水平通过体内何种机制引起肥胖的发生。方法:将60只6周龄雄性C57BL/6J小鼠适应性喂养1周,禁食8小时后,用眼眶后静脉丛取血方式收集血液,离心收集血清测胰岛素含量,按胰岛素水平是否高于中位数分成高胰岛素水平组(High Insulin,HI)和低胰岛素水平组(Low Insulin,LI)各30只。高胰岛素水平组和低胰岛素水平组两组间随机分成高脂饮食组和普食组各15只。高脂饮食小鼠组喂养高脂饮食,普通饮食组喂养基础饲料,每2周称量小鼠的体重并记录,观察小鼠体重的变化;12周后称量小鼠体重并记录,摘眼球法取血,离心收集血清测小鼠血清中胰岛素的水平和肥胖抑制素的水平,颈椎脱臼法处死小鼠,解剖小鼠,分别收集四组小鼠内脏脂肪称重并记录。比较胰岛素水平与饮食情况两者在引起小鼠体重关系,分析肥胖抑制素与肥胖之间的关系。结果:1高胰岛素水平高脂饮食组小鼠体重和内脏脂肪组织重量显著高于高胰岛素水平普食组、低胰岛素水平高脂饮食组、低胰岛素水平普食组(P0.05);高胰岛素水平普食组体重和内脏脂肪组织重量显著高于低胰岛素水平普食组(P0.05)。低胰岛素水平高脂饮食组体重和内脏脂肪组织显著高于高胰岛素水平普食组(P0.05)。2高胰岛素水平高脂饮食组小鼠肥胖抑制素水平显著低于高胰岛素水平普食组、低胰岛素水平高脂饮食组、低胰岛素水平普食组;低胰岛素水平高脂饮食组肥胖抑制素明显低于高胰岛素水平普食组(P0.05),高胰岛素水平普食组肥胖抑制素明显低于低胰岛素水平普食组(P0.05)。结论:高脂饮食和高胰岛素水平均可以引起肥胖发生,高胰岛素水平和高脂饮食均也可以减低体内肥胖抑制素的含量,说明肥胖抑制素与肥胖的发生之间存在关系。
[Abstract]:Objective: obesity is an important risk factor for type 2 diabetes (Type 2 Diabetes Mellitus, T2DM) and cardiovascular and cerebrovascular diseases. In elderly patients with type 2 diabetes, the control of blood sugar is different because of the different living conditions and dietary conditions. The quality of blood sugar control can be expressed indirectly through glycemic glycemic protein. Basic insulin level and obesity Is there a link between insulin level and obesity? What is the correlation between blood glucose control and obesity? This study aims to observe the effects of insulin levels on obesity in patients with type 2 diabetes and the level of insulin and obesity when the blood sugar is not well controlled. Methods: Hb A1c was measured in 278 elderly diabetic patients who were hospitalized in the Department of Endocrinology and Department of endocrinology in the First Affiliated Hospital of Zhengzhou University from January 2014 to June 2014. The values were divided into G1 group (Hb A1c < 6.5%) and G2 group of poor blood glucose control group (6.5%Hb A1c < 8.5%) in the normal group of blood glucose control. The level of fasting insulin was measured by whether the fasting insulin was greater than the 7.1u U/m L (G1 High Insulin, G1HI), the blood glucose controlled normal low insulin level group (G1 Low Insulin, G1LI), the low blood glucose control group (G2), and the poor insulin level control group. G2 High Insulin, G2HI) four groups. Measure patient's height, body weight and calculate body mass index (Body Mass Index, BMI), BMI= weight (kilogram) / height (meter) square. Compare high insulin level group with low insulin level group BMI; four groups of 22 groups are compared, analyze the relationship between insulin and obesity and different blood glucose level pancreas Results: in 1.278 cases of type 2 diabetes, there were 151 males and 127 females, the average age was (68.9 + 6.4) years, women (67.3 + 7.3) years, G1 group BMI (25.58 + 4.11) kg/m2, BMI (27.89 + 3.69) kg/m2 in group G2, G1 group fasting insulin (8.31 +) u U/m L, G2 group of fasting insulin 09 + 3.48%, group G2 glycated hemoglobin (7.47 + 0.56)%, 2. high insulin level group BMI significantly higher than the low insulin level group (P0.05), G1HI group BMI significantly higher than the G1LI group (P0.05), G2HI group BMI significantly higher than G2LI group (P0.05).3.G1 group. The higher correlation in group G2 (group G1 r=0.64; G2 group r=0.716). Conclusion: the higher the level of insulin in the elderly patients with diabetes, the more prone to obesity, and the higher the control of blood sugar, the higher the basal insulin, the more likely to cause obesity. The literature on the mechanism of insulin induced obesity at home is rarely proposed. This paper mainly discusses the mechanism of high insulin through the body to cause obesity. Methods: 60 6 weeks male C57BL/6J mice were fed for 1 weeks. After fasting, the blood was collected by the posterior orbital plexus collection. The content of insulin was collected from the serum, and 30 rats were divided into the high insulin level group (High Insulin, HI) and the low insulin level group (Low Insulin, LI). The high insulin level group and the low insulin level group were randomly divided into the high fat diet group and the general diet Group 15 each. The high fat diet group was fed high diet group. Fat diet, diet group fed base diet, weighing mice every 2 weeks and recording the weight of mice. After 12 weeks, the weight of mice was weighed and recorded, the blood was picked up by eyeball, the level of insulin in the serum of mice and the level of obese inhibin were measured by centrifuge collection sera, and the mice were killed and dissected by cervical dislocations. The weight of visceral fat in four groups of mice was weighed and recorded. The relationship between insulin level and diet in mice was compared, and the relationship between obesity and obesity was analyzed. Results: 1 the weight and weight of visceral adipose tissue in high insulin high fat diet group were significantly higher than that of high insulin level and low insulin level. High fat diet group, low insulin level general food group (P0.05), high insulin level body weight and visceral fat tissue weight significantly higher than low insulin level group (P0.05). Low insulin level high fat diet group weight and visceral adipose tissue are significantly higher than high insulin level diet group (P0.05).2 high insulin high fat diet group The level of obesity inhibin in mice was significantly lower than that of high insulin group, low insulin high fat diet group, low insulin level universal diet group, low insulin high fat diet group, obesity inhibin was significantly lower than high insulin level diet group (P0.05), high insulin level diet group obesity inhibin was significantly lower than low insulin level. Food group (P0.05). Conclusion: high fat diet and high insulin level can cause obesity. Both high insulin level and high fat diet can also reduce the content of obesity inhibin in the body. It shows that there is a relationship between obesity and obesity.
【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R587.1;R589.2

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