血清可溶性血红蛋白清道夫受体sCD163在不同肥胖代谢类型中的变化及意义

发布时间：2018-08-09 21:09

【摘要】：目的:本研究通过观察不同肥胖代谢类型患者的一般临床特点、比较s CD163、TNF-α、CRP在不同肥胖代谢类型中的变化及意义,探讨s CD163的变化在不同肥胖代谢类型发病中的作用及影响因素,为进一步研究不同肥胖代谢类型的发病机制提供理论基础。方法:收集2015年12月-2016年12月就诊于石河子大学第一附属医院门诊及住院的成年人的一般情况、既往病史、家族史、身体检查、吸烟史、饮酒史等信息。采集晨空腹血并使用罗氏全自动生化分析仪检测血清中空腹血糖、胆固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白、尿酸等的浓度。根据2003年《中国成人超重和肥胖症预防控制指南》定义的肥胖诊断标准和NCEP ATP-Ⅲ定义的代谢异常诊断标准,将研究对象分为正常体重代谢正常(MHNW)组、代谢正常性肥胖(MHO)组、正常体重代谢异常(MONW)组、代谢异常性肥胖(MAO)组四个组。采用酶联免疫吸附测定法测定s CD163、TNF-α及CRP的浓度。结果:1.所有研究对象平均年龄为63.6±11.2岁,四组研究对象的平均年龄及性别差异无统计学意义(p0.05)。2.MHNW组的WHR低于MHO组、MONW组、MAO组,MAO组的WHR高于MHO组、MONW组,差异有统计学意义(p0.001);MONW组、MAO组的SBP高于MHNW组、MHO组,差异有统计学意义(p0.001);MAO组的DBP高于MHNW组、MHO组、MONW组,差异有统计学意义(p0.001);MONW组、MAO组的Hb A1C、FBG、PBG、HDL-C、TG高于MHNW组、MHO组,差异均有统计学意义(p值均0.001);MAO组的ALT高于MHNW组、MONW组,差异有统计学意义(p0.05);MAO组的AST较MHNW组、MHO组、MONW组均升高,差异有统计学意义(p0.05)。而四组研究对象的TG、LDL-C、BUN和Scr的差异经比较均无统计学意义(p0.05)。3.MHO组、MONW组、MAO组的s CD163、TNF-α、CRP均高于MHNW组,差异有统计学意义(p0.001),MAO组的s CD163、TNF-α、CRP均高于MHNW组、MHO组、MAO组,差异有统计学意义(P0.001)。MHO组与MONW组间的s CD163、TNF-α差异无统计学意义(p=0.307、P=0.337),MHO组CRP水平高于MONW组,差异有统计学意义(p0.05)。4.s CD163与TNF-α、CRP、BMI、WHR、SBP、DBP、Hb A1C、FBG、PBG、TG、ALT均呈正相关,与HDL-C呈负相关(p0.001)。5.采用多元逐步线性回归方法,以s CD163为因变量,各临床指标因素为自变量,BMI、Hb A1C、DBP越高,HDL-C越低,此时s CD163浓度越高。结论:MHO组、MONW组、MAO组人群体内均存在炎症状态,以MAO组最为明显。s CD163可能参与了肥胖及代谢异常的发病。
[Abstract]:Objective: to observe the general clinical characteristics of patients with different obesity metabolic types, to compare the changes and significance of s CD163 TNF- 伪 CRP in different obesity metabolic types, and to explore the role of s CD163 in the pathogenesis of different obesity metabolic types and its influencing factors. It provides a theoretical basis for further study on the pathogenesis of different metabolic types of obesity. Methods: from December 2015 to December 2016, we collected the general information of adults in outpatient and inpatient of the first affiliated Hospital of Shihezi University, including past medical history, family history, physical examination, smoking history, drinking history and so on. Fasting blood samples were collected and serum fasting blood glucose, cholesterol, triglyceride, high density lipoprotein, low density lipoprotein and uric acid were measured by Roche automatic biochemical analyzer. According to the criteria for the diagnosis of obesity defined in the guidelines for Prevention and Control of overweight and Obesity in Chinese Adults in 2003 and the criteria for the diagnosis of Metabolism abnormality defined by NCEP ATP-III, the subjects were divided into normal body weight normal metabolic (MHNW) group and metabolic normal obese (MHO) group. Normal body weight metabolism abnormal (MONW) group, metabolic abnormal obesity (MAO) group four groups. The concentrations of sCD163 TNF- 伪 and CRP were determined by enzyme linked immunosorbent assay (Elisa). The result is 1: 1. The average age of all subjects was 63.6 卤11.2 years old. There was no significant difference in average age and sex between the four groups. 2. The WHR of MHNW group was lower than that of MHO group. The WHR of MHNW group was higher than that of MHO group. The SBP of mow group was higher than that of MHNW group (p 0.001). The DBP of Mao group was higher than that of MHNW group (P 0.001). The difference was statistically significant (p0.001). The difference was statistically significant (p = 0.001). The ALT of Mao group was higher than that of MHNW group, and the AST of Mao group was higher than that of MHNW group (p0.05). However, there was no significant difference in the levels of TG-LDL-Cnbun and Scr between the four groups. 3. The levels of sCD163TNF- 伪 Scr in MHO group were higher than those in MHNW group. The difference was statistically significant (p0.001). The difference was higher in MHO group than that in MHNW group. There was no significant difference between MHO group and MONW group (P 0.001). There was no significant difference in CRP level between MHO group and MONW group (p0. 307). The level of CRP in MHO group was higher than that in MONW group. The difference was statistically significant (p0. 05). 4. S CD163 was significantly higher than that in MONW group (p0. 05). There was a positive correlation between the CRP level of MHO group and that of MONW group (p 0. 001), and there was a negative correlation with HDL-C (p 0. 001). Using multiple stepwise linear regression method, the higher the HDL-C and the higher the concentration of s CD163 were, the higher the HDL-C was and the higher the clinical parameters were, the more dependent variables were s CD163. Conclusion there is an inflammatory state in the body of male MHO group, especially in MAO group. S CD163 may be involved in the pathogenesis of obesity and abnormal metabolism.
【学位授予单位】：石河子大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R589.2

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