2型糖尿病内脏脂肪、脂肪因子与心脏外膜脂肪及心功能关系研究

发布时间：2018-10-21 14:18

【摘要】：目的:探讨初诊2型糖尿病患者内脏脂肪、脂肪因子与心外膜脂肪及心功能的关系。方法:收集2015年08月至2016年06月20-70岁的初诊2型糖尿病患者(男65例,女35例),根据我国肥胖问题工作组2003年制定的肥胖诊断标准,分为OB组(肥胖体重组,31例)、OW组(超重体重组,35例)及NW组(正常体重组,34例)共100例。收集其人体测量学指标(如年龄、性别、身高、收缩压、舒张压)、临床生化学指标(如空腹胰岛素)、内脏脂肪含量(VAT mass、VAT area)、心外膜脂肪厚度(右心室前壁脂肪、心尖部脂肪)、脂肪因子(Apelin、Omentin-1)与心功能(EF、EDV、ESV)等指标进行相关统计学处理。数据处理采用spss 17.0统计软件进行方差分析,spearman相关分析和多元线性回归分析,P0.05表示差异有统计学意义。结果:1.三组在年龄、性别、身高、收缩压、舒张压无差异性(P0.05),OB组、OW组与NW组三组的FINS、VAT mass、VAT area、右心室前壁脂肪、心尖部脂肪、脂肪因子Apelin、Omentin-1等多项指标方面两两比较差异有统计学意义(P0.05)。2.脂肪因子Apelin浓度与内脏脂肪(VAT mass、VAT area)、心外膜脂肪(右心室前壁脂肪、心尖脂肪)、心功能(EDV、ESV)呈正相关(R=0.424、0.425、0.205、0.198、0.261、0.337,P0.05),与心功能(EF)呈负相关(R=-0.251,P0.05);脂肪因子Omentin-1与内脏脂肪(VAT mass、VAT area)、心外膜脂肪(右心室前壁脂肪、心尖脂肪)、心功能(EDV、ESV)呈负相关(R=-0.539、-0.538、-0.263、-0.260、-0.338、-0.388,P0.05)。3.多元线性回归分析提示内脏脂肪VAT area是初诊2型糖尿病心功能(EF、EDV、ESV)主要影响因素。结论:1.初诊2型糖尿病内脏脂肪与心功能相关,提示减少内脏脂肪面积对初诊2型糖尿病患者心功能具有保护作用。2.脂肪因子apelin水平与内脏脂肪、心外膜脂肪含量正相关,与心功能(EF)负相关,提示降低内脏脂肪、降低apelin水平可以改善左心射血指数。3.脂肪因子omentin-1水平与内脏脂肪、心外膜脂肪、心功能(EDV、ESV)呈负相关,提示降低内脏脂肪、提高omentin水平具有改善心功能的作用。
[Abstract]:Objective: to investigate the relationship between visceral fat, fatty factor and epicardial fat and cardiac function in newly diagnosed type 2 diabetes mellitus. Methods: type 2 diabetes patients (65 males and 35 females) aged 20-70 years from August 2015 to June 2016 were collected. The criteria for the diagnosis of obesity were established by the working Group on Obesity in China in 2003. One hundred patients were divided into OB group (obese weight group), 31), OW group (overweight weight group, 35 cases) and NW group (normal weight group, 34 cases). The anthropometric parameters (such as age, sex, height, systolic blood pressure, diastolic blood pressure), clinical biochemical indexes (such as fasting insulin), visceral fat content (VAT mass,VAT area), epicardial fat thickness (right ventricular anterior wall fat), right ventricular anterior wall fat) were collected. Apical fat), fat factor (Apelin,Omentin-1) and cardiac function (EF,EDV,ESV) were statistically correlated. Data processing using spss 17.0 statistical software for ANOVA, spearman correlation analysis and multiple linear regression analysis, P0.05 indicated the difference was statistically significant. The result is 1: 1. There was no difference in age, sex, height, systolic blood pressure and diastolic blood pressure among the three groups (P0.05 in), OB group, OW group and NW group) in FINS,VAT mass,VAT area, right ventricular anterior wall fat, apical fat, adipose factor Apelin,Omentin-1 and so on (P0.05). Fatty factor Apelin concentration and visceral fat (VAT mass,VAT area), epicardial fat) There was a positive correlation between cardiac function (EDV,ESV) and visceral fat (VAT mass,VAT area), epicardial fat, apical adipose), and a negative correlation between Omentin-1 and cardiac function (EF) (RP05), and a negative correlation between Omentin-1 and visceral fat (VAT mass,VAT area), epicardial fat, apical adipose), and heart function (EDV,ESV) (RV -0.539U -0.538U -0.263U -0.263n -0.263U -0.338- 0.388p0.05), and a negative correlation between Omentin-1 and visceral fat (VAT mass,VAT area), epicardial fat, apical fat) and cardiac function (EDV,ESV). Multiple linear regression analysis showed that visceral fat VAT area was the main factor affecting cardiac function in newly diagnosed type 2 diabetes mellitus (EF,EDV,ESV). Conclusion: 1. Visceral fat was associated with cardiac function in newly diagnosed type 2 diabetes mellitus, suggesting that reducing the area of visceral fat had protective effect on cardiac function of newly diagnosed type 2 diabetes mellitus. 2. The level of apelin was positively correlated with visceral fat and epicardial fat, and negatively correlated with cardiac function (EF), suggesting that decreasing visceral fat and decreasing apelin level could improve left ventricular ejection index. The level of omentin-1 was negatively correlated with visceral fat, epicardial fat and cardiac function (EDV,ESV), suggesting that decreasing visceral fat and increasing omentin level could improve cardiac function.
【学位授予单位】：广西中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R587.2

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