艾塞那肽对肥胖2型糖尿病患者血清FGF-21水平的影响及相关性研究
发布时间：2019-03-15 19:41
【摘要】：背景成纤维细胞生长因子21(FGF-21)是一类可正向调节糖脂代谢的新型因子,在糖尿病及肥胖等代谢性疾病中,具有增加胰岛素敏感性、改善糖耐量水平及脂代谢紊乱、调节能量代谢、减轻体重等积极作用。艾塞那肽属于胰高血糖素样肽-1受体激动剂,在控制血糖、辅助减重等方面具有突出优势。FGF-21是否参与到艾塞那肽对肥胖2型糖尿病的治疗过程中,目前仍缺乏相关文献报道。目的1.观察肥胖2型糖尿病(T2DM)患者血清成纤维细胞生长因子21(FGF-21)水平,分析其与相关代谢指标之间的关系。2.观察艾塞那肽(Exenatide)治疗对肥胖T2DM患者血清FGF-21水平的影响,分析艾塞那肽治疗前后血清FGF-21变化与代谢指标变化的相关性,旨在探究FGF-21在艾塞那肽降糖减重作用中发挥的作用。方法1.收集2015年3月至2016年4月我科门诊及住院治疗的单用口服降糖药物控制不佳的肥胖2型糖尿病患者45例(男30例,女15例)作为病例组(Exe组)。Exe组加用艾塞那肽治疗16周(前4周5ug BID,后12周10ug BID治疗)。并于社区募集同年龄段健康人群45例(男30例,女15例)作为对照组(NC组)。2.观察两组治疗前及Exe组治疗后体重、体重指数(BMI)、腰围、臀围、腰臀比(WHR)、收缩压(SBP)、舒张压(DBP)、空腹血糖(FPG)、糖化血红蛋白(Hb A1c)、空腹胰岛素(FINS)、稳态模型胰岛素抵抗指数(HOMA-IR)、胰岛β细胞功能指数(HOMA-β)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)等指标,采用酶联免疫吸附法(ELISA)测定血清FGF-21水平,分析肥胖T2DM及艾塞那肽治疗对血清FGF-21的影响,并对FGF-21与上述代谢指标进行相关性分析。结果1.Exe组共43例完成研究。肥胖T2DM患者血清FGF-21水平明显高于NC组(t=2.461,P0.05),FGF-21水平与体重、BMI、FPG、HOMA-IR、TG(r=0.428、0.514、0.551、0.660、0.634,P0.01),腰围、Hb A1c、FINS(r=0.377、0.341、0.375,P0.05)呈明显正相关。HOMA-IR与TG(β=0.552、0.520,P0.01)是影响肥胖T2DM患者血清FGF-21水平的独立危险因素。2.Exe组加用艾塞那肽治疗16周后,体重、BMI、腰围、FPG、Hb A1c、WHR、HOMA-IR(t=5.520、5.832、4.717、5.251、9.323、Z=3.386、2.566,P0.01),DBP、TG及血清FGF-21水平(t=2.391、2.362、2.400,P0.05)均较治疗前显著降低,HOMA-β(t=-2.835,P0.01)、HDL-C(t=-2.251,P0.05)较治疗前显著升高。Exe组治疗前后血清FGF-21水平的降低程度与HOMA-IR(r=0.461,P0.01),体重、BMI、FPG、Hb A1c、TG(r=0.353、0.376、0.325、0.331、0.323,P0.05)的降低程度呈明显正相关。多元逐步线性回归分析提示Exe组艾塞那肽治疗后血清FGF-21水平下降与HOMA-IR降低关系密切(β=0.461,P0.01)。结论1.肥胖T2DM患者血清FGF-21较正常对照组明显升高,肥胖T2DM患者血清FGF-21水平变化可能与糖脂代谢异常和胰岛素抵抗有关。2.艾塞那肽可显著降低肥胖T2DM患者血清FGF-21水平,且与改善胰岛素抵抗密切相关。FGF-21可能为艾塞那肽改善胰岛素抵抗及降糖减重的作用机制之一。
[Abstract]:Background Fibroblast growth factor 21 (FGF-21) is a new type of factor that can regulate glucose and lipid metabolism positively. In metabolic diseases such as diabetes mellitus and obesity, it can increase insulin sensitivity, improve glucose tolerance and lipid metabolism disorder. Regulate energy metabolism, weight loss and other positive effects. Esenapeptide, an agonist of glucagon-like peptide-1 receptor, has prominent advantages in controlling blood sugar and assisting weight loss. Whether FGF-21 is involved in the treatment of obese type 2 diabetes mellitus by esenapeptide, At present, there is still a lack of relevant literature reports. Purpose 1. To observe the level of serum fibroblast growth factor 21 (FGF-21) in obese patients with type 2 diabetes mellitus (T2DM) and analyze the relationship between serum fibroblast growth factor 21 (fibroblast growth factor 21) and related metabolic indexes. 2. To observe the effect of esenapeptide (Exenatide) treatment on serum FGF-21 level in obese T2DM patients, and to analyze the correlation between the changes of serum FGF-21 and metabolic indexes before and after treatment with esenapeptide. The aim of this study was to explore the role of FGF-21 in reducing glucose and weight loss of esenapeptide. Method 1. From March 2015 to April 2016, 45 obese type 2 diabetic patients (male 30, male 30) who were not well controlled by oral hypoglycemic drugs were collected. The patients were treated with esenapeptide for 16 weeks (the first 4 weeks after 5ug BID, 12 weeks after 10ug BID treatment) as the case group (Exe group). Exe group plus esenapeptide therapy). 45 healthy people of the same age group (30 males and 15 females) were recruited in the community as the control group (NC group). The body weight, body mass index (BMI),) waist circumference, hip circumference, waist-hip ratio of (WHR), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FPG), glycosylated hemoglobin (Hb A1c) were observed before and after treatment in Exe group. Fasting insulin (FINS), homeostasis model insulin resistance index (HOMA-IR), islet 尾 cell function index (HOMA- 尾), triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C). High density lipoprotein cholesterol (HDL-C), serum FGF-21 level was measured by enzyme linked immunosorbent assay (ELISA), and the effects of obese T2DM and esenapeptide on serum FGF-21 were analyzed. The correlation between FGF-21 and the above metabolic indexes was also analyzed. Results 43 patients in 1.Exe group completed the study. The level of serum FGF-21 in obese T2DM patients was significantly higher than that in NC group (t = 2.461, P0.05), FGF-21 level and body weight, BMI,FPG,HOMA-IR,TG (r = 0.428, 0.514, 0.551, 0.660, 0.634, P0.01), waist circumference, Hb A1c, FINS (r = 0.377,0.341, 0.375, P0.05) was positively correlated with Homa-IR and TG (尾 = 0.552, 0.520, P0.01) were independent risk factors affecting serum FGF-21 level in obese T2DM patients. 2. Exe group was treated with esenapeptide for 16 weeks. Body weight, BMI, waist circumference, FPG,Hb A1C, WHR, Homa IR (t = 5.520, 5.832, 4.717, 5.251, 9.323, Z = 3.386,2.566, P0.01), DBP,TG and serum FGF-21 levels (t = 2.391, 2.362, 2.400, P0.05) were significantly lower than those before treatment. HOMA- 尾 (t = 2.835, P0.01) and HDL-C (t = 2.251, P0.05) were significantly higher than those before treatment. The level of serum FGF-21 and HOMA-IR (r = 0.461, P0.01), body weight, BMI,FPG, in Exe group decreased significantly before and after treatment. Hb A1C, TG (r = 0.353, 0.376, 0.325, 0.331, 0.323, P 0.05) were significantly positively correlated with the decrease of TG (r = 0.353, 0.376, 0.325, 0.331, 0.323, P 0.05). Multiple stepwise linear regression analysis showed that the decrease of serum FGF-21 level was closely related to the decrease of HOMA-IR (尾 = 0.461, P0.01) in Exe group after treatment with esenapeptide. Conclusion 1. The serum FGF-21 level in obese T2DM patients is significantly higher than that in normal controls. The changes of serum FGF-21 levels in obese T2DM patients may be related to abnormal glucose and lipid metabolism and insulin resistance. 2. T2DM-21 may be one of the mechanisms of esenapeptide in improving insulin resistance and reducing weight loss in obese patients with obesity-induced insulin resistance, which may be related to the decrease of serum FGF-21 level in obese patients with insulin resistance.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R587.1
本文编号：2440924
[Abstract]:Background Fibroblast growth factor 21 (FGF-21) is a new type of factor that can regulate glucose and lipid metabolism positively. In metabolic diseases such as diabetes mellitus and obesity, it can increase insulin sensitivity, improve glucose tolerance and lipid metabolism disorder. Regulate energy metabolism, weight loss and other positive effects. Esenapeptide, an agonist of glucagon-like peptide-1 receptor, has prominent advantages in controlling blood sugar and assisting weight loss. Whether FGF-21 is involved in the treatment of obese type 2 diabetes mellitus by esenapeptide, At present, there is still a lack of relevant literature reports. Purpose 1. To observe the level of serum fibroblast growth factor 21 (FGF-21) in obese patients with type 2 diabetes mellitus (T2DM) and analyze the relationship between serum fibroblast growth factor 21 (fibroblast growth factor 21) and related metabolic indexes. 2. To observe the effect of esenapeptide (Exenatide) treatment on serum FGF-21 level in obese T2DM patients, and to analyze the correlation between the changes of serum FGF-21 and metabolic indexes before and after treatment with esenapeptide. The aim of this study was to explore the role of FGF-21 in reducing glucose and weight loss of esenapeptide. Method 1. From March 2015 to April 2016, 45 obese type 2 diabetic patients (male 30, male 30) who were not well controlled by oral hypoglycemic drugs were collected. The patients were treated with esenapeptide for 16 weeks (the first 4 weeks after 5ug BID, 12 weeks after 10ug BID treatment) as the case group (Exe group). Exe group plus esenapeptide therapy). 45 healthy people of the same age group (30 males and 15 females) were recruited in the community as the control group (NC group). The body weight, body mass index (BMI),) waist circumference, hip circumference, waist-hip ratio of (WHR), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FPG), glycosylated hemoglobin (Hb A1c) were observed before and after treatment in Exe group. Fasting insulin (FINS), homeostasis model insulin resistance index (HOMA-IR), islet 尾 cell function index (HOMA- 尾), triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C). High density lipoprotein cholesterol (HDL-C), serum FGF-21 level was measured by enzyme linked immunosorbent assay (ELISA), and the effects of obese T2DM and esenapeptide on serum FGF-21 were analyzed. The correlation between FGF-21 and the above metabolic indexes was also analyzed. Results 43 patients in 1.Exe group completed the study. The level of serum FGF-21 in obese T2DM patients was significantly higher than that in NC group (t = 2.461, P0.05), FGF-21 level and body weight, BMI,FPG,HOMA-IR,TG (r = 0.428, 0.514, 0.551, 0.660, 0.634, P0.01), waist circumference, Hb A1c, FINS (r = 0.377,0.341, 0.375, P0.05) was positively correlated with Homa-IR and TG (尾 = 0.552, 0.520, P0.01) were independent risk factors affecting serum FGF-21 level in obese T2DM patients. 2. Exe group was treated with esenapeptide for 16 weeks. Body weight, BMI, waist circumference, FPG,Hb A1C, WHR, Homa IR (t = 5.520, 5.832, 4.717, 5.251, 9.323, Z = 3.386,2.566, P0.01), DBP,TG and serum FGF-21 levels (t = 2.391, 2.362, 2.400, P0.05) were significantly lower than those before treatment. HOMA- 尾 (t = 2.835, P0.01) and HDL-C (t = 2.251, P0.05) were significantly higher than those before treatment. The level of serum FGF-21 and HOMA-IR (r = 0.461, P0.01), body weight, BMI,FPG, in Exe group decreased significantly before and after treatment. Hb A1C, TG (r = 0.353, 0.376, 0.325, 0.331, 0.323, P 0.05) were significantly positively correlated with the decrease of TG (r = 0.353, 0.376, 0.325, 0.331, 0.323, P 0.05). Multiple stepwise linear regression analysis showed that the decrease of serum FGF-21 level was closely related to the decrease of HOMA-IR (尾 = 0.461, P0.01) in Exe group after treatment with esenapeptide. Conclusion 1. The serum FGF-21 level in obese T2DM patients is significantly higher than that in normal controls. The changes of serum FGF-21 levels in obese T2DM patients may be related to abnormal glucose and lipid metabolism and insulin resistance. 2. T2DM-21 may be one of the mechanisms of esenapeptide in improving insulin resistance and reducing weight loss in obese patients with obesity-induced insulin resistance, which may be related to the decrease of serum FGF-21 level in obese patients with insulin resistance.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R587.1
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