内脏脂肪素与传统心脑血管疾病危险因素相关性分析

发布时间：2018-06-18 12:16

本文选题：内脏脂肪素 + 心脑血管疾病　；参考：《济南大学》2014年硕士论文

【摘要】：目的: 内脏脂肪素（visfatin）是一种主要由内脏脂肪组织分泌的细胞因子，其在肝脏、脾脏、骨髓、肌肉等多种组织器官中也均有表达。可结合并激活胰岛素受体，，进而发挥类胰岛素样降低血糖的作用，还参与机体脂类物质的代谢、血管内皮功能紊乱、血管再生、冠状动脉粥样硬化以及缺血再灌注损伤等心脑血管疾病发生发展的病理生理过程，有可能成为心脑血管疾病新的防治靶点。本研究试图通过分析内脏脂肪素与传统心脑血管疾病危险因素之间的关系，验证其与相关心脑血管病危险因素间一致性，为心脑血管病危险因素及防控对策的研究提供依据。方法: 课题组于2010年8月至9月在山东省宁阳县东疏镇的49个行政村中，采用随机整群抽样的方法选取17个村中35-74岁所有常住居民共3500人作为调查对象。对全部调查对象进行问卷调查、体格测量及空腹血液标本的检测。采用Spearman相关性分析和多元线性逐步回归分析，分析血浆内脏脂肪素水平与收缩压、舒张压、空腹血糖、血脂四项、腰围、体重指数、吸烟量、饮酒量等传统心脑血管疾病危险因素之间的关系，并分别比较高血压、糖尿病、血脂异常、代谢综合征等慢性疾病的患者与正常人群间血浆内脏脂肪素水平的差异，以此来推断内脏脂肪素与心脑血管疾病之间的关系。结果: （1）血浆内脏脂肪素水平与体重、腰围、腰高比、体重指数、舒张压、空腹血糖、低密度脂蛋白胆固醇、甘油三酯及C反应蛋白呈正相关（r=0.221、0.271、0.310、0.326、0.075、0.184、0.042、0.178、0.069，P＜0.05），与年龄、酒精摄入量、高密度脂蛋白胆固醇以及脉压差呈负相关（r=-0.131、-0.173、-0.184、-0.048，P＜0.01），与总胆固醇、收缩压、吸烟量未见明显相关关系；（2）多元线性逐步回归分析发现，体重指数、空腹血糖、甘油三脂、高密度脂蛋白胆固醇被纳入回归方程，为能够影响血浆内脏脂肪素水平的影响因素；（3）在糖尿病、高血压、血脂异常、超重/肥胖及代谢综合征等慢性疾病的患者中血浆内脏脂肪素水平均显著高于正常人群。结论: 血浆内脏脂肪素与传统心脑血管疾病危险因素间存在明显的相关关系，各种与心脑血管疾病相关的慢性疾病的患者与正常人群相比，血浆内脏脂肪素水平均显著升高，提示内脏脂肪素与心脑血管疾病的发生发展存在密切关系，或可成为心脑血管疾病防治的新靶点。但内脏脂肪素对心脑血管疾病的具体作用机制尚不明确，其与心脑血管疾病间关系的确定仍需大样本人群队列研究进行证实。
[Abstract]:Objective: visfatin is a cytokine secreted mainly by visceral adipose tissue. It is also expressed in liver, spleen, bone marrow, muscle and other tissues and organs. It can bind and activate insulin receptor, and then play the role of insulin-like hypoglycemia, also participate in the metabolism of lipid substances, vascular endothelial dysfunction, vascular regeneration, The pathophysiological process of cardiovascular and cerebrovascular diseases such as coronary atherosclerosis and ischemia-reperfusion injury may become a new target for the prevention and treatment of cardiovascular and cerebrovascular diseases. This study attempts to analyze the relationship between visceral fat and traditional cardiovascular and cerebrovascular disease risk factors, and to verify the consistency between visceral fat and related cardiovascular and cerebrovascular disease risk factors, so as to provide the basis for the study of cardiovascular and cerebrovascular disease risk factors and prevention and control countermeasures. Methods: from August to September 2010, 3500 residents aged 35-74 years were selected from 49 administrative villages in Dongshu Town, Ningyang County, Shandong Province. All subjects were investigated by questionnaire, physical measurement and fasting blood samples. Spearman correlation analysis and multiple linear stepwise regression analysis were used to analyze plasma visceral fat levels and systolic blood pressure, diastolic blood pressure, fasting blood glucose, blood lipids, waist circumference, body mass index and smoking. The relationship between the risk factors of traditional cardiovascular and cerebrovascular diseases, such as alcohol consumption, and the differences in plasma visceral fat levels between patients with hypertension, diabetes mellitus, dyslipidemia, metabolic syndrome and the normal population were compared. The relationship between visceral fat and cardiovascular and cerebrovascular diseases was inferred. Results: plasma visceral fat levels were positively correlated with body weight, waist circumference, waist height ratio, body mass index, diastolic blood pressure, fasting blood glucose, low density lipoprotein cholesterol, triglyceride and C-reactive protein (P < 0.05). Alcohol intake, high density lipoprotein cholesterol and pulse pressure difference were negatively correlated (P < 0.01). There was no significant correlation between alcohol intake, high density lipoprotein cholesterol and pulse pressure difference (P < 0.01). Triglyceride, high density lipoprotein cholesterol were incorporated into the regression equation for influencing plasma visceral fat levels in patients with diabetes, hypertension, and dyslipidemia. Plasma visceral fat levels in patients with overweight / obesity and metabolic syndrome were significantly higher than those in normal controls. Conclusion: there is a significant correlation between plasma visceral fat and the risk factors of traditional cardiovascular and cerebrovascular diseases. The level of visceral fat in plasma was significantly increased, which suggested that visceral adipotin was closely related to the occurrence and development of cardiovascular and cerebrovascular diseases, and might be a new target for the prevention and treatment of cardiovascular and cerebrovascular diseases. However, the mechanism of visceral fat on cardiovascular and cerebrovascular diseases is not clear, and the relationship between visceral and cerebrovascular diseases still needs to be confirmed by cohort study in large sample population.
【学位授予单位】：济南大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R54;R743

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