湿性老年性黄斑变性患者血浆脂联素水平的研究

发布时间：2018-03-20 11:55

本文选题：脂联素　切入点：胰岛素抵抗　出处：《重庆医科大学》2012年硕士论文　论文类型：学位论文

【摘要】：背景：老年性黄斑变性是全世界范围内最常见的致盲疾病之一，而且其发病率不断升高。特别是湿性老年性黄斑变性，以脉络膜新生血管为病理特征，是导致严重的不可逆性视力损伤的主要原因。当前的治疗措施，包括光动力学治疗和抗新生血管药物，都集中于逆转血管新生的过程。鉴于即便联合当前的治疗措施也只能得到有限疗效的现状和最近研究的结果显示，人体系统的其他因素可能在该疾病的严重程度和预后情况中起到重要作用。脂联素是一新型的蛋白质激素，由脂肪细胞专一分泌然后进入血流从而调节一系列新陈代谢过程，，包括血糖水平的调节和脂肪酸的分解代谢。已有报道证实了脂联素的抗新生血管作用。因此，本研究从脂联素入手，进行相关的研究。目的：观察湿性老年性黄斑变性患者的血浆脂联素水平。同时，还观察了这些患者的外周血单个核细胞脂联素受体1、受体2的表达水平。方法：15个患者（平均年龄69.07±6.71岁）和15个健康对照（平均年龄64.2±7.46岁）纳入本研究。所有人都不患有糖尿病、高脂血症、肾脏疾病、冠心病、心衰、肾衰等疾病。血浆脂联素水平由ELISA测定。外周血单个核细胞的脂联素受体表达水平由Real-time PCR测定。采用Pearson相关分析处理两变量相关性分析，包括血浆脂联素，脂联素受体1、受体2，内环境稳态模型评估的胰岛素抵抗指数(HOMA-IR)。结果：病例组的血浆脂联素水平明显低于对照组(病例组：1.18±0.65μg/ml, n=15;对照组：2.00±0.63μg/ml, n=15; P=0.002)。还发现病例组的血糖水平明显高于对照组(病例组：5.42±0.64mmol/l, n=15;对照组：4.79±0.39mmol/l, n=15; P=0.003)。但是，两组的外周血单个核细胞的脂联素受体的mRNA表达水平差异无统计学意义(P0.05)。结论：我们的结果显示血浆脂联素浓度在湿性老年性黄斑变性患者中是降低的，提示与脂联素相关的胰岛素抵抗可能存在于湿性老年性黄斑变性的病理性血管新生过程中。
[Abstract]:Background: age-related macular degeneration is one of the most common causes of blindness worldwide, and its incidence is increasing. Especially, wet age-related macular degeneration is characterized by choroidal neovascularization. Is the main cause of severe irreversible visual impairment. Current treatment measures, including photodynamic therapy and anti-angiogenic drugs, Both focus on reversing the process of angiogenesis. Given the limited efficacy of even combined current treatment measures, recent studies have shown that, Other factors in the human system may play an important role in the severity and prognosis of the disease. Adiponectin, a new type of protein hormone, is secreted by adipocytes and enters the bloodstream to regulate a series of metabolic processes. The regulation of blood glucose and the catabolism of fatty acids have been reported to confirm the antiangiogenic effect of adiponectin. Aim: to observe the plasma adiponectin levels and the expression of adiponectin receptor 1 and receptor 2 in peripheral blood mononuclear cells from patients with wettable age-related macular degeneration. Methods: fifteen patients (mean age 69.07 卤6.71 years) and 15 healthy controls (mean age 64.2 卤7.46 years) were included in the study. Renal failure and other diseases. Plasma adiponectin level was measured by ELISA. Adiponectin receptor expression in peripheral blood mononuclear cells was measured by Real-time PCR. Two variables correlation analysis was performed by Pearson correlation analysis, including plasma adiponectin. Adiponectin receptor 1, receptor 2, homeostasis assessment of insulin resistance index (Homa-IRN). Results: the plasma adiponectin level in the case group was significantly lower than that in the control group (1. 18 卤0. 65 渭 g / ml, n = 15; control group: 2. 00 卤0. 63 渭 g / ml, n = 15; P = 0. 002). It was also found that the blood glucose level in the case group was significantly higher than that in the control group (5. 42 卤0. 64 mmol / r, n = 15; control group: 4. 79 卤0. 39 mmol / L, n = 15; P 0.0033). There was no significant difference in mRNA expression of adiponectin receptor between the two groups. Conclusion: our results suggest that plasma adiponectin concentration is decreased in patients with wettable age-related macular degeneration, suggesting that adiponectin related insulin resistance may exist during pathological angiogenesis of wet age-related macular degeneration.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R774.5

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