2型糖尿病合并冠心病患者的血清非对称二甲基精氨酸水平及其影响因素

发布时间：2018-04-14 23:01

本文选题：非对称二甲基精氨酸 + 2型糖尿病　；参考：《昆明医科大学》2017年硕士论文

【摘要】：[目的]探讨2型糖尿病合并冠心病患者的血清非对称二甲基精氨酸水平及其影响因素。[方法]随机选取我院内分泌科住院部2型糖尿病患者67例(其中单纯糖尿病组39例,合并冠心病组28例),及在我院进行体检的无亲缘关系的健康人33例,记录研究对象的一般临床资料、病史,检验各血液生化指标,应用酶联免疫法吸附法检测研究对象的血清ADMA浓度,比较分析各组间血清ADMA水平和相关临床指标。[结果]1.ADMA水平在2型糖尿病合并冠心病组单纯2型糖尿病组健康对照组,差异有统计学意义(P0.05),协方差分析校正TC、LDL、FPG等因素干扰后,ADMA水平在各组间差异仍有统计学意义(P0.05);2.TC、LDL、FPG、HBA1c、HOMA-IR在2型糖尿病合并冠心病组单纯2型糖尿病组健康对照组,各组间差异均有统计学意义(P0.05);3.糖尿病病程在2型糖尿病合并冠心病组单纯2型糖尿病组,差异有统计学意义(P0.05):4.HDL在2型糖尿病合并冠心病组单纯2型糖尿病组健康对照组,各组间差异均有统计学意义(P0.5);5.TG、ALT、AST、2hPG在2型糖尿病合并冠心病组健康对照组,在单纯2型糖尿病组健康对照组,差异有统计学意义(P0.05),单纯2型糖尿病组和2型糖尿病合并冠心病组间差异无统计学意义;6.年龄、性别构成、SBP、DBP、BMI、WHR、BUN、Scr在三组人群之间差异无统计学意义(P0.05);7.Pearson 分析显示血清 ADMA水平与病程、TC、TG、LDL、FPG、2hPG、HBA1c、HOMA-IR呈正相关,与HDL呈负相关,与年龄、SBP、DBP、BMI、WHR、ALT、AST、BUN、Scr无明显相关性;8.多元回归分析血清ADMA水平,HOMA-IR、HBA1c、LDL进入方程,F=121.4,P0.01,回归方程成立,标准化偏回归系数分别为 0.326、0.319、0.230,HOMA-IR 对血清 ADMA 的影响比 HBA1c、LDL 更大;9.多元回归分析2型糖尿病合并冠心病发生示:ADMA、LDL、HBA1c进入方程,F=102.3,P0.01,回归方程成立,标准化偏回归系数分别为0.404、0.380、0.185,ADMA对2型糖尿病合并冠心病发生的影响比HBA1c、LDL更大。[结论]1.血清ADMA水平在2型糖尿病合并冠心病组单纯2型糖尿病组健康对照组,差异有统计学意义,推测ADMA可能参与2型糖尿病合并冠心病的发生发展;2.影响血清ADMA水平的因素有HOMA-IR、LDL、HBA1c,影响2型糖尿病合并冠心病发生的因素有:HBA1c、LDL、ADMA,改善胰岛素抵抗、降糖、降脂综合治疗可能有利于ADMA的减低,减缓2型糖尿病合并冠心病的发生发展进程。
[Abstract]:Objective: to investigate the serum asymmetric dimethyl arginine level and its influencing factors in patients with type 2 diabetes mellitus complicated with coronary heart disease.[methods] Sixty-seven patients with type 2 diabetes mellitus in the Department of Endocrinology in our hospital were randomly selected, including 39 cases of simple diabetes mellitus group, 28 cases of coronary heart disease group, and 33 cases of unrelated healthy persons who were examined in our hospital.The general clinical data, medical history and blood biochemical indexes were recorded. The serum ADMA concentration was detected by enzyme linked immunosorbent assay (Elisa), and the serum ADMA levels and related clinical indexes were compared and analyzed among each group.[results] the level of 1.ADMA in type 2 diabetes with coronary heart disease group was normal control group.There was significant difference in ADMA level between the two groups after adjusted by covariance analysis of TCU LDLN FPG and other factors. 2. The level of ADMA in type 2 diabetes complicated with coronary heart disease group was significantly higher than that in the control group with type 2 diabetes mellitus (type 2 diabetes mellitus and coronary heart disease alone), and there was no significant difference in the level of ADMA between the two groups (P < 0. 05 or P 0. 05). 2. The level of ADMA in patients with type 2 diabetes mellitus complicated with coronary heart disease was significantly different.The differences among the groups were statistically significant (P 0.05).The course of diabetes in type 2 diabetes complicated with coronary heart disease group, the difference was statistically significant in type 2 diabetes mellitus with coronary heart disease group, the difference was statistically significant in type 2 diabetes mellitus with coronary heart disease group, the difference was significant in type 2 diabetes mellitus with coronary heart disease group, type 2 diabetes mellitus group was healthy control group.There were significant differences among the three groups (P0. 5). 5. The level of alt AST2hPG in patients with type 2 diabetes complicated with coronary heart disease was significantly higher than that in patients with type 2 diabetes mellitus and only type 2 diabetes, and there was no significant difference between the two groups.The difference was statistically significant (P 0.05). There was no significant difference between type 2 diabetes mellitus and type 2 diabetes mellitus with coronary heart disease.There was no significant difference in serum ADMA level between the three groups. Pearson analysis showed that the level of serum ADMA was positively correlated with the course of disease, and negatively correlated with HDL. There was no significant correlation between serum ADMA level and HDL.Multivariate regression analysis showed that the serum ADMA level of HOMA-IRN HBA1cP0. 01, the regression equation was established, the normalized partial regression coefficient was 0. 326 ~ 0. 319 ~ 0. 230 Homa-IR had a greater effect on serum ADMA than HBA1 / cLDL.Multivariate regression analysis showed that the incidence of type 2 diabetes mellitus complicated with coronary heart disease (CHD) was higher than that of HBA1c in type 2 diabetes mellitus complicated with coronary heart disease. The regression equation was established and the standardized partial regression coefficient was 0.404 ~ 0.380 ~ 0.185% ADMA was more effective than HBA1cLDL in the occurrence of type 2 diabetes mellitus with coronary heart disease.[conclusion] 1.The level of serum ADMA in type 2 diabetic patients with coronary heart disease was significantly higher than that in healthy controls. It was speculated that ADMA might be involved in the occurrence and development of type 2 diabetes mellitus with coronary heart disease (CHD).The factors influencing the serum ADMA level were HOMA-IRN LDLL + HBA1c, and the factors affecting the occurrence of type 2 diabetes mellitus complicated with coronary heart disease were: 1 / HBA1 / LDL-ADMA. improving insulin resistance, lowering blood glucose and lowering lipid may be beneficial to the decrease of ADMA.To slow down the development of type 2 diabetes with coronary heart disease.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R587.2;R541.4

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