血清胎球蛋白与2型糖尿病痰湿证的相关性研究

发布时间：2018-04-16 11:37

本文选题：2型糖尿病 + 胎球蛋白A　；参考：《南京中医药大学》2017年硕士论文

【摘要】：目的:探讨在2型糖尿病中血清胎球蛋白A(fetuinA)和胎球蛋白B(fetuinB)与糖脂代谢等指标的相关性,为临床2型糖尿病的防治提供新的思路;同时探讨在2型糖尿病中fetuin A和fetuin B与中医痰湿证的相关性,为糖尿病中医证型的客观化提供新的参考依据。方法:本研究收集32例正常人和93例2型糖尿病患者的血清,同时根据中医辨证分型将93例糖尿病患者分为51例痰湿证组和42例非痰湿证组。分别在不同组中测定血清fetuinA和fetuinB的水平,并分析其与性别、年龄、血压(SBP、DBP)、体重指数(BMI)、C反应蛋白(CRP)以及糖脂代谢指标,包括空腹血糖(FPG)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)、空腹C肽(FCP)、胰岛素抵抗指数(HOMA-IR)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、尿酸(UA)的相关性。结果:1、糖尿病组的年龄、SBP、DBP、BMI、FPG、TG均高于正常人组(均p0.01),HDL-C低于正常人组(p0.01),两组间性别、UA、TC、LDL-C、fetuinA、fetuinB无显著性差异;2、在正常人组中行单因素相关分析,显示fetuinA与HDL-C、UA呈负相关(均p0.05),与fetuin B呈正相关(p0.01),逐步回归结果显示fetuin B与fetuin A呈独立相关(p0.01);3、在糖尿病患者中行单因素相关分析,显示fetuinA与BMI、FPG、UA呈正相关(均p0.05),与TC、LDL-C呈负相关(均p0.05),单因素相关分析显示fetuinB与TG、HbA1c呈正相关(均p0.05),逐步回归显示CRP、BMI、TG、LDL-C与fetuin A呈独立相关(均p0.05),FCP与fetuinB呈独立相关(p0.05);4、糖尿病痰湿证组的BMI、FPG、UA、TG、FCP及fetuinA显著高于糖尿病非痰湿证组(均p0.05),其余指标无显著性差异;5、在痰湿证组中行单因素相关分析,显示fetuinA与BMI呈正相关(p0.01),与LDL-C呈负相关(p0.01),单因素相关分析显示fetuinB与SBP呈负相关(p0.05),逐步回归显示BMI与fetuin A呈独立相关(p0.01),UA与fetuinB呈独立相关(p0.05)。结论:1、在2型糖尿病中,患者血清fetuin A和fetuinB的水平与BMI、糖脂代谢等指标具有一定的相关性,可见fetuin A和fetuinB分别参与体内糖脂代谢,二者有望成为监测和干预糖尿病患者治疗的新指标;2、2型糖尿病中痰湿证组的fetuinA水平显著高于非痰湿证组,提示fetuinA在中医痰湿证中具有重要作用,是糖尿病痰湿证区别于非痰湿证的客观指标之一;3、FetuinB在痰湿与非痰湿证组间无显著性差异,且在痰湿证中和糖脂代谢指标之间无显著联系,fetuinB在痰湿证中的作用有待后续进一步研究。
[Abstract]:Objective: to explore the correlation between serum fetal protein A (FEA) and fetal globulin (FG) and glucose and lipid metabolism in type 2 diabetes mellitus (T2DM), and to provide a new idea for the prevention and treatment of type 2 diabetes mellitus (T2DM).At the same time, the relationship between fetuin A and fetuin B and phlegm dampness syndrome in type 2 diabetes mellitus was discussed, which provided a new reference for the objectivity of TCM syndrome type of diabetes mellitus.Methods: the serum samples of 32 normal subjects and 93 patients with type 2 diabetes were collected and divided into 51 phlegm dampness syndrome group and 42 non-phlegm dampness syndrome group according to TCM syndrome differentiation.The serum levels of fetuinA and fetuinB were measured in different groups, and their correlation with sex, age, blood pressure, body mass index (BMI) and carbohydrate metabolism were analyzed.These include FBG FPGN, HbA1cU, FINSN, FCPP, HOMA-IRN, TGN, TCU, HDL-CU, LDL-CU, UAA.Results at 1: 1, the levels of TG in the age group of diabetes mellitus group were higher than those in the normal control group (P 0.01) and HDL-C was lower than that in the normal group (P 0.01). There was no significant difference between the two groups in terms of gender, and there was no significant difference between the two groups. The single factor correlation analysis was carried out in the normal control group, and there was no significant difference between the two groups.The results showed that there was a negative correlation between fetuinA and HDL-Con UA (all p0.05, positive correlation with fetuin B, p0.01a), and stepwise regression analysis showed that fetuin B and fetuin A were independent correlation (P 0.01), and univariate correlation analysis was performed in diabetic patients.The results showed that there was a positive correlation between fetuinA and fetuin A (all p0.05) and a negative correlation with TCU LDL-C (all p0.05%). Univariate correlation analysis showed that fetuinB was positively correlated with TGV HbA1c (all p0.05%). Stepwise regression analysis showed that there was an independent correlation between fetuinB and fetuin A (all p0.05% FCP and fetuinB were significantly correlated with fetuinB (p0.05%), and diabetes mellitus (DM) had a positive correlation (p0.05%).The FCP and fetuinA of TGG and fetuinA in the dampness syndrome group were significantly higher than those in the non-phlegm dampness syndrome group (all p0.05), and there was no significant difference in the other indexes. The single factor correlation analysis was performed in the phlegm dampness syndrome group.The results showed that fetuinA was positively correlated with BMI and negatively correlated with LDL-C (p0.01a). Univariate correlation analysis showed that fetuinB was negatively correlated with SBP (p0.05). Stepwise regression analysis showed that BMI and fetuin A had independent correlation (P 0.01U) and fetuinB (P 0.05).Conclusion: in type 2 diabetes mellitus, the levels of serum fetuin A and fetuinB are correlated with BMI, glucose and lipid metabolism. It can be seen that fetuin A and fetuinB are involved in the metabolism of glucose and lipid, respectively.It is expected that the fetuinA level of phlegm dampness syndrome group is significantly higher than that of non-phlegm dampness syndrome group, suggesting that fetuinA plays an important role in TCM phlegm dampness syndrome.There was no significant difference between phlegm dampness syndrome and non-phlegm dampness syndrome group, and there was no significant difference between phlegm dampness syndrome and non-phlegm dampness syndrome group.And there is no significant relationship between phlegm dampness syndrome and glucose and lipid metabolism indexes. The role of fetuinB in phlegm dampness syndrome needs further study.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R259

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