發(fā)布時間：2018-07-02 19:23

  本文選題：2型糖尿病 + 胰島素抵抗　； 參考：《新疆醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:研究正常對照組(A組)、2型糖尿病非下肢血管病變組(B組)和2型糖尿病下肢血管病變組的血清胎球蛋白A(Fetuin-A)的水平與胰島素抵抗、血脂、血糖、踝肱指數(shù)(Ankle brachial index,ABI)的相關(guān)性,并探討ABI的影響因素。方法:選取2015年3月至2016年12月在我院體檢中心、內(nèi)分泌科住院及門診病人,根據(jù)血糖、糖化血紅蛋白、糖耐量試驗(yàn)及ABI指標(biāo)等將患者分為3組:正常對照組(A組),共30例,糖尿病非下肢血管病變組(B組),共31例,糖尿病下肢血管病變組(C組),共35例。測量血壓(BP)、體重(BW)、身高(H),計算體重指數(shù)(BMI),同時,空腹取血測定其血糖(GLU)、糖化血紅蛋白(Hb Alc)、甘油三酯(TG)、膽固醇(TC)、高密度脂蛋白膽固醇(HDL)、低密度脂蛋白膽固醇(LDL)。采用酶聯(lián)免疫吸附法(ELISA)測定血清胎球蛋白A的水平。結(jié)果:(1)一般情況,96例患者中,男52例,女44例,平均年齡59.65士4.23歲。A組(30例)、B組(31例)、C組(35例)的年齡、性別、病程、身高及DBP無統(tǒng)計學(xué)差異(P0.05),體重、BMI及SBP及ABI具有統(tǒng)計學(xué)意義(P0.05)。(2)B組和C組的CRP、FPG、PPG、HbA1c、HOMA-IR、TG、TC、LDL、HDL均高于A組,除TG外與正常對照組比較,差異均有統(tǒng)計學(xué)意義(P0.05),C組高于A組,除HbA1c外,兩者差異均有統(tǒng)計學(xué)意義(P0.05))。(3)Fetuin-A水平在A、B、C三組中分別為(389.75±79.1)、(513.77±75.51)(456.92±75.53),且差異均具有統(tǒng)計學(xué)意義(P0.05)。(4)相關(guān)分析結(jié)果顯示,在A組中,Fetuin-A與年齡呈負(fù)相關(guān),且有統(tǒng)計學(xué)意義(P0.05)。在B組中,Fetuin-A與體重、BMI、PPG、Hb A1c、HOMA-IR、TG成正相關(guān),與HDL成負(fù)相關(guān),且有統(tǒng)計學(xué)意義(P0.05)。在C組中,Fetuin-A與年齡、HDL呈負(fù)相關(guān),與體重、BMI、ABI、CRP、PPG、HbA1c、HOMA-IR、TG成正相關(guān),且有統(tǒng)計學(xué)意義(P0.05)。(5)在C組中隨著ABI的逐漸降低,血清Fetuin-A水平逐漸下降,且有顯著性差異(P0.05)。多元線性逐步回歸分析顯示:Fetuin-A、HDL及SBP是ABI的獨(dú)立影響因素。結(jié)論:2型糖尿病非下肢血管病變組和2型糖尿病下肢血管病變組與正常對照組相比,存在明顯的IR和較高水平的血清胎球蛋白A,提示高水平的血清胎球蛋白A參與了糖尿病胰島素抵抗的發(fā)展,促進(jìn)了糖尿病的發(fā)生。血清胎球蛋白A在2型糖尿病下肢血管病變患者中隨著ABI值降低,水平逐漸降低,提示低水平的血清胎球蛋白A預(yù)示著糖尿病下肢血管的病變,胎球蛋白A可能參與血管鈣化。
[Abstract]:Objective: to study the correlation between serum fetuin-A (Fetuin-A) levels and insulin resistance, blood lipid, blood glucose, ankle-brachial index (Ankle brachial) in patients with type 2 diabetes mellitus (group B) and patients with type 2 diabetes mellitus (group B). The influencing factors of ABI were discussed. Methods: according to blood glucose, glycosylated hemoglobin, glucose tolerance test and ABI index, the patients were divided into 3 groups: normal control group (group A). There were 31 cases in diabetic group (group B) and 35 cases in group C (group C). Blood pressure (BP), body weight (BW), height (H), body mass index (BMI), blood glucose (GLU), glycosylated hemoglobin (TG), cholesterol (TC), high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) were measured. The level of serum fetal globin A was determined by enzyme linked immunosorbent assay (Elisa). Results: (1) the average age, sex and course of disease were 59.65 鹵4.23 years old in group A (30 cases), 31 cases in group B (31 cases) and 35 cases in group C (35 cases). There was no significant difference in height and DBP (P0.05). There were significant differences in body weight,). (and). (between group B and group C (P0.05). The HDL-C of). (group B and group C were significantly higher than those of group A, except TG, the difference was statistically significant (P0.05), except for HbA1c, HbA1c, HbA1c, HbA1c, HbA1c, HbA1c, HbA1c, HbA1c, HbA1c, HbA1c, HbA1c, HbA1c, HbA1c, HbA1c, HbA1c. The level of Fetuin-A was (389.75 鹵79.1), (513.77 鹵75.51) (456.92 鹵75.53) in group C (P0.05). (3), and the correlation analysis showed that Fetuin-A was negatively correlated with age in group A (P0.05). In group B, Fetuin-A was positively correlated with HbA1cHMA-IRTG, and negatively correlated with HDL (P0.05). In group C, Fetuin-A was negatively correlated with age and serum Fetuin-A was significantly lower than that in group C (P0.05), and the serum Fetuin-A level was significantly lower than that in group C (P0.05). Multivariate linear stepwise regression analysis showed that: Fetuin-Atrol HDL and SBP were independent influencing factors of ABI. Conclusion compared with the normal control group, the non-lower extremity vascular lesion group of type 2 diabetes mellitus and the lower limb vascular disease group of type 2 diabetes mellitus are different from those of the normal control group. There is obvious IR and high level of serum fetal globin A, which suggests that the high level of serum fetal globin A is involved in the development of insulin resistance in diabetes mellitus and promotes the development of diabetes mellitus. The level of serum fetal globin A in patients with type 2 diabetic lower extremity vascular disease decreased with the decrease of ABI value, suggesting that the low level of serum fetal globin A may be involved in vascular calcification of the lower extremity of diabetes mellitus.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R587.2;R543

【參考文獻(xiàn)】

相關(guān)期刊論文 前4條

1 劉云濤;簡磊;;2型糖尿病患者血清胎球蛋白A水平與踝肱指數(shù)的關(guān)系[J];廣東醫(yī)學(xué);2013年19期

2 程千鵬;呂肖鋒;張星光;;血糖波動與下肢血管病變程度的關(guān)系研究[J];中國全科醫(yī)學(xué);2012年16期

3 陳茜;陳漢平;;妊娠期糖尿病病因?qū)W研究[J];中國優(yōu)生與遺傳雜志;2008年02期

4 李光偉;少些完美,多些自由——臨床及科研工作中胰島β細(xì)胞功能評估的困難與對策[J];中華內(nèi)分泌代謝雜志;2003年01期

，

本文編號：2090662