發(fā)布時(shí)間：2018-04-18 00:30

  本文選題：2型糖尿病 + 血胰高糖素樣肽1　； 參考：《安徽醫(yī)科大學(xué)》2017年碩士論文

【摘要】：研究目的2型糖尿病(type 2 diabetes mellitus,T2DM)的發(fā)病機(jī)制目前仍然不明確,隨著研究的深入,胰高糖素樣肽1(Glucagon-like peptide 1,GLP-1)與T2DM的關(guān)系逐漸受到關(guān)注。近年來,多數(shù)研究主要集中在外源性GLP-1(即胰高糖素樣肽1類似物或受體激動(dòng)劑)對(duì)T2DM血糖的控制、體重和肥胖的改善方面。然而初診T2DM內(nèi)源性GLP-1水平及其與腹型肥胖的關(guān)系目前尚無定論。故本研究通過檢測(cè)初診T2DM伴腹型肥胖患者內(nèi)源性血GLP-1水平,以及所有入組患者的空腹血糖、血脂、糖化血紅蛋白、C肽、胰高糖素、肝腎功能等指標(biāo),探討初診T2DM伴腹型肥胖與GLP-1的相關(guān)性以及影響GLP-1水平的因素。研究方法本課題的研究對(duì)象均選自于2015年2月至2016年2月在安徽醫(yī)科大學(xué)第三附屬醫(yī)院內(nèi)分泌科住院的初診T2DM患者,共計(jì)102例,其中男性60例,女性42例,年齡在29-76歲之間。T2DM診斷標(biāo)準(zhǔn)均符合1999年世界衛(wèi)生組織診斷標(biāo)準(zhǔn)。腹型肥胖符合2007年《中國(guó)成人血脂異常防治指南標(biāo)準(zhǔn)》中的診斷標(biāo)準(zhǔn)(即男性腰圍≥90cm,女性腰圍≥85cm)。按腰圍不同分為腹型肥胖組(AO組)59例、非腹型肥胖組(NA0組)43例。所有患者測(cè)量身高、體重、腰圍,并于次日清晨抽取空腹靜脈血,測(cè)定糖化血紅蛋白、空腹血糖、血尿酸、總膽固醇、甘油三酯、高密度脂蛋白膽固醇、低密度脂蛋白膽固醇、極低密度脂蛋白膽固醇、谷丙轉(zhuǎn)氨酶、谷草轉(zhuǎn)氨酶、谷氨酰胺轉(zhuǎn)肽酶、堿性磷酸酶、肌酐、尿素氮、C肽、血胰高糖素、GLP-1。研究結(jié)果1.NA0組血GLP-1水平明顯高于AO組,差異有統(tǒng)計(jì)學(xué)意義(P0.05);AO組腰圍、體重指數(shù)、血尿酸、血糖、C肽、胰高糖素、總膽固醇、甘油三酯、極低密度脂蛋白膽固醇、谷丙轉(zhuǎn)氨酶、谷草轉(zhuǎn)氨酶均明顯高于NAO組,差異均有統(tǒng)計(jì)學(xué)意義(P0.05),而兩組其他指標(biāo)差異無統(tǒng)計(jì)學(xué)意義(P0.05)。2.GLP-1與各指標(biāo)Pearson相關(guān)分析結(jié)果顯示:血GLP-1與腰圍、體質(zhì)指數(shù)、血糖、糖化血紅蛋白A1c、總膽固醇均呈負(fù)相關(guān)(r值分別為-0.518,-0.230,-0.221,-0.591,-0.632),差異均有統(tǒng)計(jì)學(xué)意義(P0.05),與C肽呈正相關(guān)(r值為0.244),差異有統(tǒng)計(jì)學(xué)意義(P0.05),而與甘油三酯、高密度脂蛋白膽固醇、低密度脂蛋白膽固醇、極低密度脂蛋白膽固醇、血尿酸、胰高糖素等指標(biāo)無相關(guān)性(P0.05)。3.以血GLP-1為因變量,以腰圍、體質(zhì)指數(shù)、血糖、糖化血紅蛋白A1c、總膽固醇為自變量,進(jìn)行回歸分析,結(jié)果顯示腰圍、總膽固醇、血糖、糖化血紅蛋白A1c為血清GLP-1水平的獨(dú)立影響因素(β值分別為-0.452,-0.311,0.237,-0.398;P0.05)。研究結(jié)論1.初診T2DM伴腹型肥胖血GLP-1水平明顯低于非腹型肥胖T2DM。2.腰圍、總膽固醇、血糖、糖化血紅蛋白A1c與GLP-1具有相關(guān)性,是影響其水平的因素。
[Abstract]:Objective the pathogenesis of type 2 diabetes mellitus type 2 diabetes mellitusus T2DMis is still unclear. With the further study, the relationship between 1(Glucagon-like peptide 1 and T2DM has been paid more and more attention.In recent years, most studies have focused on the effects of exogenous GLP-1 (glucagon like peptide-1 analogues or receptor agonists) on T2DM blood glucose control, weight and obesity improvement.However, the level of endogenous GLP-1 in newly diagnosed T2DM and its relationship with abdominal obesity are still unknown.Therefore, the levels of endogenous GLP-1 in newly diagnosed T2DM patients with abdominal obesity, fasting blood glucose, blood lipid, glycosylated hemoglobin C peptide, glucagon, liver and kidney function were measured.To investigate the correlation between newly diagnosed T2DM with abdominal obesity and GLP-1 and the factors influencing the level of GLP-1.Methods the subjects of this study were 102 newly diagnosed T2DM patients, including 60 males and 42 females, who were hospitalized in the Endocrinology Department of the third affiliated Hospital of Anhui Medical University from February 2015 to February 2016.The diagnostic criteria of. T2DM between 29-76 years old were in accordance with the 1999 WHO diagnostic criteria.Abdominal obesity was in accordance with the diagnostic criteria in 2007 (male waist 鈮，

本文編號(hào)：1766017