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  本文選題：T2DM + 骨質(zhì)疏松�。� 參考：《延邊大學》2017年碩士論文

【摘要】：目的:研究和探討延邊地區(qū)2型糖尿病(Type 2 diabetes mellitus,T2DM)患者骨密度與可溶性低密度脂蛋白受體 11(soluble low-density lipoprotein recptor family member 11,sLR11)基因多態(tài)性及相關危險因素的分析,為T2DM患者骨質(zhì)疏松癥的預防及治療提供理論依據(jù)。方法:選取2012年～2016年在延邊醫(yī)院內(nèi)分泌科住院治療的T2DM患者124例,根據(jù)所選研究對象骨密度值將其分為3組,骨量正常組(48例)、骨量減低組(53例)及骨質(zhì)疏松組(23例)。通過超聲骨密度檢測儀測定右足踝部骨密度,利用LDR-PCR技術進行SNP分型及測序,運用Hard-Weinberg平衡定律,確定樣本群體代表性。計量資料數(shù)據(jù)用M(P25,P75)、均數(shù)士標準差(x±s),組間均數(shù)比較用秩和檢驗、單因素方法分析,多因素分析采用二元Logistic分析,P0.05有統(tǒng)計學意義。結(jié)果:1.延邊地區(qū)T2DM患者在骨量正常組、骨量減低組、骨質(zhì)疏松組等位基因A、T,基因型AA、AT、TT分布差異無統(tǒng)計學意義。但與骨量正常組比較,骨量減低組及骨質(zhì)疏松組等位基因T有上升趨勢;在顯性模式下,與骨量正常組相比較,骨量減低組及骨質(zhì)疏松組基因型AA有下降趨勢;隱性模式下,與骨量正常組比較,骨量減低組基因型TT有上升趨勢。延邊地區(qū)T2DM患者三組基因型間比較BMD水平差異無統(tǒng)計學意義。2.T2DM患者女性BMD 水平低于男性;年齡大于50歲者低于年齡小于50歲者;吸煙者BMD水平低于不吸煙者;BMI正常者BMD水平低于超重組及肥胖組;頸動脈內(nèi)膜增厚組、頸動脈粥樣硬化斑塊組BMD水平低于頸動脈正常組;病程大于10年者BMD水平低于病程小于5年,差異有統(tǒng)計學意義,P0.05。漢族與朝鮮族BMD水平之間差異無統(tǒng)計學意義。3.T2DM患者BMD水平與LDL-C、HbA1c呈負相關。T2DM患者OP的影響因素有LDL-C、HbA1c、病程、BMI、年齡。結(jié)論:1.sLR11基因rs3824968基因多態(tài)性可能與延邊地區(qū)T2DM骨質(zhì)疏松無相關性。2.T2DM患者BMD與吸煙、年齡、性別、動脈粥樣硬化、病程長密切相關。3.T2DM患者BMD與LDL-C、HbA1c密切相關。4.T2DM患者BMI是BMD的保護因素。
[Abstract]:Objective: to investigate the polymorphism of bone mineral density (BMD) and soluble low density lipoprotein receptor (11(soluble low-density lipoprotein recptor family member 11s LR11) gene in type 2 diabetes mellitus patients with type 2 diabetes mellitus (T2DM) in Yanbian area. To provide theoretical basis for the prevention and treatment of osteoporosis in patients with T2DM. Methods: 124 T2DM patients who were hospitalized in the Department of Endocrinology in Yanbian Hospital from 2012 to 2016 were divided into 3 groups according to the BMD of the selected subjects: 48 cases of normal bone mass group, 53 cases of osteopenia group and 23 cases of osteoporosis group. The bone mineral density of right foot and malleolus was measured by ultrasonic bone density detector. SNP typing and sequencing were carried out by LDR-PCR technique. The representative sample population was determined by Hard-Weinberg equilibrium law. The metrological data were measured by MKP25, P75, and the standard deviation of mean value was x 鹵s.There was statistical significance in the comparison of mean between groups by rank sum test, single factor analysis and multivariate Logistic analysis (P0.05). The result is 1: 1. There was no significant difference in the distribution of allele ACTT and genotypes of T2DM in normal bone mass group, low bone mass group and osteoporosis group in Yanbian area. However, the allele T of bone mass reduction group and osteoporosis group showed an upward trend compared with that of normal bone mass group; in dominant mode, compared with normal bone mass group, genotype AA of bone mass decreased group and osteoporosis group showed a tendency to decrease; in recessive mode, there was a decrease trend in genotype AA of bone mass reduction group and osteoporosis group. Compared with the normal bone mass group, the TT genotype of the decreased bone mass group showed an increasing trend. There was no significant difference in BMD level among the three groups of T2DM patients in Yanbian area. 2. The BMD level of female patients with T2DM was lower than that of males, and that of patients older than 50 years was lower than that of those aged less than 50 years old. The level of BMD in smokers was lower than that in non-smokers with normal BMD, and the level of BMD in carotid intima-thickening and carotid atherosclerotic plaques was lower than that in normal carotid. The level of BMD was lower in patients with more than 10 years duration than that in 5 years, and the difference was statistically significant (P 0.05). There was no significant difference in BMD level between Han nationality and Korean nationality. 3. The level of BMD in T2DM patients was negatively correlated with HbA1c of LDL-C2DM. The influencing factors of op in T2DM patients were LDL-C2DM HbA1c, course of disease and age. Conclusion: 1. The rs3824968 polymorphism of sLR11 gene may not be associated with osteoporosis of T2DM in Yanbian area. 2.The BMD of T2DM patients is closely related to smoking, age, sex, atherosclerosis and long course of disease. 3. BMD in T2DM patients is closely related to BMI HbA1c in LDL-C2DM patients. 4. BMI in T2DM patients is the protective factor of BMD.
【學位授予單位】：延邊大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R580

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