發(fā)布時(shí)間：2018-05-23 18:05

  本文選題：2型糖尿病 + 血清胎球蛋白A�。� 參考：《蘇州大學(xué)》2015年碩士論文

【摘要】：目的:探討2型糖尿病(T2DM)患者血清中胎球蛋白A(Fetuin-A)與頸動(dòng)脈粥樣斑塊的相關(guān)性。方法:根據(jù)彩色多普勒超聲儀檢查雙側(cè)頸動(dòng)脈的結(jié)果,將60例2型糖尿病患者分為T(mén)2DM合并頸動(dòng)脈粥樣斑塊組(A組,30例)、T2DM無(wú)頸動(dòng)脈粥樣斑塊組(B組,30例);同期門(mén)診健康體檢者28例為正常對(duì)照組(C組)。測(cè)量血壓、身高、體重、空腹血糖(FPG)、總膽固醇(TC)、甘油三酯(TG)、低密度脂蛋白膽固醇(LDL-C)、高密度脂蛋白膽固醇(HDL-C)、胰島素(FINS)、糖化血紅蛋白(Hb Alc)、超敏C反應(yīng)蛋白(hs CRP),并計(jì)算體重指數(shù)(BMI)、胰島素抵抗指數(shù)(HOMA-IR)。采用雙抗體夾心酶聯(lián)免疫吸附實(shí)驗(yàn)(ELISA)檢測(cè)所有受試者血清Fetuin-A濃度。結(jié)果:①三組方差分析結(jié)果顯示A、B組血清Fetuin-A水平均低于C組[(0.65?0.26)g/l、(1.05?0.39)g/l vs(1.57?0.58)g/l](P0.01),A組血清Fetuin-A水平明顯低于B組(P0.01)。②單因素相關(guān)分析結(jié)果顯示,血清Fetuin-A水平與HDL-C、FINS呈正相關(guān)(r=0.218,P0.05;r=0.468,P0.05),與FBG、Hb A1C、CRP、WHR呈負(fù)相關(guān)(r=-0.343,P0.01;r=-0.505,P0.01;r=-0.544,P0.01;r=-0.353,P0.01)。③多元線(xiàn)性逐步回歸分析表明,FINS、Hb A1c是血清Fetuin-A水平的獨(dú)立影響因素(β分別為-0.411、0.227,P0.05)。結(jié)論:①2型糖尿病合并頸動(dòng)脈斑塊患者血清Fetuin-A水平較2型糖尿病無(wú)頸動(dòng)脈斑塊患者低,提示血清Fetuin-A水平下降可能促進(jìn)了2型糖尿病患者頸動(dòng)脈粥樣斑塊的早期形成,監(jiān)測(cè)其水平或有助于糖尿病大血管并發(fā)癥的早期發(fā)現(xiàn)。②相關(guān)分析顯示Fetuin-A水平與炎癥指標(biāo)hs CRP呈負(fù)相關(guān),提示或是炎癥狀態(tài)導(dǎo)致了Fetuin-A水平的下降,從而導(dǎo)致了2型糖尿病患者頸動(dòng)脈粥樣硬化的發(fā)生發(fā)展。③2型糖尿病無(wú)頸動(dòng)脈斑塊組血清Fetuin-A水平低于正常對(duì)照組,且血清Fetuin-A水平與血糖、血脂均相關(guān),提示良好的血糖、血脂控制,或可使血清Fetuin-A水平升高,有利于延緩甚至減少2型糖尿病及其大血管并發(fā)癥的發(fā)生、發(fā)展。
[Abstract]:Objective: to investigate the relationship between fetuin-A and carotid atherosclerotic plaque in patients with type 2 diabetes mellitus (T2DM). Methods: according to the results of color Doppler ultrasound examination of bilateral carotid artery, 60 patients with type 2 diabetes mellitus were divided into two groups: T2DM with carotid atherosclerotic plaque group (n = 30) and control group (n = 30) with T2DM without carotid atherosclerotic plaque group (n = 30). Measuring blood pressure, height, weight, Fasting blood glucose (FPG), total cholesterol (TCC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), insulin (FINS), glycosylated hemoglobin (HbAlcn), hypersensitive C-reactive protein (hsCRPN), body mass index (BMI), insulin resistance index (HOMA-IRN) were calculated. The serum Fetuin-A concentration of all subjects was determined by double antibody sandwich enzyme linked immunosorbent assay (Elisa). Results the results of ANOVA showed that the level of serum Fetuin-A in group A was lower than that in group C (0.65 ~ 0.26g / g / l vs(1.57?0.58)g/l). The level of serum Fetuin-A in group A was significantly lower than that in group B (P 0.01g / l vs(1.57?0.58)g/l), and the level of serum Fetuin-A in group A was significantly lower than that in group B (P 0.01). There was a positive correlation between serum Fetuin-A level and HDL-CCAFINS. The linear regression analysis showed that the serum Fetuin-A level was positively correlated with the levels of HDL-Cnn 0.218P0.05P0.05, and negatively correlated with the serum Fetuin-A levels (尾 = -0.4110.227P0.01r-0.505P0.01r-0.544P0.01P0.01P0.01p0.01. the regression analysis showed that FINSHAB A1c was an independent factor of serum Fetuin-A level (尾 = -0.4110.227P0.05). Conclusion the level of serum Fetuin-A in patients with type 12 diabetes mellitus complicated with carotid plaque is lower than that in patients with type 2 diabetes without carotid artery plaque, suggesting that the decrease of serum Fetuin-A level may promote the early formation of carotid atherosclerotic plaque in type 2 diabetes mellitus patients. 2 correlation analysis showed that the level of Fetuin-A was negatively correlated with the inflammatory marker hs CRP, suggesting that the inflammatory state led to the decrease of Fetuin-A level. As a result, the level of serum Fetuin-A in type 32 diabetic patients without carotid plaque was lower than that in normal control group, and the serum Fetuin-A level was correlated with blood glucose and blood lipids, indicating good blood glucose. The control of blood lipid may increase the level of serum Fetuin-A, which can delay or even reduce the occurrence and development of type 2 diabetes mellitus and its macrovascular complications.
【學(xué)位授予單位】：蘇州大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類(lèi)號(hào)】：R587.1

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本文編號(hào)：1925779