本文選題：2型糖尿病 + Betatrophin　； 參考：《江蘇大學》2017年碩士論文

【摘要】：目的Betatrophin是新發(fā)現(xiàn)的一種分泌蛋白,近年來一些臨床及基礎研究發(fā)現(xiàn),在胰島素抵抗(IR)狀態(tài)下,Betatrophin表達顯著增高。本研究首次觀察了初診2型糖尿病(T2DM)患者經短期持續(xù)性胰島素皮下輸注(CSII)強化治療前后,血清Betatrophin水平的變化,以進一步探討其與胰島素抵抗(IR)、2型糖尿病的相關性。方法本研究總共招募120例研究對象,其中初診T2DM患者(T2DM組)60例,年齡、性別及體重指數(shù)(BMI)相匹配的正常對照組(NC組)60例。所有受試者均采用統(tǒng)一的標準測定人體基本參數(shù)、口服葡萄糖耐量試驗(OGTT)、胰島素釋放試驗、糖化血紅蛋白(Hb A1c)、血糖、血脂、胰島素抵抗指數(shù)(HOMA-IR)、胰島β細胞功能指數(shù)(HOMA-β)及Betatrophin等基線指標。初診T2DM組的受試者均接受為期2周的CSII強化治療,于停用CSII 24h后復測上述指標;血清Betatrophin的測定均采用酶聯(lián)免疫吸附法(ELISA)。結果(1)與NC組相比較,初診T2DM組患者基線的Hb A1c、空腹血糖(Glu0)、OGTT 2h血糖(Glu120)、HOMA-IR、甘油三酯(TG)、總膽固醇(TC)、低密度脂蛋白膽固醇(LDL-C)均顯著增高(P(27)0.05或P(27)0.01),而空腹胰島素(Ins0)、高密度脂蛋白膽固醇(HDL-C)及HOMA-β則呈顯著下降(P(27)0.05或P(27)0.01)。(2)初診T2DM組患者基線血清Betatrophin水平顯著高于正常對照組,差異具有統(tǒng)計學意義(P(27)0.01)。(3)相關分析結果顯示,初診T2DM組患者基線血清Betatrophin水平與Glu0、Glu120、Hb A1c、及HOMA-IR呈顯著正相關(P(27)0.05)。(4)經2周CSII強化治療后,初診T2DM組患者Glu0、OGTT 30min血糖(Glu30)、OGTT 1h血糖(Glu60)、Glu120、OGTT 3h血糖(Glu180)、TG、TC、HDL-C、LDL-C及HOMA-IR均顯著低于治療前(P(27)0.05或P(27)0.01);而OGTT 30min胰島素(Ins30)、OGTT 1h胰島素(Ins60)、OGTT 2h胰島素(Ins120)、OGTT 3h胰島素(Ins180)、OGTT 30min C肽(C-P30)、OGTT 1h C肽(C-P60)、OGTT 2h C肽(C-P120)、OGTT 3h C肽(C-P180)及HOMA-β均顯著高于治療前,差異有統(tǒng)計學意義(P(27)0.05或P(27)0.01)(5)初診T2DM組患者經2周CSII強化治療后血清Betatrophin水平顯著高于治療前,[448.83(229.89-719.68)vs.393.79(168.51-577.63)pg/m L,P(27)0.05]。(6)相關結果顯示,初診T2DM組患者CSII治療前血清Betatrophin水平與治療前后空腹血糖差值(△Glu0)、OGTT 1h血糖差值(△Glu60)、及胰島素抵抗指數(shù)差值(△HOMA-IR)呈顯著負相關(P(27)0.05);與OGTT 30min胰島素差值(△Ins30)、OGTT 1h胰島素差值(△Ins60)、OGTT 2h胰島素差值(△Ins120)、OGTT 30min C肽差值(△C-P30)、OGTT 1h C肽差值(△C-P60)、OGTT 2h C肽差值(△C-P120)、OGTT 3h C肽差值(△C-P180)均呈顯著正相關(P(27)0.05)。初診T2DM組患者治療前后血清Betatrophin水平差值(△Betatrophin)與治療前后空腹C肽差值(△C-P0)及治療前后空腹胰島素差值(△Ins0)均呈正相關(P(27)0.05)。(7)在初診T2DM組,以△Betatrophin為因變量,△Glu0、△C-P0、△Ins0、△HOMA-IR為自變量建立多元線性逐步回歸模型,結果顯示△C-P0(β=172.03,P=0.016)最終進入方程(R2=0.103,P(27)0.05)。結論(1)與正常對照組相比較,初診T2DM組患者血清Betatrophin水平顯著升高,且其與胰島素抵抗(IR)、糖脂代謝等指標具有顯著相關性。(2)經過短期CSII強化治療后,初診T2DM組患者血清Betatrophin水平顯著升高,治療前后Betatrophin差值(△Betatrophin)與治療前后空腹C肽差值(△C-P0)及治療前后空腹胰島素差值(△Ins0)呈顯著正相關;且△C-P0是△Betatrophin的獨立影響因素。(3)Betatrophin與胰島素抵抗(IR)密切相關,提示其可能在2型糖尿病的發(fā)生發(fā)展中發(fā)揮了重要作用。
[Abstract]:Objective Betatrophin is a newly discovered secretory protein. In recent years, some clinical and basic studies have found that the expression of Betatrophin is significantly higher in the state of insulin resistance (IR). This study was the first to observe the level of serum Betatrophin in patients with newly diagnosed type 2 diabetes (T2DM) before and after short-term continuous subcutaneous insulin infusion (CSII). To further explore its correlation with insulin resistance (IR) and type 2 diabetes. Methods a total of 120 subjects were recruited in this study, of which 60 cases of first diagnosed T2DM patients (group T2DM), age, sex and body mass index (BMI) matched the normal control group (group NC), all of the subjects were determined by a unified standard to determine the basic parameters of the human body. Oral glucose tolerance test (OGTT), insulin release test, glycated hemoglobin (Hb A1c), blood glucose, blood lipid, insulin resistance index (HOMA-IR), islet beta cell function index (HOMA- beta) and Betatrophin and other baseline indicators. The subjects in the first diagnosed T2DM group were treated with CSII intensive treatment for 2 weeks, and the above indexes were remeasured after the discontinuation of CSII 24h. Serum Betatrophin was measured by enzyme linked immunosorbent assay (ELISA). Results (1) compared with group NC, the baseline Hb A1c, Glu0, OGTT 2H blood glucose (Glu120), HOMA-IR, triglyceride (TG), total cholesterol, low density lipoprotein cholesterol (27) 0.05 or 0.01 (27) 0.01) were found in the first diagnosed group. Ins0, high density lipoprotein cholesterol (HDL-C) and HOMA- beta were significantly decreased (P (27) 0.05 or P (27) 0.01). (2) the baseline serum Betatrophin level in the first diagnosed T2DM group was significantly higher than that in the normal control group. The difference was statistically significant (P (27) 0.01). (3) the correlation analysis showed that the baseline serum Betatrophin level of the patients in the first diagnosis group and Glu0, G Lu120, Hb A1c, and HOMA-IR have significant positive correlation (P (27) 0.05). (4) after 2 weeks of CSII intensive treatment, Glu0, OGTT 30min glucose (Glu30) in the first diagnosed T2DM group were significantly lower than before the treatment (27) 0.05 or 27 (27) 0.01). Ins60, OGTT 2H insulin (Ins120), OGTT 3H insulin (Ins180) and OGTT 30min C peptide (C-P30) were significantly higher than those before treatment. The difference was statistically significant (27) 0.05 or (27) 0.01) (5) after 2 weeks of intensive treatment Significantly higher than before treatment, [448.83 (229.89-719.68) vs.393.79 (168.51-577.63) pg/m L, P (27) 0.05]. (6) related results showed that the serum Betatrophin level before treatment in the early diagnosis group was significantly negatively correlated with the difference value of fasting blood glucose (delta Glu0) before and after treatment (delta Glu0), and the difference value of insulin resistance index (delta) (delta). 27) 0.05); the difference between OGTT 30min insulin (delta Ins30), OGTT 1H insulin difference (delta Ins60), OGTT 2H insulin difference value (delta Ins120), OGTT 30min C peptide difference value (delta) difference value (delta) difference value (27) 0.05). The difference of serum Betatrophin level (delta Betatrophin) was positively correlated with the difference value of fasting C peptide (delta C-P0) before and after treatment and the difference of fasting insulin (delta Ins0) before and after treatment (P (27) 0.05). (7) in the first diagnosed T2DM group, Delta Betatrophin as the dependent variable, Delta Glu0, Delta C-P0, Delta Ins0, Delta HOMA-IR was a multivariate linear stepwise regression model, and the result was obvious. The indication Delta C-P0 (beta =172.03, P=0.016) finally entered the equation (R2=0.103, P (27) 0.05). Conclusion (1) compared with the normal control group, the serum Betatrophin level of the first diagnosed T2DM group was significantly higher, and it had a significant correlation with insulin resistance (IR), glycolipid metabolism and so on. (2) after short-term CSII intensive treatment, the serum Betatro in the newly diagnosed T2DM group The level of Phin was significantly higher, and the difference of Betatrophin (delta Betatrophin) before and after treatment was positively correlated with the difference value of the fasting C peptide (delta C-P0) before and after treatment and the difference of fasting insulin (delta Ins0) before and after treatment; and delta C-P0 was an independent factor of Delta Betatrophin. (3) Betatrophin is closely related to insulin resistance (IR), suggesting that it may be in type 2 diabetes. The disease has played an important role in the development and development of the disease.
【學位授予單位】：江蘇大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R587.1

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相關期刊論文 前8條

1 張涵;陳宏;陳容平;易敏;;非酒精性脂肪肝病患者血清betatrophin濃度及其與代謝參數(shù)的相關性[J];實用醫(yī)學雜志;2016年16期

2 李培培;王建華;張寶s，

本文編號：1948184