本文選題：2型糖尿病 + 鳶尾素��； 參考：《山西醫(yī)科大學》2017年碩士論文

【摘要】：目的:糖尿病屬常見的內(nèi)分泌疾病,發(fā)病機制復雜,與環(huán)境、遺傳等有關,是由胰島素分泌和(或)作用障礙導致的代謝紊亂,可致心、眼、腎及神經(jīng)等部位的病變,嚴重時可威脅生命。隨生活水平提高,患病人數(shù)逐年增多,影響患者生存質(zhì)量,成為主要的公共衛(wèi)生問題,因此,糖尿病的早期篩查顯得尤為重要。本研究旨在探討新診斷2型糖尿病患者血清鳶尾素(irisin)及網(wǎng)膜素(omentin-1)的變化,為糖尿病的早期診斷提供一定指導。方法:1.研究對象:選取2015年12月至2016年5月于我院內(nèi)分泌科確診的新診斷T2DM患者60例為實驗組,同期選擇年齡、性別相匹配的健康者60例為對照組。2.臨床資料收集:記錄所有受試者的年齡、身高、體質(zhì)量、收縮壓(SBP)、舒張壓(DBP),測定空腹血糖(FPG)、空腹胰島素(FINS)、餐后2小時血糖(2h PG)、糖化血紅蛋白(Hb A1c)、血脂等指標,血清omentin-1、irisin采用酶聯(lián)免疫吸附法(ELISA)測定。結(jié)果:1.兩組一般臨床觀察指標的比較:兩組間性別、年齡、BMI、SBP、DBP水平差異無統(tǒng)計學意義(P0.05),T2DM組的FPG、2h PG、FINS、Hb A1c、HOMA-IR、TG、TC、LDL-C水平均明顯高于NGT組(P0.05或P0.01),omentin-1、irisin、HOMA-β、HDL-C水平明顯低于NGT組(P0.05或P0.01)。2.irisin、omentin-1與各指標的相關分析:spearman相關分析結(jié)果顯示,irisin與FPG、2h PG、Hb A1c、FINS、HOMA-IR、LDL-C呈負相關(sr=-0.183,P=0.046)、(sr=-0.182,P=0.047)、(sr=-0.242,P=0.008)、(rs=-0.186,P=0.041)、、(sr=-0.248,P=0.006)、(sr=-0.199,P=0.029),與HDL-C呈正相關(sr=0.261,P=0.004);omentin-1與FPG、2h PG、Hb A1c、FINS、HOMA-IR、LDL-C呈負相關(sr=-0.233,P=0.010)、(sr=-0.310,P=0.001)、(sr=-0.415,P=0.000)、(sr=-0.266,P=0.003)(sr=-0.271,P=0.003)、(sr=-0.239,P=0.009),與HDL-C呈正相關(sr=0.270,P=0.003);irisin與omentin-1呈正相關(sr=0.227,P=0.013)。3.回歸分析:多元逐步回歸分析顯示,Hb A1c是血清irisin的相關因素(P0.01),Hb A1c、HDL-C是血清omentin-1的相關因素(P0.01或P0.05),Logistic回歸分析顯示血清irisin、omentin-1是影響糖代謝的保護因素(OR:0.522,95%CI:0.293~0.930,P=0.027)、(OR:0.934,95%CI:0.891~0.979,P=0.005)。結(jié)論:1.新診斷2型糖尿病患者的血清irisin、omentin-1水平較正常糖耐量者明顯降低,提示irisin、omentin-1可能與2型糖尿病有關。2.血清irisin、omentin-1與FPG、2h PG、Hb A1c、FINS、HOMA-IR、LDL-C呈負相關,與HDL-C呈正相關;irisin與omentin-1呈正相關,提示irisin、omentin-1可能與胰島素抵抗、脂代謝有關,并存在相互調(diào)節(jié)作用。3.血清irisin、omentin-1是影響糖代謝的保護因素,多元逐步回歸顯示Hb A1c是血清irisin的相關因素,Hb A1c、HDL-C是血清omentin-1的相關因素,提示血清irisin、omentin-1受糖脂代謝影響,其水平下降可能是糖尿病發(fā)生、發(fā)展的原因之一。
[Abstract]:Objective: diabetes is a common endocrine disease, which has complex pathogenesis and is related to environment and heredity. It is a metabolic disorder caused by insulin secretion and / or dysfunction, which can cause heart, eye, kidney and nerve diseases. When it is serious, it can be life-threatening. With the improvement of living standards, the number of patients increases year by year, which affects the quality of life of patients and becomes the main public health problem. Therefore, the early screening of diabetes is particularly important. The purpose of this study was to investigate the changes of serum irisin (Iris) and omentin-1 (omentin-1) in newly diagnosed type 2 diabetic patients, and to provide guidance for early diagnosis of diabetes mellitus. Method 1: 1. Participants: from December 2015 to May 2016, 60 patients with newly diagnosed T2DM were selected as experimental group, and 60 healthy persons with matched age and sex were selected as control group. Clinical data were collected: the age, height, body mass, systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FPG), fasting insulin (Fin), 2 h postprandial blood glucose (2 h) PGN, HbA1cU, blood lipid were recorded. Serum omentin-1 irisin was determined by enzyme linked immunosorbent assay (Elisa). The result is 1: 1. Comparison of general clinical observation indexes between two groups: sex between two groups, 騫撮緞,BMI,SBP,DBP姘村鉤宸紓鏃犵粺璁″鎰忎箟(P0.05),T2DM緇勭殑FPG,2h PG,FINS,Hb A1c,HOMA-IR,TG,TC,LDL-C姘村鉤鍧囨槑鏄鵑珮浜嶯GT緇，

本文編號：1965632