本文選題：鳶尾素 + 糖尿病��； 參考：《上海醫(yī)學(xué)》2017年08期

【摘要】：目的探討2型糖尿病(T2DM)患者血清鳶尾素(Irisin)與頸動脈粥樣硬化(CAS)的相關(guān)性。方法選擇2014年7月—2015年10月于三峽大學(xué)仁和醫(yī)院內(nèi)分泌科住院的新診斷的T2DM患者92例,其中不合并CAS組(T2DM組)45例,合并CAS組(T2DM合并CAS組)47例;同期于門診就診的糖耐量正常的CAS患者(CAS組)46例和在體檢中心經(jīng)口服葡萄糖耐量試驗(OGTT試驗)排除T2DM的健康體檢者(對照組)48名。受試者禁食8h后,測量其收縮壓(SBP)、舒張壓(DBP);于清晨抽取空腹肘靜脈血,檢測三酰甘油(TG)、總膽固醇(TC)、低密度脂蛋白膽固醇(LDL-C)、高密度脂蛋白膽固醇(HDL-C)、糖化血紅蛋白(HbA_(1c))、TNF-α、人纖溶酶原激活物抑制劑1(PAI-1)、胰島素、超氧化物歧化酶(SOD)、Irisin、空腹血糖(FPG)和餐后2h血糖(2hPG)水平,計算胰島素抵抗指數(shù)(HOMA-IR),并測量頸動脈內(nèi)膜中層厚度(IMT)。結(jié)果 4組間的性別構(gòu)成、年齡、SBP、DBP的差異均無統(tǒng)計學(xué)意義(P值均0.05)。CAS組的TC、LDL-C、PAI-1、TNF-α、IMT,T2DM組的LDL-C、PAI-1、胰島素、HOMA-IR、HbA_(1c)、TNF-α、IMT,T2DM合并CAS組的TG、TC、LDL-C、PAI-1、胰島素、HOMA-IR、HbA_(1c)、TNF-α、IMT均顯著高于對照組(P值分別0.05、0.01);CAS組的HDL-C、SOD,T2DM組HDL-C、SOD,T2DM合并CAS組的HDL-C、SOD均顯著低于對照組(P值分別0.05、0.01)。T2DM組的胰島素、HOMA-IR、HbA_(1c)均顯著高于CAS組(P值分別0.05、0.01)。CAS組的LDL-C、IMT,T2DM合并CAS組的LDL-C、PAI-1、胰島素、HOMA-IR、HbA_(1c)、TNF-α、IMT均顯著高于T2DM組(P值分別0.05、0.01);T2DM合并CAS組的SOD顯著低于T2DM組(P0.05)。對照組的血清Irisin水平顯著高于其他3組(P值分別0.05、0.01),T2DM合并CAS組的血清Irisin水平顯著低于CAS組和T2DM組(P值均0.05)。血清Irisin水平與LDL-C(r=-0.531,P=0.011)、FPG(r=-0.603,P=0.002)、2hPG(r=-0.596,P=0.006)、HbA_(1c)(r=-0.596,P=0.003)、TNF-ɑ(r=-0.597,P=0.003)、胰島素(r=-0.521,P=0.014)、HOMA-IR(r=-0.552,P=0.011)、IMT(r=-0.639,P=0.001)、PAI-1(r=-0.591,P=0.007)均呈負(fù)相關(guān),與HDL-C(r=0.597,P=0.006)、SOD(r=0.605,P=0.002)均呈正相關(guān),與年齡、性別、SBP、DBP、TG、TC均不相關(guān)(P值均0.05)。以IMT為因變量,FPG、HbA_(1c)、HOMA-IR、SOD、TNF-α、Irisin、PAI-1等為自變量進(jìn)行多元逐步回歸分析,結(jié)果顯示,Irisin(回歸系數(shù)=-0.208,P=0.006)、HbA_(1c)(回歸系數(shù)=9.321,P=0.022)為影響IMT的獨立相關(guān)因素�；貧w方程:IMT=9.321×HbA_(1c)-0.208×Irisin-3.156。結(jié)論 CAS患者Irisin水平降低,Irisin與糖脂代謝、胰島素抵抗、TNF-α、氧化應(yīng)激、PAI-1關(guān)系密切,低水平的Irisin參與了CAS的發(fā)生,其機(jī)制值得進(jìn)一步深入研究。
[Abstract]:Objective to investigate the relationship between serum Irisin (Irisin) and carotid atherosclerosis (CAS) in patients with type 2 diabetes mellitus (T2DM). Methods 92 newly diagnosed T2DM patients in Department of Endocrinology, Renhe Hospital, three Gorges University from July 2014 to October 2015 were selected, including 45 cases of T2DM without CAS and 47 cases of T2DM with CAS in CAS group. At the same time, 46 patients with normal glucose tolerance in CAS group and 48 healthy controls who were excluded from T2DM by oral glucose tolerance test (OGTT test) in the physical examination center. After fasting for 8 hours, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured. Triacylglycerol (TGG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-CU), high density lipoprotein cholesterol (HDL-C), glycosylated hemoglobin (HbA), human plasminogen activator inhibitor (HPA), human plasminogen activator inhibitor (PAI-1), insulin were detected. The levels of superoxide dismutase (SOD) Irisin, fasting blood glucose (FPG) and postprandial blood glucose (2 h) were calculated to calculate the insulin resistance index (HOMA-IRN), and the carotid intima-media thickness (IMT) was measured. Results the sex composition of the four groups, 騫撮緞,SBP,DBP鐨勫樊寮傚潎鏃犵粺璁″鎰忎箟(P鍊煎潎0.05).CAS緇勭殑TC,LDL-C,PAI-1,TNF-偽,IMT,T2DM緇勭殑LDL-C,PAI-1,鑳板矝绱，

本文編號：1973259