本文選題：2型糖尿病 + 絕經(jīng)后女性��； 參考：《山東中醫(yī)藥大學》2017年碩士論文

【摘要】：目的1、分析女性2型糖尿病患者絕經(jīng)后性激素水平變化的特點;2、分析女性2型糖尿病患者絕經(jīng)后血脂、內(nèi)臟脂肪面積變化的特點;3、探索女性2型糖尿病患者絕經(jīng)后性激素水平與血脂、內(nèi)臟脂肪面積的相關(guān)性。方法所有病例資料均來源于2015年3月1日至2016年12月31日山東省立醫(yī)院內(nèi)分泌科病房,共收集符合課題要求的女性2型糖尿病絕經(jīng)后患者147例,其中絕經(jīng)時間1-5年者為A組,共26例;絕經(jīng)時間6-10年者為B組,共30例;絕經(jīng)時間大于10年者為C組,共91例。收集并登記患者信息:一般資料(包括住院號、年齡、糖尿病病程、既往史、月經(jīng)情況、血壓、BMI等)、相關(guān)生化指標(包括血糖、血脂、性激素、肝功、腎功等)、內(nèi)臟脂肪面積、皮下脂肪面積。對三組病例進行回顧性研究,采用單因素方差分析、多元線性回歸分析等方法分析絕經(jīng)后不同階段性激素、血脂、內(nèi)臟脂肪面積的變化特點及性激素與血脂、內(nèi)臟脂肪面積的相關(guān)性。結(jié)果1、三組研究對象各指標比較隨著絕經(jīng)時間的增加,三組研究對象冠心病患病率、腦血管病患病率逐漸升高,差異無統(tǒng)計學意義(P=0.080,0.081),脂肪肝患病率逐漸下降,差異無統(tǒng)計學意義(P=0.483)。隨著絕經(jīng)時間的增加,三組研究對象年齡、收縮壓、肌酐顯著升高(P=0.000,0.021,0.004),谷丙轉(zhuǎn)氨酶顯著下降(P=0.007),總膽固醇先升高再下降(P=0.045)。三組研究對象間糖尿病病程、舒張壓、身高、體重、BMI、促卵泡刺激素、促黃體生成素、雌二醇、睪酮、高密度脂蛋白膽固醇、低密度脂蛋白膽固醇、甘油三酯、內(nèi)臟脂肪面積、皮下脂肪面積、空腹血糖、糖化血紅蛋白、空腹C肽、胰島素抵抗指數(shù)、谷草轉(zhuǎn)氨酶、谷氨酰胺轉(zhuǎn)肽酶、堿性磷酸酶、尿酸差異無統(tǒng)計學意義(P0.05)。2、三組研究對象多元線性回歸分析校正混雜因素后,總膽固醇與空腹血糖(β=0.246,P=0.002)、促卵泡刺激素(β=0.173,P=0.032)獨立正相關(guān);總膽固醇與空腹血糖(β=0.254,P=0.001)、促黃體生成素(β=0.238,P=0.003)獨立正相關(guān);性激素與高密度脂蛋白膽固醇無關(guān);低密度脂蛋白膽固醇與空腹血糖(β=0.225,P=0.006)、促卵泡刺激素(β=0.169,P=0.037)獨立正相關(guān);低密度脂蛋白膽固醇與空腹血糖(β=0.234,P=0.004)、促黃體生成素(β=0.222,P=0.006)獨立正相關(guān);性激素與甘油三酯無關(guān);內(nèi)臟脂肪面積與BMI(β=0.695,P=0.000)、睪酮(β=0.189,P=0.009)、胰島素抵抗指數(shù)(β=0.166,P=0.018)獨立正相關(guān);性激素與皮下脂肪面積無關(guān)。3、根據(jù)睪酮中位數(shù)將研究對象分為兩組比較高睪酮組低密度脂蛋白膽固醇、內(nèi)臟脂肪面積顯著高于低睪酮組(P=0.045,0.001);高密度脂蛋白膽固醇低于低睪酮組,差異無統(tǒng)計學意義(P=0.440);總膽固醇、甘油三酯、皮下脂肪面積高于低睪酮組,差異無統(tǒng)計學意義(P=0.108,0.169,0.055)。結(jié)論(1)女性2型糖尿病患者隨著絕經(jīng)年限的增加,總膽固醇先升高再降低;(2)女性2型糖尿病患者絕經(jīng)后總膽固醇、低密度脂蛋白膽固醇隨著促卵泡刺激素、促黃體生成素的升高而升高;內(nèi)臟脂肪面積隨著睪酮的升高而升高;(3)女性2型糖尿病患者絕經(jīng)后高睪酮組低密度脂蛋白膽固醇、內(nèi)臟脂肪面積顯著高于低睪酮組。
[Abstract]:Objective 1 to analyze the characteristics of postmenopausal sex hormone changes in postmenopausal women with type 2 diabetes; 2, analyze the characteristics of postmenopausal blood lipids and visceral fat area changes in women with type 2 diabetes mellitus; 3, explore the correlation between postmenopausal sex hormone levels in women with type 2 diabetes and the area of visceral fat and visceral fat. All of the cases were derived from 201 In the Department of endocrinology of the Shangdong Province-owned Hospital from March 1st to December 31, 2016, 147 cases of postmenopausal women with type 2 diabetes mellitus were collected, of which 1-5 years of menopause were group A, 26 cases were A, 6-10 years for menopause were group B, 30 cases were in group C for more than 10 years, and 91 cases were collected and registered patient information: 1 Data (including hospital number, age, course of diabetes, past history, menstruation, blood pressure, BMI, etc.), related biochemical indexes (including blood sugar, blood lipid, sex hormone, liver function, kidney work, etc.), visceral fat area, subcutaneous fat area. A retrospective study on three groups of cases, analysis of single factor ANOVA, multiple linear regression analysis, and so on. The changes of sex hormones, blood lipid, visceral fat area and the correlation between sex hormone and blood fat and visceral fat area after different stages. Results 1, the three groups of subjects compared with the increase of menopause time, three groups of subjects with coronary heart disease rate, cerebrovascular disease rate gradually increased, the difference was not statistically significant (P=0.080,0.081 The prevalence rate of fatty liver decreased gradually, the difference was not statistically significant (P=0.483). With the increase of menopause time, three groups of subjects age, systolic pressure, creatinine increased significantly (P=0.000,0.021,0.004), alanine aminotransferase significantly decreased (P=0.007), total cholesterol increased first and then decreased (P=0.045). The course of diabetes, diastolic pressure and body pressure between the three groups of subjects were between the subjects. High, weight, BMI, follicle stimulating hormone, luteinizing hormone, estradiol, testosterone, high density lipoprotein cholesterol, low density lipoprotein cholesterol, triglyceride, visceral fat area, subcutaneous fat area, fasting blood sugar, glycosylated hemoglobin, fasting C peptide, islopanin resistance index, glutamine transaminase, glutamine transpeptidase, alkaline phosphatase, urine There was no significant difference in acid difference (P0.05).2. After multivariate linear regression analysis of the three groups, the total cholesterol was independent positive correlation with fasting blood glucose (beta =0.246, P=0.002) and follicle stimulating hormone (beta =0.173, P=0.032), and total cholesterol was independently and positively correlated with fasting blood glucose (beta =0.254, P=0.001) and luteinizing hormone (beta =0.238, P=0.003). Sex hormones are not related to high-density lipoprotein cholesterol; low density lipoprotein cholesterol is independent positively associated with fasting blood glucose (beta =0.225, P=0.006), follicle stimulating hormone (beta =0.169, P=0.037), low density lipoprotein cholesterol (LDL) and fasting blood glucose (beta =0.234, P=0.004), luteinizing hormone (beta =0.222, P=0.006) independent positive correlation; sex hormone and triglyceride The area of visceral fat was independent of BMI (beta =0.695, P=0.000), testosterone (beta =0.189, P=0.009), and insulin resistance index (beta =0.166, P=0.018); sex hormones were not related to the area of subcutaneous fat.3, and the subjects were divided into two groups of high testosterone group low density lipoprotein cholesterol according to the median of testosterone, and the area of visceral fat was significantly higher than that of low testosterone. Group (P=0.045,0.001); high density lipoprotein cholesterol was lower than low testosterone group, the difference was not statistically significant (P=0.440), total cholesterol, triglyceride, subcutaneous fat area was higher than low testosterone group, the difference was not statistically significant (P=0.108,0.169,0.055). Conclusion (1) female type 2 diabetes patients with the increase of menopause, total cholesterol first increase and then drop (2) the total cholesterol and low density lipoprotein cholesterol increased with the increase of follicle stimulating hormone and luteinizing hormone in women with type 2 diabetes, and the area of visceral fat increased with the increase of testosterone; (3) the area of low density lipoprotein cholesterol in postmenopausal women with type 2 diabetic patients was significantly higher than that in the high testosterone group and the area of visceral fat was significantly higher than that of the patients with type 2 diabetes. Low testosterone group.
【學位授予單位】：山東中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R587.1

【參考文獻】

相關(guān)期刊論文 前10條

1 邢玉鑒;;圍絕經(jīng)期婦女應(yīng)用HRT對血脂及骨密度的影響[J];中國實驗診斷學;2014年02期

2 龔明霞;吳俊妍;;402例圍絕經(jīng)婦女性激素和血脂變化分析[J];安徽醫(yī)藥;2013年04期

3 姜秀麗;;激素替代治療更年期婦女泌尿生殖系統(tǒng)癥狀療效分析[J];中國婦幼保健;2012年21期

4 李松珊;李晶;徐濤;王曉峰;;雄激素與代謝相關(guān)疾病的研究進展[J];生理科學進展;2011年03期

5 裴利軍;姜睿;;糖尿病女性性功能障礙研究進展[J];中華男科學雜志;2011年03期

6 俞蘭;石福彥;;性激素與Ⅱ型糖尿病的關(guān)系及其作用機制[J];內(nèi)蒙古醫(yī)學院學報;2008年S2期

7 孫愛軍;Dympna Gallagher;Richard N. PiersonJr.;;不同人種絕經(jīng)后全身與局部脂肪分布的改變情況[J];生殖醫(yī)學雜志;2007年06期

8 梁東明;王建昌;李源;張婧;陳花;;二氫睪酮對大鼠血脂代謝及肝細胞脂肪沉積影響的實驗研究[J];中國老年學雜志;2007年03期

9 強宏娟,張春妮,莊一義,梁元姣,許瑞吉;絕經(jīng)后婦女雌激素缺乏與膽固醇酯轉(zhuǎn)運蛋白水平改變的關(guān)系[J];臨床檢驗雜志;2002年06期

10 黃繼良 ,施錦仁 ,趙瑞芝 ,王柏川 ,鄭飛鳴;絕經(jīng)后2型糖尿病性激素變化與微血管并發(fā)癥關(guān)系[J];現(xiàn)代中西醫(yī)結(jié)合雜志;2001年20期

相關(guān)博士學位論文 前1條

1 曹遠奎;絕經(jīng)后婦女性激素環(huán)境的改變與胰島素抵抗[D];復旦大學;2012年

，

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