發(fā)布時(shí)間：2018-06-21 10:45

  本文選題：2型糖尿病 + 血脂因素　； 參考：《錦州醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的研究血脂(甘油三酯、總膽固醇、高密度脂蛋白、低密度脂蛋白)及其相關(guān)因素(體重指數(shù)、收縮壓、舒張壓、家族史)與2型糖尿病(type2 diabetes mellitus,T2DM)發(fā)病之間的關(guān)系,側(cè)重探討血脂及血壓因素的致病性及效力,辨析國內(nèi)外相關(guān)研究結(jié)論不一致的原因,為2型糖尿病預(yù)防提供建議。方法采用1:1配比的病例對照研究法,于錦州市四家三級甲等醫(yī)院體檢中心選取286對研究對象作為研究樣本。收集資料方法為問卷調(diào)查法及醫(yī)學(xué)指標(biāo)檢測摘錄法。調(diào)查資料工具采用自行設(shè)計(jì)的《事業(yè)單位人員基本信息采集表》和《體檢報(bào)告》。選取依據(jù)體檢血糖異常結(jié)果經(jīng)建議確診為新發(fā)T2DM者為病例組,對照依據(jù)匹配條件在體檢中心大數(shù)據(jù)庫中選取。資料統(tǒng)計(jì)分析采用SPSS 21.0統(tǒng)計(jì)分析軟件,單因素分析方法為計(jì)量資料采用方差分析及t檢驗(yàn),計(jì)數(shù)資料采用X2檢驗(yàn);多因素分析方法采用條件Logistic回歸分析。結(jié)果1、病例組與對照組人口學(xué)統(tǒng)計(jì)特征如:年齡、性別、民族、職業(yè)、文化程度等匹配因素資料進(jìn)行均衡性檢驗(yàn),差異均無統(tǒng)計(jì)學(xué)意義(P0.05)。2、病例組與對照組甘油三酯、總膽固醇、低密度脂蛋白、高密度脂蛋白、收縮壓、舒張壓、體重指數(shù)及家族史各指標(biāo)近3年實(shí)測值經(jīng)單因素方差分析,差異均無統(tǒng)計(jì)學(xué)意義;經(jīng)t檢驗(yàn)及X2檢驗(yàn)比較,差異均具有統(tǒng)計(jì)學(xué)意義(P0.05)。按性別分類分析后略有不同。3、條件Logistic回歸分析:(1)甘油三酯、低密度脂蛋白、總膽固醇、體重、家族史、收縮壓和舒張壓均與T2DM發(fā)病有關(guān)(P0.05),相對危險(xiǎn)度及95%置信區(qū)間分別為(ORTG=1.163,95%CI:1.009~1.341;ORLDL=1.776,95%CI:1.231~2.562;ORTC=1.694,95%CI:1.393~2.062;ORBMI=1.184,95%CI:1.101~1.273;OR家族史=1.375,95%CI:1.074~1.758;ORSBP=1.041,95%CI:1.031~1.050;ORDBP=1.013,95%CI:1.003~1.023)。(2)甘油三酯、總膽固醇、收縮壓及舒張壓與T2DM發(fā)病的相關(guān)性存在性別差異。男性人群中:(1)舒張壓與T2DM發(fā)病無關(guān)(P=0.545),收縮壓則有關(guān)(ORSBP=1.021,95%CI:1.009~1.033);(2)總膽固醇未進(jìn)入模型,甘油三酯與T2DM發(fā)病有關(guān)(ORTG=1.245,95%CI:1.071~1.447)。女性人群中:(1)收縮壓與T2DM發(fā)病無關(guān)(P=0.312),舒張壓則有關(guān)(ORDBP=1.018,95%CI:1.005~1.032);(2)甘油三酯未進(jìn)入模型,總膽固醇與T2DM發(fā)病有關(guān)(ORTC=2.418,95%CI:1.777~3.291)。結(jié)論1、錦州地區(qū)事業(yè)單位人群中,甘油三酯增高、總膽固醇增高、低密度脂蛋白增高、體重超重、家族史等可增加T2DM發(fā)病的風(fēng)險(xiǎn)。而高密度脂蛋白增高則可使該人群T2DM發(fā)病風(fēng)險(xiǎn)降低。2、錦州地區(qū)事業(yè)單位人群中,甘油三酯及總膽固醇對T2DM致病作用存在性別差異。男性人群中,甘油三酯增高可使T2DM發(fā)病風(fēng)險(xiǎn)增加,總膽固醇與T2DM發(fā)病無關(guān);女性人群中,總膽固醇增高可使T2DM發(fā)病風(fēng)險(xiǎn)增加,甘油三酯與T2DM發(fā)病無關(guān)。3、錦州地區(qū)事業(yè)單位人群中,血壓增高與T2DM存在弱關(guān)聯(lián),且致病作用存在性別差異。男性人群中,收縮壓增高能增加T2DM發(fā)病風(fēng)險(xiǎn),舒張壓與T2DM發(fā)病無關(guān);女性人群中,舒張壓增高可增加T2DM發(fā)病風(fēng)險(xiǎn),收縮壓與T2DM發(fā)病無關(guān)。
[Abstract]:Objective to study the relationship between blood lipid (triglyceride, total cholesterol, high density lipoprotein, low density lipoprotein) and its related factors (body mass index, systolic pressure, diastolic pressure, family history) and the pathogenesis of type2 diabetes mellitus (T2DM), and focus on the pathogenicity and efficacy of blood lipid and blood pressure factors, and to differentiate and analyze the related research at home and abroad. The reasons for the inconsistency were to provide suggestions for the prevention of type 2 diabetes. Methods using the 1:1 matched case control study, 286 pairs of research objects were selected as the research samples in the medical center of four grade A hospitals in Jinzhou city. The methods of collecting data were collected by the questionnaire survey method and the excerpt of the medical index detection. The survey data tool was designed by itself. The basic information collection table of the personnel of the institution and the physical examination report were selected. The case group was selected according to the results of abnormal blood glucose in the medical examination center, which was selected according to the matching condition in the large database of the physical examination center. The statistical analysis of the data was used in the statistical analysis of the soft parts with SPSS 21, and the single factor analysis method was used for the measurement data. ANOVA analysis and t test, X2 test was used for counting data, and conditional Logistic regression analysis was used in multi factor analysis. Results 1, the demographic characteristics of case group and control group such as age, sex, nationality, occupation and educational level were tested with no statistical significance (P0.05).2, case group and control group The measured values of triglyceride, total cholesterol, low density lipoprotein, high density lipoprotein, systolic pressure, diastolic pressure, body mass index and family history were analyzed by single factor variance in the last 3 years. The differences were statistically significant (P0.05) by t test and X2 test. A slight difference of.3, condition Lo after sex classification was found. Gistic regression analysis: (1) triglyceride, low density lipoprotein, total cholesterol, body weight, family history, systolic and diastolic pressure were associated with T2DM (P0.05), relative risk and 95% confidence interval were (ORTG=1.163,95%CI:1.009~1.341; ORLDL=1.776,95%CI: 1.231~2.562; ORTC=1.694,95%CI:1.393~2.062; ORBMI=1.184,95%CI:1.101~1.273; OR) Family history =1.375,95%CI:1.074~1.758; ORSBP=1.041,95%CI:1.031~1.050; ORDBP=1.013,95%CI:1.003~1.023). (2) the correlation between triglyceride, total cholesterol, systolic and diastolic pressure and the incidence of T2DM is gender differences. (1) diastolic pressure is not related to T2DM (P=0.545), and systolic pressure is related (ORSBP=1.021,95%CI:1.009~1.033); (2) Total cholesterol did not enter the model, triglyceride was associated with T2DM (ORTG=1.245,95%CI:1.071~1.447). (1) systolic pressure was not related to T2DM (P=0.312), diastolic pressure was related (ORDBP=1.018,95%CI:1.005~1.032); (2) triglyceride did not enter the model, total cholesterol was associated with T2DM (ORTC=2.418,95%CI:1.777~3.291). Conclusion 1, Among the Jinzhou regional institutions, the increase of triglyceride, the increase of total cholesterol, the increase of low density lipoprotein, the overweight and the family history can increase the risk of T2DM. The increase of high density lipoprotein can reduce the risk of T2DM in this population by.2. In the single population of Jinzhou, triglyceride and total cholesterol are responsible for the pathogenesis of T2DM. In male populations, increased triglyceride may increase the risk of T2DM, and total cholesterol is not related to T2DM; in women, increased total cholesterol may increase the risk of T2DM, and triglycerides are not associated with.3. In the Jinzhou regional institutions, there is a weak association between high blood pressure and T2DM, and the pathogenicity of T2DM. There is a gender difference. In the male population, the increased systolic pressure increases the risk of T2DM. Diastolic pressure is not related to T2DM; in women, the increased diastolic pressure increases the risk of T2DM, and systolic pressure is not related to the incidence of T2DM.
【學(xué)位授予單位】：錦州醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R587.1

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1 李志強(qiáng);錦州地區(qū)事業(yè)單位人員2型糖尿病危險(xiǎn)因素病例對照研究[D];錦州醫(yī)科大學(xué);2017年

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本文編號：2048343