本文選題：糖尿病 + 高胰島素血癥��； 參考：《鄭州大學(xué)》2015年碩士論文

【摘要】：目的:肥胖是導(dǎo)致2型糖尿病(Type 2 Diabetes Mellitus,T2DM)及心腦血管疾病的重要危險(xiǎn)因素,老年2型糖尿病患者因生活、飲食條件的不同,血糖控制情況有所差異,血糖控制的好壞可以間接的通過糖化血糖蛋白來表示�；A(chǔ)胰島素水平與肥胖存在一定的聯(lián)系,那么胰島素水平的高低與肥胖之間是否存在著關(guān)聯(lián)?血糖控制的好壞對胰島素水平高低導(dǎo)致肥胖有什么相關(guān)性?本研究旨在通過觀察2型糖尿病患者空腹胰島素水平對肥胖的影響及血糖控制欠佳時(shí)胰島素水平與肥胖的相關(guān)分析。方法:對2014年1月至2014年6月年在鄭州大學(xué)第一附屬醫(yī)院老年內(nèi)分泌科和內(nèi)分泌科住院的278例老年糖尿病患者測糖化血紅蛋白(Hb A1c),按其數(shù)值高低分為血糖控制正常組G1組(Hb A1c≤6.5%)和血糖控制較差組G2組(6.5%Hb A1c≤8.5%);測空腹胰島素水平,按空腹胰島素是否大于7.1u U/m L分為血糖控制正常高胰島素水平組(G1 High Insulin,G1HI)、血糖控制正常低胰島素水平組(G1 Low Insulin,G1LI)、血糖控制較差高胰島素水平組(G2 High Insulin,G2HI)和血糖控制較差低胰島素水平組(G2 High Insulin,G2HI)四組。測量患者身高、體重并計(jì)算體質(zhì)指數(shù)(Body Mass Index,BMI),BMI=體重(千克)/身高(米)的平方。進(jìn)行高胰島素水平組和低胰島素水平組BMI相比較;四組中兩兩組之間BMI進(jìn)行比較,分析胰島素與肥胖的關(guān)系及不同血糖水平胰島素與肥胖關(guān)系。結(jié)果:1.278例2型糖尿病患者中男性151例,女性127例,平均年齡男性(68.9±6.4)歲,女性(67.3±7.3)歲,G1組BMI(25.58±4.11)kg/m2,G2組BMI(27.89±3.69)kg/m2;G1組空腹胰島素(8.31±6.26)u U/m L,G2組空腹胰島素(7.96±4.51)u U/m L;G1組糖化血紅蛋白(6.09±3.48)%,G2組糖化血紅蛋白(7.47±0.56)%;2.高胰島素水平組較低胰島素水平組BMI明顯增高(P0.05),G1HI組較G1LI組BMI明顯增高(P0.05),G2HI組較G2LI組BMI明顯增高(P0.05)。3.G1組、G2組間空腹胰島素與BMI的Pearson相關(guān)分析,G1和G2組空腹胰島素與BMI成相關(guān),G2組相關(guān)性更高(G1組r=0.64;G2組r=0.716)。結(jié)論:老年糖尿病患者體內(nèi)基礎(chǔ)胰島素水平越高,越容易引起肥胖的發(fā)生,而血糖控制越差基礎(chǔ)胰島素越高,更容易引起肥胖的發(fā)生。目的:高胰島素水平容易導(dǎo)致肥胖的發(fā)生,引起2型糖尿病、心腦血管病等慢性疾病,胰島素通過何種機(jī)制引肥胖發(fā)生國內(nèi)的文獻(xiàn)鮮有提出,本文主要探討高胰島素水平通過體內(nèi)何種機(jī)制引起肥胖的發(fā)生。方法:將60只6周齡雄性C57BL/6J小鼠適應(yīng)性喂養(yǎng)1周,禁食8小時(shí)后,用眼眶后靜脈叢取血方式收集血液,離心收集血清測胰島素含量,按胰島素水平是否高于中位數(shù)分成高胰島素水平組(High Insulin,HI)和低胰島素水平組(Low Insulin,LI)各30只。高胰島素水平組和低胰島素水平組兩組間隨機(jī)分成高脂飲食組和普食組各15只。高脂飲食小鼠組喂養(yǎng)高脂飲食,普通飲食組喂養(yǎng)基礎(chǔ)飼料,每2周稱量小鼠的體重并記錄,觀察小鼠體重的變化;12周后稱量小鼠體重并記錄,摘眼球法取血,離心收集血清測小鼠血清中胰島素的水平和肥胖抑制素的水平,頸椎脫臼法處死小鼠,解剖小鼠,分別收集四組小鼠內(nèi)臟脂肪稱重并記錄。比較胰島素水平與飲食情況兩者在引起小鼠體重關(guān)系,分析肥胖抑制素與肥胖之間的關(guān)系。結(jié)果:1高胰島素水平高脂飲食組小鼠體重和內(nèi)臟脂肪組織重量顯著高于高胰島素水平普食組、低胰島素水平高脂飲食組、低胰島素水平普食組(P0.05);高胰島素水平普食組體重和內(nèi)臟脂肪組織重量顯著高于低胰島素水平普食組(P0.05)。低胰島素水平高脂飲食組體重和內(nèi)臟脂肪組織顯著高于高胰島素水平普食組(P0.05)。2高胰島素水平高脂飲食組小鼠肥胖抑制素水平顯著低于高胰島素水平普食組、低胰島素水平高脂飲食組、低胰島素水平普食組;低胰島素水平高脂飲食組肥胖抑制素明顯低于高胰島素水平普食組(P0.05),高胰島素水平普食組肥胖抑制素明顯低于低胰島素水平普食組(P0.05)。結(jié)論:高脂飲食和高胰島素水平均可以引起肥胖發(fā)生,高胰島素水平和高脂飲食均也可以減低體內(nèi)肥胖抑制素的含量,說明肥胖抑制素與肥胖的發(fā)生之間存在關(guān)系。
[Abstract]:Objective: obesity is an important risk factor for type 2 diabetes (Type 2 Diabetes Mellitus, T2DM) and cardiovascular and cerebrovascular diseases. In elderly patients with type 2 diabetes, the control of blood sugar is different because of the different living conditions and dietary conditions. The quality of blood sugar control can be expressed indirectly through glycemic glycemic protein. Basic insulin level and obesity Is there a link between insulin level and obesity? What is the correlation between blood glucose control and obesity? This study aims to observe the effects of insulin levels on obesity in patients with type 2 diabetes and the level of insulin and obesity when the blood sugar is not well controlled. Methods: Hb A1c was measured in 278 elderly diabetic patients who were hospitalized in the Department of Endocrinology and Department of endocrinology in the First Affiliated Hospital of Zhengzhou University from January 2014 to June 2014. The values were divided into G1 group (Hb A1c < 6.5%) and G2 group of poor blood glucose control group (6.5%Hb A1c < 8.5%) in the normal group of blood glucose control. The level of fasting insulin was measured by whether the fasting insulin was greater than the 7.1u U/m L (G1 High Insulin, G1HI), the blood glucose controlled normal low insulin level group (G1 Low Insulin, G1LI), the low blood glucose control group (G2), and the poor insulin level control group. G2 High Insulin, G2HI) four groups. Measure patient's height, body weight and calculate body mass index (Body Mass Index, BMI), BMI= weight (kilogram) / height (meter) square. Compare high insulin level group with low insulin level group BMI; four groups of 22 groups are compared, analyze the relationship between insulin and obesity and different blood glucose level pancreas Results: in 1.278 cases of type 2 diabetes, there were 151 males and 127 females, the average age was (68.9 + 6.4) years, women (67.3 + 7.3) years, G1 group BMI (25.58 + 4.11) kg/m2, BMI (27.89 + 3.69) kg/m2 in group G2, G1 group fasting insulin (8.31 +) u U/m L, G2 group of fasting insulin 09 + 3.48%, group G2 glycated hemoglobin (7.47 + 0.56)%, 2. high insulin level group BMI significantly higher than the low insulin level group (P0.05), G1HI group BMI significantly higher than the G1LI group (P0.05), G2HI group BMI significantly higher than G2LI group (P0.05).3.G1 group. The higher correlation in group G2 (group G1 r=0.64; G2 group r=0.716). Conclusion: the higher the level of insulin in the elderly patients with diabetes, the more prone to obesity, and the higher the control of blood sugar, the higher the basal insulin, the more likely to cause obesity. The literature on the mechanism of insulin induced obesity at home is rarely proposed. This paper mainly discusses the mechanism of high insulin through the body to cause obesity. Methods: 60 6 weeks male C57BL/6J mice were fed for 1 weeks. After fasting, the blood was collected by the posterior orbital plexus collection. The content of insulin was collected from the serum, and 30 rats were divided into the high insulin level group (High Insulin, HI) and the low insulin level group (Low Insulin, LI). The high insulin level group and the low insulin level group were randomly divided into the high fat diet group and the general diet Group 15 each. The high fat diet group was fed high diet group. Fat diet, diet group fed base diet, weighing mice every 2 weeks and recording the weight of mice. After 12 weeks, the weight of mice was weighed and recorded, the blood was picked up by eyeball, the level of insulin in the serum of mice and the level of obese inhibin were measured by centrifuge collection sera, and the mice were killed and dissected by cervical dislocations. The weight of visceral fat in four groups of mice was weighed and recorded. The relationship between insulin level and diet in mice was compared, and the relationship between obesity and obesity was analyzed. Results: 1 the weight and weight of visceral adipose tissue in high insulin high fat diet group were significantly higher than that of high insulin level and low insulin level. High fat diet group, low insulin level general food group (P0.05), high insulin level body weight and visceral fat tissue weight significantly higher than low insulin level group (P0.05). Low insulin level high fat diet group weight and visceral adipose tissue are significantly higher than high insulin level diet group (P0.05).2 high insulin high fat diet group The level of obesity inhibin in mice was significantly lower than that of high insulin group, low insulin high fat diet group, low insulin level universal diet group, low insulin high fat diet group, obesity inhibin was significantly lower than high insulin level diet group (P0.05), high insulin level diet group obesity inhibin was significantly lower than low insulin level. Food group (P0.05). Conclusion: high fat diet and high insulin level can cause obesity. Both high insulin level and high fat diet can also reduce the content of obesity inhibin in the body. It shows that there is a relationship between obesity and obesity.
【學(xué)位授予單位】：鄭州大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R587.1;R589.2

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