【摘要】：目的:本研究通過觀察不同肥胖代謝類型患者的一般臨床特點(diǎn)、比較s CD163、TNF-α、CRP在不同肥胖代謝類型中的變化及意義,探討s CD163的變化在不同肥胖代謝類型發(fā)病中的作用及影響因素,為進(jìn)一步研究不同肥胖代謝類型的發(fā)病機(jī)制提供理論基礎(chǔ)。方法:收集2015年12月-2016年12月就診于石河子大學(xué)第一附屬醫(yī)院門診及住院的成年人的一般情況、既往病史、家族史、身體檢查、吸煙史、飲酒史等信息。采集晨空腹血并使用羅氏全自動(dòng)生化分析儀檢測(cè)血清中空腹血糖、膽固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白、尿酸等的濃度。根據(jù)2003年《中國成人超重和肥胖癥預(yù)防控制指南》定義的肥胖診斷標(biāo)準(zhǔn)和NCEP ATP-Ⅲ定義的代謝異常診斷標(biāo)準(zhǔn),將研究對(duì)象分為正常體重代謝正常(MHNW)組、代謝正常性肥胖(MHO)組、正常體重代謝異常(MONW)組、代謝異常性肥胖(MAO)組四個(gè)組。采用酶聯(lián)免疫吸附測(cè)定法測(cè)定s CD163、TNF-α及CRP的濃度。結(jié)果:1.所有研究對(duì)象平均年齡為63.6±11.2歲,四組研究對(duì)象的平均年齡及性別差異無統(tǒng)計(jì)學(xué)意義(p0.05)。2.MHNW組的WHR低于MHO組、MONW組、MAO組,MAO組的WHR高于MHO組、MONW組,差異有統(tǒng)計(jì)學(xué)意義(p0.001);MONW組、MAO組的SBP高于MHNW組、MHO組,差異有統(tǒng)計(jì)學(xué)意義(p0.001);MAO組的DBP高于MHNW組、MHO組、MONW組,差異有統(tǒng)計(jì)學(xué)意義(p0.001);MONW組、MAO組的Hb A1C、FBG、PBG、HDL-C、TG高于MHNW組、MHO組,差異均有統(tǒng)計(jì)學(xué)意義(p值均0.001);MAO組的ALT高于MHNW組、MONW組,差異有統(tǒng)計(jì)學(xué)意義(p0.05);MAO組的AST較MHNW組、MHO組、MONW組均升高,差異有統(tǒng)計(jì)學(xué)意義(p0.05)。而四組研究對(duì)象的TG、LDL-C、BUN和Scr的差異經(jīng)比較均無統(tǒng)計(jì)學(xué)意義(p0.05)。3.MHO組、MONW組、MAO組的s CD163、TNF-α、CRP均高于MHNW組,差異有統(tǒng)計(jì)學(xué)意義(p0.001),MAO組的s CD163、TNF-α、CRP均高于MHNW組、MHO組、MAO組,差異有統(tǒng)計(jì)學(xué)意義(P0.001)。MHO組與MONW組間的s CD163、TNF-α差異無統(tǒng)計(jì)學(xué)意義(p=0.307、P=0.337),MHO組CRP水平高于MONW組,差異有統(tǒng)計(jì)學(xué)意義(p0.05)。4.s CD163與TNF-α、CRP、BMI、WHR、SBP、DBP、Hb A1C、FBG、PBG、TG、ALT均呈正相關(guān),與HDL-C呈負(fù)相關(guān)(p0.001)。5.采用多元逐步線性回歸方法,以s CD163為因變量,各臨床指標(biāo)因素為自變量,BMI、Hb A1C、DBP越高,HDL-C越低,此時(shí)s CD163濃度越高。結(jié)論:MHO組、MONW組、MAO組人群體內(nèi)均存在炎癥狀態(tài),以MAO組最為明顯。s CD163可能參與了肥胖及代謝異常的發(fā)病。
[Abstract]:Objective: to observe the general clinical characteristics of patients with different obesity metabolic types, to compare the changes and significance of s CD163 TNF- 偽 CRP in different obesity metabolic types, and to explore the role of s CD163 in the pathogenesis of different obesity metabolic types and its influencing factors. It provides a theoretical basis for further study on the pathogenesis of different metabolic types of obesity. Methods: from December 2015 to December 2016, we collected the general information of adults in outpatient and inpatient of the first affiliated Hospital of Shihezi University, including past medical history, family history, physical examination, smoking history, drinking history and so on. Fasting blood samples were collected and serum fasting blood glucose, cholesterol, triglyceride, high density lipoprotein, low density lipoprotein and uric acid were measured by Roche automatic biochemical analyzer. According to the criteria for the diagnosis of obesity defined in the guidelines for Prevention and Control of overweight and Obesity in Chinese Adults in 2003 and the criteria for the diagnosis of Metabolism abnormality defined by NCEP ATP-III, the subjects were divided into normal body weight normal metabolic (MHNW) group and metabolic normal obese (MHO) group. Normal body weight metabolism abnormal (MONW) group, metabolic abnormal obesity (MAO) group four groups. The concentrations of sCD163 TNF- 偽 and CRP were determined by enzyme linked immunosorbent assay (Elisa). The result is 1: 1. The average age of all subjects was 63.6 鹵11.2 years old. There was no significant difference in average age and sex between the four groups. 2. The WHR of MHNW group was lower than that of MHO group. The WHR of MHNW group was higher than that of MHO group. The SBP of mow group was higher than that of MHNW group (p 0.001). The DBP of Mao group was higher than that of MHNW group (P 0.001). The difference was statistically significant (p0.001). The difference was statistically significant (p = 0.001). The ALT of Mao group was higher than that of MHNW group, and the AST of Mao group was higher than that of MHNW group (p0.05). However, there was no significant difference in the levels of TG-LDL-Cnbun and Scr between the four groups. 3. The levels of sCD163TNF- 偽 Scr in MHO group were higher than those in MHNW group. The difference was statistically significant (p0.001). The difference was higher in MHO group than that in MHNW group. There was no significant difference between MHO group and MONW group (P 0.001). There was no significant difference in CRP level between MHO group and MONW group (p0. 307). The level of CRP in MHO group was higher than that in MONW group. The difference was statistically significant (p0. 05). 4. S CD163 was significantly higher than that in MONW group (p0. 05). There was a positive correlation between the CRP level of MHO group and that of MONW group (p 0. 001), and there was a negative correlation with HDL-C (p 0. 001). Using multiple stepwise linear regression method, the higher the HDL-C and the higher the concentration of s CD163 were, the higher the HDL-C was and the higher the clinical parameters were, the more dependent variables were s CD163. Conclusion there is an inflammatory state in the body of male MHO group, especially in MAO group. S CD163 may be involved in the pathogenesis of obesity and abnormal metabolism.
【學(xué)位授予單位】：石河子大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R589.2

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