超重人群血清C1q腫瘤壞死因子相關(guān)蛋白12水平的研究
發(fā)布時(shí)間：2018-08-28 10:38
【摘要】：目的:脂肪組織通過表達(dá)和分泌脂肪因子調(diào)節(jié)能量代謝。肥胖狀態(tài)下,脂肪因子的異常分泌促進(jìn)代謝性及心血管疾病的發(fā)生發(fā)展。C1q腫瘤壞死因子相關(guān)蛋白12(complement-C1q/TNF-related protein 12,CTRP12)是一種新型脂肪因子,屬于補(bǔ)體C1q/腫瘤壞死因子相關(guān)蛋白超家族,在調(diào)節(jié)代謝及心血管功能方面發(fā)揮積極作用。研究發(fā)現(xiàn),肥胖患者血清中CTRP12的水平降低。進(jìn)一步研究其機(jī)制發(fā)現(xiàn)CTRP12通過抑制脂肪組織炎性反應(yīng)改善糖代謝。最新數(shù)據(jù)顯示,近40%男性及30%女性屬于超重范疇,表明超重在人群中占有很大比例。本研究旨在檢測超重和肥胖人群血清CTRP12的水平,并分析CTRP12與生化指標(biāo)的關(guān)系,探討這一新型脂肪因子在超重人群中的變化及臨床意義。方法:選取2016年3月-6月于河北省人民醫(yī)院體檢中心進(jìn)行體檢的人群為受試對象,共282人納入研究,其中正常組(CON)81例、超重組(OW)93例、肥胖組(OB)108例。應(yīng)用全自動(dòng)生化分析儀檢測血糖、血脂等生化指標(biāo);應(yīng)用電化學(xué)發(fā)光法檢測血清胰島素水平;應(yīng)用高壓液相色譜法測定糖化血紅蛋白(glycosylated hemoglobin,Hb A1c)水平;應(yīng)用酶聯(lián)免疫吸附法(enzyme-linked immunsorbent assay,ELISA)試劑盒檢測CTRP12、脂聯(lián)素(adiponectin,APN)及抵抗素(Resistin)的水平;采用穩(wěn)態(tài)模型胰島素抵抗指數(shù)(homeostasis model assessment of insulin resistance,HOMA-IR)評估受試者胰島素敏感性。采用SPSS21.0軟件對上述數(shù)據(jù)進(jìn)行統(tǒng)計(jì)分析。結(jié)果:1三組一般資料與生化指標(biāo)的比較1.1三組受試者一般資料比較比較三組間性別、年齡、體重指數(shù)(BMI)、腰圍(WC)、腰臀比(WHR)以及血壓的差異。結(jié)果提示,與CON組相比,OW組受試者BMI、WC及WHR顯著升高(P0.001),OB組SBP、DBP、BMI、WC和WHR顯著升高(P0.001)。此外,OW組SBP、DBP、BMI、WC和WHR均低于OB組(P0.05)。1.2三組受試者生化指標(biāo)比較與CON組比,OW及OB組FBG、2h PBG、FINS、2h INS、Hb A1c、TG、LDL-C顯著升高,HDL-C及Apo A1顯著降低(P0.05)。OB組TC較CON組顯著升高。OW組FBG、2h PBG、FINS、2h INS、Hb A1c、TG較OB組顯著降低(P0.05),HDL-C及Apo A1顯著升高(P0.05)。TC及LDL-C在OW與OB組間無顯著差異。1.3三組胰島素敏感性指標(biāo)比較與CON組比,OW和OB組HOMA-IR均顯著升高(P0.001)。與OB組相比,OW組HOMA-IR顯著降低(P0.001)。2各組受試者血清脂肪因子水平的比較2.1血清脂肪因子水平的比較應(yīng)用方差分析比較三組人群血清脂肪因子(CTRP12、APN、Resistin)水平的差異。與CON組比較,CTRP12的水平在OW組(P=0.03)及OB組(P=0.001)顯著降低;APN水平在OW組(P=0.001)及OB組(P0.001)顯著降低,而Resistin水平在OW組(P=0.034)及OB組(P0.001)顯著升高。與OB組比較,OW組血清CTRP12和APN水平有升高趨勢,血清Resistin水平顯著降低(P=0.04)。2.2按性別分層比較血清脂肪因子水平本研究納入的研究對象中,包含男性133人,女性149人。應(yīng)用Mann-Whitney U非參數(shù)檢驗(yàn)對不同性別亞組間血清脂肪因子水平進(jìn)行比較。結(jié)果提示血清CTRP12,APN,Resistin水平無性別差異。3血清CTRP12與各生化指標(biāo)的關(guān)聯(lián)分析3.1血清CTRP12與一般資料及各生化指標(biāo)的相關(guān)性應(yīng)用Pearson或Spearman秩相關(guān)系數(shù)評價(jià)CTRP12與年齡、BMI、WC等一般資料以及各生化指標(biāo)之間的相關(guān)性。結(jié)果提示血清CTRP12水平與年齡、BMI、WC、WHR、SBP、FBG、2h PBG、Hb A1c、HOMA-IR、TC、TG、LDL-C呈顯著的負(fù)相關(guān)關(guān)系。3.2血清CTRP12水平的影響因素分析應(yīng)用多元線性逐步回歸分析,以CTRP12作為因變量,觀察BMI、WC、WHR、FBG、Hb A1c、HOMA-IR、TG等對CTRP12的影響,結(jié)果提示W(wǎng)C是血清CTRP12的重要影響因素(P=0.001)。結(jié)論:1血清CTRP12水平不僅在肥胖患者,而且在超重者已經(jīng)顯著降低,提示其可能為肥胖的早期預(yù)測指標(biāo)。2 CTRP12與年齡、BMI、WC、WHR、HOMA-IR、FBG、2h PBG、TC、TG、LDL-C、Hb A1c和SBP呈負(fù)相關(guān),且WC是CTRP12的重要影響因素。
[Abstract]:Objective: Adipose tissue regulates energy metabolism through the expression and secretion of adipocytokines. Abnormal secretion of adipocytokines promotes the development of metabolic and cardiovascular diseases under obesity. Complement-C1q/TNF-related protein 12 (CTRP12) is a novel adipocytokine, belonging to complement C1q/tumor damage. The death factor-related protein superfamily plays an active role in regulating metabolism and cardiovascular function. Studies have found that the level of serum CTRP12 in obese patients decreases. Further studies have found that CTRP12 improves glucose metabolism by inhibiting inflammatory responses in adipose tissue. Recent data show that nearly 40% of men and 30% of women are overweight. The purpose of this study was to detect the levels of serum CTRP12 in overweight and obese people, and to analyze the relationship between CTRP12 and biochemical indicators, and to explore the changes and clinical significance of this new fat factor in overweight people. A total of 282 subjects were included in the study, including 81 normal subjects (CON), 93 overweight subjects (OW) and 108 obese subjects (OB). The levels of CTRP12, adiponectin (APN) and resistin (Resistin) were detected by enzyme-linked immunosorbent assay (ELISA), and insulin sensitivity was assessed by homeostasis model of insulin resistance (HOMA-IR). SPSS21.0 software was used to analyze the above data. Results: 1 Comparison of general data and biochemical indicators of three groups 1.1 Comparison of general data of three groups of subjects sex, age, body mass index (BMI), waist circumference (WC), waist-hip ratio (WHR) and blood pressure differences between the three groups. In addition, SBP, DBP, BMI, WC and WHR in OW group were lower than those in OB group (P 0.05). 1.2 Compared with CON group, FBG, 2H PBG, FINS, 2H INS, Hb A1c, TG, LDL-C, HDL-C and Apo A1 in OW group were significantly higher than those in CON group (P 0.05). There was no significant difference between OW and OB groups in TC and LDL-C. Compared with C ON group, HOMA-IR in OW and OB groups were significantly increased (P 0.001). Compared with OB group, HOMA-IR in OW and OB group was significantly decreased (P 0.05). Comparison of serum adipokine levels 2.1 Comparison of serum adipokine levels using variance analysis of three groups of people with serum adipokine (CTRP12, APN, Resistin) levels. Compared with the CON group, CTRP12 levels in OW group (P = 0.03) and OB group (P = 0.001) were significantly lower; APN levels in OW group (P = 0.001) and OB group (P = 0.001) were significantly lower, while Resistin levels in OW group (P = 0.001) were significantly lower. Compared with OB group, serum CTRP12 and APN levels in OW group increased, serum Resistin levels decreased significantly (P = 0.04). 2. The serum levels of CTRP12, APN and Resistin were not significantly different between the sexes. 3 Correlation analysis of serum CTRP12 with biochemical indexes 3.1 Correlation analysis of serum CTRP12 with general data and biochemical indexes Pearson or Spearman rank correlation coefficient was used to evaluate CTRP12 with age, BMI and WC. The results showed that serum CTRP12 levels were negatively correlated with age, BMI, WC, WHR, SBP, FBG, 2H PBG, Hb A1c, HOMA-IR, TC, TG, LDL-C. 3.2 The influencing factors of serum CTRP12 levels were analyzed by multivariate linear stepwise regression analysis. BMI, WC, WHR, FBG, Hb A1c, HOMA-IR, TC, TG and LDL-C were observed as dependent variables. Conclusion: 1. Serum CTRP12 levels have been significantly decreased not only in obese patients, but also in overweight patients, suggesting that it may be an early predictor of obesity. 2. CTRP12 is negatively correlated with age, BMI, WC, WHR, HOMA-IR, FBG, 2H PBG, TC, TG, LDL-C, Hb A1c and SBP. WC is an important influence factor of CTRP12.
【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R589.2
[Abstract]:Objective: Adipose tissue regulates energy metabolism through the expression and secretion of adipocytokines. Abnormal secretion of adipocytokines promotes the development of metabolic and cardiovascular diseases under obesity. Complement-C1q/TNF-related protein 12 (CTRP12) is a novel adipocytokine, belonging to complement C1q/tumor damage. The death factor-related protein superfamily plays an active role in regulating metabolism and cardiovascular function. Studies have found that the level of serum CTRP12 in obese patients decreases. Further studies have found that CTRP12 improves glucose metabolism by inhibiting inflammatory responses in adipose tissue. Recent data show that nearly 40% of men and 30% of women are overweight. The purpose of this study was to detect the levels of serum CTRP12 in overweight and obese people, and to analyze the relationship between CTRP12 and biochemical indicators, and to explore the changes and clinical significance of this new fat factor in overweight people. A total of 282 subjects were included in the study, including 81 normal subjects (CON), 93 overweight subjects (OW) and 108 obese subjects (OB). The levels of CTRP12, adiponectin (APN) and resistin (Resistin) were detected by enzyme-linked immunosorbent assay (ELISA), and insulin sensitivity was assessed by homeostasis model of insulin resistance (HOMA-IR). SPSS21.0 software was used to analyze the above data. Results: 1 Comparison of general data and biochemical indicators of three groups 1.1 Comparison of general data of three groups of subjects sex, age, body mass index (BMI), waist circumference (WC), waist-hip ratio (WHR) and blood pressure differences between the three groups. In addition, SBP, DBP, BMI, WC and WHR in OW group were lower than those in OB group (P 0.05). 1.2 Compared with CON group, FBG, 2H PBG, FINS, 2H INS, Hb A1c, TG, LDL-C, HDL-C and Apo A1 in OW group were significantly higher than those in CON group (P 0.05). There was no significant difference between OW and OB groups in TC and LDL-C. Compared with C ON group, HOMA-IR in OW and OB groups were significantly increased (P 0.001). Compared with OB group, HOMA-IR in OW and OB group was significantly decreased (P 0.05). Comparison of serum adipokine levels 2.1 Comparison of serum adipokine levels using variance analysis of three groups of people with serum adipokine (CTRP12, APN, Resistin) levels. Compared with the CON group, CTRP12 levels in OW group (P = 0.03) and OB group (P = 0.001) were significantly lower; APN levels in OW group (P = 0.001) and OB group (P = 0.001) were significantly lower, while Resistin levels in OW group (P = 0.001) were significantly lower. Compared with OB group, serum CTRP12 and APN levels in OW group increased, serum Resistin levels decreased significantly (P = 0.04). 2. The serum levels of CTRP12, APN and Resistin were not significantly different between the sexes. 3 Correlation analysis of serum CTRP12 with biochemical indexes 3.1 Correlation analysis of serum CTRP12 with general data and biochemical indexes Pearson or Spearman rank correlation coefficient was used to evaluate CTRP12 with age, BMI and WC. The results showed that serum CTRP12 levels were negatively correlated with age, BMI, WC, WHR, SBP, FBG, 2H PBG, Hb A1c, HOMA-IR, TC, TG, LDL-C. 3.2 The influencing factors of serum CTRP12 levels were analyzed by multivariate linear stepwise regression analysis. BMI, WC, WHR, FBG, Hb A1c, HOMA-IR, TC, TG and LDL-C were observed as dependent variables. Conclusion: 1. Serum CTRP12 levels have been significantly decreased not only in obese patients, but also in overweight patients, suggesting that it may be an early predictor of obesity. 2. CTRP12 is negatively correlated with age, BMI, WC, WHR, HOMA-IR, FBG, 2H PBG, TC, TG, LDL-C, Hb A1c and SBP. WC is an important influence factor of CTRP12.
【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R589.2
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