【摘要】：目的:動物研究發(fā)現(xiàn)睫狀神經(jīng)營養(yǎng)因子(ciliary neurotrophic factor,CNTF)具有抑制食欲、減輕體重、改善胰島抵抗的作用,本研究旨在觀察2型糖尿病以及糖尿病并發(fā)癥與血清CNTF水平的關系,為糖尿病及其并發(fā)癥的防治提供新的思路。方法:選取自2015年3月至2015年8月于無錫市人民醫(yī)院內(nèi)分泌科住院的2型糖尿病患者,納入符合標準的2型糖尿病無并發(fā)癥者27例(DM組),合并糖尿病視網(wǎng)膜病變24例(DR組),合并糖尿病周圍神經(jīng)病變者20例(DPN組),并以同時段我院體檢中心正常健康人群20例。采集一般資料,包括年齡、性別、糖尿病病程、身高、體重、腰圍等指標;清晨空腹采集靜脈血,由檢驗科完成生化、空腹C肽、糖化血紅蛋白檢測,收集血清采用ELISA測定CNTF水平。應用SPSS17.0軟件統(tǒng)計,各計量資料數(shù)據(jù)均采用x±SD表示,各樣本均數(shù)用方差分析,多組間比較采用Dunnett t檢驗方法,計數(shù)資料采用卡方檢驗,CNTF與臨床其他指標進行Pearson相關分析、多重線性回歸分析。P0.05表示差異有統(tǒng)計學意義。結(jié)果:(1)各組性別、年齡、身高、體重、體重指數(shù)、腰圍均無顯著差異。DR組、DPN組糖尿病病程、空腹血糖、糖化血紅蛋白(glycosylated hemoglobin,HbA1c)、低密度膽固醇(low-density lipoprotein cholesterol,LDL-C)水平均顯著高于DM組(P值0.05)。DR組腎小球濾過濾估值86.38±20.59ml/min,顯著低于DM組、DPN組。糖尿病各組CNTF水平均顯著低于正常對照組,F=49.612,P0.001。DR組、DPN組CNTF水平分別為47.89±10.55pg/ml、45.41±12.00pg/ml,低于DM組62.60±5.84pg/ml(P值均0.001)。(2)Pearson相關分析,糖尿病并發(fā)視網(wǎng)膜病變、周圍神經(jīng)病變與血清CNTF水平呈負相關(r值=-0.634,P值0.001)。(3)多重線性回歸分析,模擬多重線性回歸方程為:Y=116.471-7.295X1-0.598X2-1.791X3+6.626X4-4.265X5(Y表示血清CNTF水平,X1表示有無糖尿病并發(fā)癥,X2表示糖尿病病程,X3體重指數(shù),X4表示甘油三脂水平,X5表示高密度膽固醇)。結(jié)論:2型糖尿病患者血清CNTF水平顯著低于正常人,并發(fā)視網(wǎng)膜病變、周圍神經(jīng)病變可進一步降低CNTF表達含量,同時體重指數(shù)、脂質(zhì)代謝等與CNTF水平密切相關,期待CNTF及其相關衍生物可在未來應用于2型糖尿病以及并發(fā)癥的治療。
[Abstract]:Objective: to investigate the effects of ciliary neurotrophic factor (ciliary neurotrophic factor,CNTF) on appetite inhibition, weight loss and islet resistance. The aim of this study was to observe the relationship between type 2 diabetes mellitus and diabetic complications and serum CNTF levels. To provide a new idea for the prevention and treatment of diabetes mellitus and its complications. Methods: type 2 diabetes mellitus patients were selected from March 2015 to August 2015 in Department of Endocrinology, Wuxi people's Hospital. Twenty-seven patients with type 2 diabetes without complications (DM group), 24 patients with diabetic retinopathy (DR group) and 20 patients with diabetic peripheral neuropathy (DPN group) were included in this study. General data were collected, including age, sex, course of diabetes, height, weight, waist circumference and so on. Venous blood was collected on an empty stomach in the morning, and biochemistry, fasting C-peptide and glycosylated hemoglobin were detected by laboratory. Serum levels of CNTF were measured by ELISA. By using SPSS17.0 software, the data were expressed by x 鹵SD, the mean of each sample was analyzed by ANOVA, the Dunnett t test method was used to compare the data among groups, and the Pearson correlation analysis was carried out by chi-square test and other clinical indexes. Multiple linear regression analysis. P0.05 indicated that the difference was statistically significant. Results: (1) there was no significant difference in sex, age, height, body mass index, waist circumference. The levels of glycosylated hemoglobin (glycosylated hemoglobin,HbA1c) and low density cholesterol (low-density lipoprotein cholesterol,LDL-C) were significantly higher than those in the DM group (P < 0. 05). The glomerular filtration estimation of Dr group was 86.38 鹵20. 59ml / min, which was significantly lower than that of DM group. The level of CNTF in diabetic group was significantly lower than that in normal control group (47.89 鹵10.55pg / ml, 45.41 鹵12.00pg / ml, P = 0.001). (2, P = 0.001). (2). The level of CNTF in diabetic group was 47.89 鹵10.55pg / ml and 62.60 鹵5.84pg/ml (P = 0.001). (2), respectively. There was a negative correlation between peripheral neuropathy and serum CNTF level (r = -0.634 P = 0.001). (3). The simulated multiple linear regression equation was: Y116.471-7.295X1-0.598X2-1.791X3 6.626X4-4.265X5 (Y indicates serum CNTF level X1 indicates diabetic complications X2 indicates the course of diabetes and X3 body mass index X4 indicates triglyceride level X5 indicates high density cholesterol). Conclusion the serum CNTF level in patients with type 2 diabetes mellitus is significantly lower than that in normal controls. Retinopathy and peripheral neuropathy can further decrease the expression of CNTF, and the body mass index and lipid metabolism are closely related to the level of CNTF. It is expected that CNTF and its related derivatives can be used in the treatment of type 2 diabetes mellitus and complications in the future.
【學位授予單位】：蘇州大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R587.2

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