吸煙對糖調(diào)節(jié)受損患者血漿同型半胱氨酸濃度的影響
發(fā)布時間：2018-12-16 07:41
【摘要】：目的:探討吸煙與糖調(diào)節(jié)受損(IGR)患者血漿同型半胱氨酸(Hcy)水平的關(guān)系及其可能的機制。方法:選擇236例經(jīng)口服葡萄糖耐量試驗(OGTT)確診的IGR患者,其中吸煙的IGR患者86例作為吸煙IGR組,不吸煙的IGR患者150例作為不吸煙IGR組,另選擇年齡、性別構(gòu)成、體重指數(shù)(BMI)與IGR患者相似且不吸煙的70例空腹及OGTT2小時血糖均正常者作為正常對照組。檢測3組入選者空腹Hcy,空腹胰島素(FIns),血糖組份[空腹血糖(FPG)、服用75g無水葡萄糖后2小時血糖(OGTT2hPG)、糖化血紅蛋白(HbA1C)],血脂組份[總膽固醇(TC)、高密度脂蛋白膽固醇(HDL-C)、低密度脂蛋白膽固醇(LDL-C)、甘油三酯(TG)]及肝腎功能,并計算或測量其胰島素抵抗指數(shù)(HOMA-IR)、體重指數(shù)(BMI)、吸煙指數(shù)(支數(shù)/天×吸煙年限)、收縮壓(SBP)、舒張壓(DBP)等相關(guān)參數(shù),比較各組間上述指標的差異。結(jié)果:1、3組入選者在年齡、性別構(gòu)成、BMI、肌酐、SBP及DBP方面差異無統(tǒng)計學(xué)意義(均P0.05)。2、在對照組、不吸煙IGR組、吸煙IGR組3組中,ln(HOMA-IR)、FPG、HbA1C、TC、TG及Hcy水平逐漸升高,差異有統(tǒng)計學(xué)意義(P0.05)。吸煙和不吸煙IGR組LDL-C水平均顯著高于對照組(P0.05)。而吸煙IGR組的HDL-C水平要低于其他兩組(P0.05)。3、吸煙致IGR患者高Hcy血癥的危險性:同時調(diào)整了年齡、性別、ln(HOMA-IR)、BMI、TG、TC等混雜因素后,吸煙與IGR患者人群高Hcy血癥的發(fā)生仍密切相關(guān)[OR(95%CI)=2.103(1.017~4.348)],P0.05。且吸煙指數(shù)越大,血漿Hcy濃度可能越高(F=7.391,P0.01)。4、在236例IGR患者中,其ln(HOMA-IR)與血漿Hcy濃度呈正相關(guān)(相關(guān)系數(shù)r=0.296,P0.01),且ln(HOMA-IR)與HbA1C亦顯著正相關(guān)(r=0.163,P0.05)。結(jié)論:1.不僅糖尿病患者出現(xiàn)Hcy的代謝紊亂,在IGR階段人群中就已存在血漿Hcy的異常升高。2.吸煙為IGR者高Hcy血癥的獨立危險因素之一,且吸煙量和IGR患者Hcy濃度之間可能存在一種量效關(guān)系。3.在IGR人群中,胰島素抵抗與其血漿Hcy、HbA1C水平均顯著正相關(guān)。4.吸煙可加重IGR患者胰島素抵抗程度,吸煙導(dǎo)致IGR患者高Hcy血癥的重要機制之一可能為吸煙所引起的胰島素抵抗加重。
[Abstract]:Aim: to investigate the relationship between smoking and plasma homocysteine (Hcy) level in (IGR) patients with impaired glucose regulation. Methods: a total of 236 patients with IGR diagnosed by oral glucose tolerance test (OGTT) were selected, including 86 patients with IGR who smoked as smoking IGR group, 150 patients with IGR who did not smoke as non-smoking IGR group. The body mass index (BMI) was similar to that in IGR patients, and 70 cases with normal fasting and OGTT2 blood glucose were taken as normal control group. Fasting Hcy, fasting insulin (FIns), blood glucose component [fasting glucose (FPG), 75 g anhydrous glucose 2 hours blood glucose (OGTT2hPG), glycosylated hemoglobin (HbA1C)], blood lipid component [total cholesterol (TC),] High density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), triglyceride (TG), liver and kidney function, insulin resistance index (HOMA-IR), body mass index (BMI),) were calculated or measured. Smoking index (number / day 脳 smoking years) systolic blood pressure (SBP),) diastolic blood pressure (DBP) and other related parameters were compared among the groups. Results: 1 there was no significant difference in age, sex composition, BMI, creatinine, SBP and DBP among the three groups (P0.05). 2., ln (HOMA-IR, FPG,HbA1C,TC, in the control group, non-smoking IGR group and smoking IGR group) TG and Hcy levels gradually increased, the difference was statistically significant (P0.05). The level of LDL-C in IGR group was significantly higher than that in control group (P 0.05). However, the HDL-C level of smoking IGR group was lower than that of the other two groups (P0.05). The risk of hyperHcy in patients with IGR caused by smoking was adjusted for age, sex, ln (HOMA-IR, BMI,TG,TC and so on. Smoking was still closely related to the incidence of hyperHcy in patients with IGR [OR (95%CI) = 2.103 (1.017 鹵4.348), P 0.05]. The higher the smoking index was, the higher the plasma Hcy concentration was (F = 7.391g / P0.01). (4) in 236 patients with IGR, there was a positive correlation between ln (HOMA-IR) and plasma Hcy concentration (r = 0.296, P 0.01). Ln (HOMA-IR) was also positively correlated with HbA1C (r = 0.163, P 0.05). Conclusion: 1. It was not only the metabolic disorder of Hcy in diabetic patients, but also the abnormal increase of plasma Hcy in IGR patients. Smoking is one of the independent risk factors for hyperHcy in IGR patients, and there may be a dose-effect relationship between smoking and Hcy concentration in IGR patients. In IGR population, insulin resistance was significantly positively correlated with plasma Hcy,HbA1C levels. 4. 4. Smoking can aggravate the degree of insulin resistance in patients with IGR. One of the important mechanisms of hyperHcy in patients with IGR may be the increase of insulin resistance caused by smoking.
【學(xué)位授予單位】：南昌大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R589
本文編號：2382011
[Abstract]:Aim: to investigate the relationship between smoking and plasma homocysteine (Hcy) level in (IGR) patients with impaired glucose regulation. Methods: a total of 236 patients with IGR diagnosed by oral glucose tolerance test (OGTT) were selected, including 86 patients with IGR who smoked as smoking IGR group, 150 patients with IGR who did not smoke as non-smoking IGR group. The body mass index (BMI) was similar to that in IGR patients, and 70 cases with normal fasting and OGTT2 blood glucose were taken as normal control group. Fasting Hcy, fasting insulin (FIns), blood glucose component [fasting glucose (FPG), 75 g anhydrous glucose 2 hours blood glucose (OGTT2hPG), glycosylated hemoglobin (HbA1C)], blood lipid component [total cholesterol (TC),] High density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), triglyceride (TG), liver and kidney function, insulin resistance index (HOMA-IR), body mass index (BMI),) were calculated or measured. Smoking index (number / day 脳 smoking years) systolic blood pressure (SBP),) diastolic blood pressure (DBP) and other related parameters were compared among the groups. Results: 1 there was no significant difference in age, sex composition, BMI, creatinine, SBP and DBP among the three groups (P0.05). 2., ln (HOMA-IR, FPG,HbA1C,TC, in the control group, non-smoking IGR group and smoking IGR group) TG and Hcy levels gradually increased, the difference was statistically significant (P0.05). The level of LDL-C in IGR group was significantly higher than that in control group (P 0.05). However, the HDL-C level of smoking IGR group was lower than that of the other two groups (P0.05). The risk of hyperHcy in patients with IGR caused by smoking was adjusted for age, sex, ln (HOMA-IR, BMI,TG,TC and so on. Smoking was still closely related to the incidence of hyperHcy in patients with IGR [OR (95%CI) = 2.103 (1.017 鹵4.348), P 0.05]. The higher the smoking index was, the higher the plasma Hcy concentration was (F = 7.391g / P0.01). (4) in 236 patients with IGR, there was a positive correlation between ln (HOMA-IR) and plasma Hcy concentration (r = 0.296, P 0.01). Ln (HOMA-IR) was also positively correlated with HbA1C (r = 0.163, P 0.05). Conclusion: 1. It was not only the metabolic disorder of Hcy in diabetic patients, but also the abnormal increase of plasma Hcy in IGR patients. Smoking is one of the independent risk factors for hyperHcy in IGR patients, and there may be a dose-effect relationship between smoking and Hcy concentration in IGR patients. In IGR population, insulin resistance was significantly positively correlated with plasma Hcy,HbA1C levels. 4. 4. Smoking can aggravate the degree of insulin resistance in patients with IGR. One of the important mechanisms of hyperHcy in patients with IGR may be the increase of insulin resistance caused by smoking.
【學(xué)位授予單位】：南昌大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R589
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