艾塞那肽對(duì)肥胖2型糖尿病患者血清FGF-21水平的影響及相關(guān)性研究
發(fā)布時(shí)間：2019-03-15 19:41
【摘要】：背景成纖維細(xì)胞生長(zhǎng)因子21(FGF-21)是一類可正向調(diào)節(jié)糖脂代謝的新型因子,在糖尿病及肥胖等代謝性疾病中,具有增加胰島素敏感性、改善糖耐量水平及脂代謝紊亂、調(diào)節(jié)能量代謝、減輕體重等積極作用。艾塞那肽屬于胰高血糖素樣肽-1受體激動(dòng)劑,在控制血糖、輔助減重等方面具有突出優(yōu)勢(shì)。FGF-21是否參與到艾塞那肽對(duì)肥胖2型糖尿病的治療過(guò)程中,目前仍缺乏相關(guān)文獻(xiàn)報(bào)道。目的1.觀察肥胖2型糖尿病(T2DM)患者血清成纖維細(xì)胞生長(zhǎng)因子21(FGF-21)水平,分析其與相關(guān)代謝指標(biāo)之間的關(guān)系。2.觀察艾塞那肽(Exenatide)治療對(duì)肥胖T2DM患者血清FGF-21水平的影響,分析艾塞那肽治療前后血清FGF-21變化與代謝指標(biāo)變化的相關(guān)性,旨在探究FGF-21在艾塞那肽降糖減重作用中發(fā)揮的作用。方法1.收集2015年3月至2016年4月我科門診及住院治療的單用口服降糖藥物控制不佳的肥胖2型糖尿病患者45例(男30例,女15例)作為病例組(Exe組)。Exe組加用艾塞那肽治療16周(前4周5ug BID,后12周10ug BID治療)。并于社區(qū)募集同年齡段健康人群45例(男30例,女15例)作為對(duì)照組(NC組)。2.觀察兩組治療前及Exe組治療后體重、體重指數(shù)(BMI)、腰圍、臀圍、腰臀比(WHR)、收縮壓(SBP)、舒張壓(DBP)、空腹血糖(FPG)、糖化血紅蛋白(Hb A1c)、空腹胰島素(FINS)、穩(wěn)態(tài)模型胰島素抵抗指數(shù)(HOMA-IR)、胰島β細(xì)胞功能指數(shù)(HOMA-β)、甘油三酯(TG)、總膽固醇(TC)、低密度脂蛋白膽固醇(LDL-C)、高密度脂蛋白膽固醇(HDL-C)等指標(biāo),采用酶聯(lián)免疫吸附法(ELISA)測(cè)定血清FGF-21水平,分析肥胖T2DM及艾塞那肽治療對(duì)血清FGF-21的影響,并對(duì)FGF-21與上述代謝指標(biāo)進(jìn)行相關(guān)性分析。結(jié)果1.Exe組共43例完成研究。肥胖T2DM患者血清FGF-21水平明顯高于NC組(t=2.461,P0.05),FGF-21水平與體重、BMI、FPG、HOMA-IR、TG(r=0.428、0.514、0.551、0.660、0.634,P0.01),腰圍、Hb A1c、FINS(r=0.377、0.341、0.375,P0.05)呈明顯正相關(guān)。HOMA-IR與TG(β=0.552、0.520,P0.01)是影響肥胖T2DM患者血清FGF-21水平的獨(dú)立危險(xiǎn)因素。2.Exe組加用艾塞那肽治療16周后,體重、BMI、腰圍、FPG、Hb A1c、WHR、HOMA-IR(t=5.520、5.832、4.717、5.251、9.323、Z=3.386、2.566,P0.01),DBP、TG及血清FGF-21水平(t=2.391、2.362、2.400,P0.05)均較治療前顯著降低,HOMA-β(t=-2.835,P0.01)、HDL-C(t=-2.251,P0.05)較治療前顯著升高。Exe組治療前后血清FGF-21水平的降低程度與HOMA-IR(r=0.461,P0.01),體重、BMI、FPG、Hb A1c、TG(r=0.353、0.376、0.325、0.331、0.323,P0.05)的降低程度呈明顯正相關(guān)。多元逐步線性回歸分析提示Exe組艾塞那肽治療后血清FGF-21水平下降與HOMA-IR降低關(guān)系密切(β=0.461,P0.01)。結(jié)論1.肥胖T2DM患者血清FGF-21較正常對(duì)照組明顯升高,肥胖T2DM患者血清FGF-21水平變化可能與糖脂代謝異常和胰島素抵抗有關(guān)。2.艾塞那肽可顯著降低肥胖T2DM患者血清FGF-21水平,且與改善胰島素抵抗密切相關(guān)。FGF-21可能為艾塞那肽改善胰島素抵抗及降糖減重的作用機(jī)制之一。
[Abstract]:Background Fibroblast growth factor 21 (FGF-21) is a new type of factor that can regulate glucose and lipid metabolism positively. In metabolic diseases such as diabetes mellitus and obesity, it can increase insulin sensitivity, improve glucose tolerance and lipid metabolism disorder. Regulate energy metabolism, weight loss and other positive effects. Esenapeptide, an agonist of glucagon-like peptide-1 receptor, has prominent advantages in controlling blood sugar and assisting weight loss. Whether FGF-21 is involved in the treatment of obese type 2 diabetes mellitus by esenapeptide, At present, there is still a lack of relevant literature reports. Purpose 1. To observe the level of serum fibroblast growth factor 21 (FGF-21) in obese patients with type 2 diabetes mellitus (T2DM) and analyze the relationship between serum fibroblast growth factor 21 (fibroblast growth factor 21) and related metabolic indexes. 2. To observe the effect of esenapeptide (Exenatide) treatment on serum FGF-21 level in obese T2DM patients, and to analyze the correlation between the changes of serum FGF-21 and metabolic indexes before and after treatment with esenapeptide. The aim of this study was to explore the role of FGF-21 in reducing glucose and weight loss of esenapeptide. Method 1. From March 2015 to April 2016, 45 obese type 2 diabetic patients (male 30, male 30) who were not well controlled by oral hypoglycemic drugs were collected. The patients were treated with esenapeptide for 16 weeks (the first 4 weeks after 5ug BID, 12 weeks after 10ug BID treatment) as the case group (Exe group). Exe group plus esenapeptide therapy). 45 healthy people of the same age group (30 males and 15 females) were recruited in the community as the control group (NC group). The body weight, body mass index (BMI),) waist circumference, hip circumference, waist-hip ratio of (WHR), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FPG), glycosylated hemoglobin (Hb A1c) were observed before and after treatment in Exe group. Fasting insulin (FINS), homeostasis model insulin resistance index (HOMA-IR), islet 尾 cell function index (HOMA- 尾), triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C). High density lipoprotein cholesterol (HDL-C), serum FGF-21 level was measured by enzyme linked immunosorbent assay (ELISA), and the effects of obese T2DM and esenapeptide on serum FGF-21 were analyzed. The correlation between FGF-21 and the above metabolic indexes was also analyzed. Results 43 patients in 1.Exe group completed the study. The level of serum FGF-21 in obese T2DM patients was significantly higher than that in NC group (t = 2.461, P0.05), FGF-21 level and body weight, BMI,FPG,HOMA-IR,TG (r = 0.428, 0.514, 0.551, 0.660, 0.634, P0.01), waist circumference, Hb A1c, FINS (r = 0.377,0.341, 0.375, P0.05) was positively correlated with Homa-IR and TG (尾 = 0.552, 0.520, P0.01) were independent risk factors affecting serum FGF-21 level in obese T2DM patients. 2. Exe group was treated with esenapeptide for 16 weeks. Body weight, BMI, waist circumference, FPG,Hb A1C, WHR, Homa IR (t = 5.520, 5.832, 4.717, 5.251, 9.323, Z = 3.386,2.566, P0.01), DBP,TG and serum FGF-21 levels (t = 2.391, 2.362, 2.400, P0.05) were significantly lower than those before treatment. HOMA- 尾 (t = 2.835, P0.01) and HDL-C (t = 2.251, P0.05) were significantly higher than those before treatment. The level of serum FGF-21 and HOMA-IR (r = 0.461, P0.01), body weight, BMI,FPG, in Exe group decreased significantly before and after treatment. Hb A1C, TG (r = 0.353, 0.376, 0.325, 0.331, 0.323, P 0.05) were significantly positively correlated with the decrease of TG (r = 0.353, 0.376, 0.325, 0.331, 0.323, P 0.05). Multiple stepwise linear regression analysis showed that the decrease of serum FGF-21 level was closely related to the decrease of HOMA-IR (尾 = 0.461, P0.01) in Exe group after treatment with esenapeptide. Conclusion 1. The serum FGF-21 level in obese T2DM patients is significantly higher than that in normal controls. The changes of serum FGF-21 levels in obese T2DM patients may be related to abnormal glucose and lipid metabolism and insulin resistance. 2. T2DM-21 may be one of the mechanisms of esenapeptide in improving insulin resistance and reducing weight loss in obese patients with obesity-induced insulin resistance, which may be related to the decrease of serum FGF-21 level in obese patients with insulin resistance.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R587.1
本文編號(hào)：2440924
[Abstract]:Background Fibroblast growth factor 21 (FGF-21) is a new type of factor that can regulate glucose and lipid metabolism positively. In metabolic diseases such as diabetes mellitus and obesity, it can increase insulin sensitivity, improve glucose tolerance and lipid metabolism disorder. Regulate energy metabolism, weight loss and other positive effects. Esenapeptide, an agonist of glucagon-like peptide-1 receptor, has prominent advantages in controlling blood sugar and assisting weight loss. Whether FGF-21 is involved in the treatment of obese type 2 diabetes mellitus by esenapeptide, At present, there is still a lack of relevant literature reports. Purpose 1. To observe the level of serum fibroblast growth factor 21 (FGF-21) in obese patients with type 2 diabetes mellitus (T2DM) and analyze the relationship between serum fibroblast growth factor 21 (fibroblast growth factor 21) and related metabolic indexes. 2. To observe the effect of esenapeptide (Exenatide) treatment on serum FGF-21 level in obese T2DM patients, and to analyze the correlation between the changes of serum FGF-21 and metabolic indexes before and after treatment with esenapeptide. The aim of this study was to explore the role of FGF-21 in reducing glucose and weight loss of esenapeptide. Method 1. From March 2015 to April 2016, 45 obese type 2 diabetic patients (male 30, male 30) who were not well controlled by oral hypoglycemic drugs were collected. The patients were treated with esenapeptide for 16 weeks (the first 4 weeks after 5ug BID, 12 weeks after 10ug BID treatment) as the case group (Exe group). Exe group plus esenapeptide therapy). 45 healthy people of the same age group (30 males and 15 females) were recruited in the community as the control group (NC group). The body weight, body mass index (BMI),) waist circumference, hip circumference, waist-hip ratio of (WHR), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FPG), glycosylated hemoglobin (Hb A1c) were observed before and after treatment in Exe group. Fasting insulin (FINS), homeostasis model insulin resistance index (HOMA-IR), islet 尾 cell function index (HOMA- 尾), triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C). High density lipoprotein cholesterol (HDL-C), serum FGF-21 level was measured by enzyme linked immunosorbent assay (ELISA), and the effects of obese T2DM and esenapeptide on serum FGF-21 were analyzed. The correlation between FGF-21 and the above metabolic indexes was also analyzed. Results 43 patients in 1.Exe group completed the study. The level of serum FGF-21 in obese T2DM patients was significantly higher than that in NC group (t = 2.461, P0.05), FGF-21 level and body weight, BMI,FPG,HOMA-IR,TG (r = 0.428, 0.514, 0.551, 0.660, 0.634, P0.01), waist circumference, Hb A1c, FINS (r = 0.377,0.341, 0.375, P0.05) was positively correlated with Homa-IR and TG (尾 = 0.552, 0.520, P0.01) were independent risk factors affecting serum FGF-21 level in obese T2DM patients. 2. Exe group was treated with esenapeptide for 16 weeks. Body weight, BMI, waist circumference, FPG,Hb A1C, WHR, Homa IR (t = 5.520, 5.832, 4.717, 5.251, 9.323, Z = 3.386,2.566, P0.01), DBP,TG and serum FGF-21 levels (t = 2.391, 2.362, 2.400, P0.05) were significantly lower than those before treatment. HOMA- 尾 (t = 2.835, P0.01) and HDL-C (t = 2.251, P0.05) were significantly higher than those before treatment. The level of serum FGF-21 and HOMA-IR (r = 0.461, P0.01), body weight, BMI,FPG, in Exe group decreased significantly before and after treatment. Hb A1C, TG (r = 0.353, 0.376, 0.325, 0.331, 0.323, P 0.05) were significantly positively correlated with the decrease of TG (r = 0.353, 0.376, 0.325, 0.331, 0.323, P 0.05). Multiple stepwise linear regression analysis showed that the decrease of serum FGF-21 level was closely related to the decrease of HOMA-IR (尾 = 0.461, P0.01) in Exe group after treatment with esenapeptide. Conclusion 1. The serum FGF-21 level in obese T2DM patients is significantly higher than that in normal controls. The changes of serum FGF-21 levels in obese T2DM patients may be related to abnormal glucose and lipid metabolism and insulin resistance. 2. T2DM-21 may be one of the mechanisms of esenapeptide in improving insulin resistance and reducing weight loss in obese patients with obesity-induced insulin resistance, which may be related to the decrease of serum FGF-21 level in obese patients with insulin resistance.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R587.1
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