發(fā)布時間：2018-04-18 01:22

  本文選題：Ⅱ型糖尿病(T2DM) + 定量CT（QCT）　； 參考：《山西醫(yī)科大學(xué)》2013年碩士論文

【摘要】：目的 運用定量CT（QCT）測量II型糖尿病（T2DM）患者及正常人腹部脂肪面積，能夠了解II型糖尿病患者腹部體脂分布的特征，為II型糖尿病患者早期預(yù)防提供間接依據(jù)和有益信息。同時進(jìn)行骨密度的測量，對T2DM患者腹部脂肪分布變化與椎體骨密度變化相關(guān)性進(jìn)行初探。 方法 收集近一年來在醫(yī)院內(nèi)分泌科經(jīng)臨床病史、實驗室檢查及相關(guān)參數(shù)確診的病程早期糖尿病患者67例和無糖尿病健康體檢人員及志愿者65例。搜集各組研究對象一般資料（年齡、性別、身高、體重，就診時血脂、血糖生化指標(biāo)）。利用螺旋CT對II型糖尿病患者及志愿者進(jìn)行腹部螺旋掃描，并利用定量CT專用工作軟件系統(tǒng)，得到腹部內(nèi)臟脂肪(visceral adipose，VA)面積、腹部皮下脂肪(abdominal subcutaneous adipose，SA)面積、并計算腹部內(nèi)臟脂肪與腹部皮下脂肪的比值（內(nèi)壁脂肪比,VSR），并同時測量腰2-4各椎體中間層面骨密度值。按實驗分組進(jìn)行統(tǒng)計學(xué)分析，評估II型糖尿病人體脂分布特點；對II型糖尿病人體脂分布特點與血脂、血糖生化指標(biāo)進(jìn)行相關(guān)性研究；分析2型糖尿病人腹部脂肪變化與骨密度之間是否具有相關(guān)性。 結(jié)果 1、均衡性檢驗糖尿病組、與正常對照組組間兩兩比較平均年齡、性別、身高、體重比例構(gòu)成匹配，均無顯著性差異(p0.05)。 2、使用定量CT技術(shù)檢測，II型糖尿病患者腹部內(nèi)臟脂肪面積（VA）、腹部內(nèi)臟脂肪面積與腹部皮下脂肪面積比值(VSR)，具有明顯統(tǒng)計學(xué)差異(P＜0.005)。 3、II型糖尿病患者內(nèi)臟脂肪面積與TC、TG、HDL-C、LDL-C、FBG相關(guān)性（r=0.279，r=0.370，r=-0.041，r=0.247，r=0.246）大于腹部皮下脂肪面積（r=0.264，r=0.313，r=-0.027，r=0.140，r=0.161）。 4、當(dāng)II型糖尿病患者VA、SA明顯增加(VA120cm2，SA160cm2）與骨密度變化之間存在正相關(guān)性(r=0.413，r=0.469)。 結(jié)論 1、定量CT測量能夠反映早期II型糖尿病患者腹部脂肪分布變化情況，II型糖尿病患者向心性肥胖為特征的腹部脂肪分布以腹部內(nèi)臟脂肪堆積明顯；當(dāng)內(nèi)壁脂肪比0.685時，所患糖尿病的機率約95%，，所以當(dāng)肥胖者以腹部內(nèi)臟脂肪增多為主時且內(nèi)壁脂肪比0.685時，可以明確提示實驗對象患II型糖尿病的幾率大大增加。對于臨床有十分重要的意義，為II型糖尿病患者早期預(yù)防提供有利依據(jù)。 2、定量CT測量II型糖尿病患者內(nèi)臟脂肪含量與皮下脂肪含量與代謝指標(biāo)的相關(guān)性是不同的。腹部內(nèi)臟脂肪組織與TC、TG、LDL-C、FBG有明顯的正相關(guān)性，與HDL-C呈負(fù)相關(guān)性，表明腹部內(nèi)臟脂肪組織越多，對代謝的危害也就越明顯。腹部皮下脂肪組織與TC、TG、LDL-C、FBG也有著正相關(guān)關(guān)系，但是相關(guān)性弱于腹部內(nèi)臟脂肪組織。腹內(nèi)脂肪分布的變化特點，能較好的反應(yīng)血脂、血糖生化指標(biāo)的變化。3、T2DM患者病程早期腹部脂肪含量增加明顯時伴有骨密度值增高，可為T2DM患者病程發(fā)展提供參考價值。
[Abstract]:PurposeIn order to understand the characteristics of abdominal fat distribution in patients with type II diabetes mellitus (T2DM) and normal subjects, the quantitative CT-QCTs can provide indirect basis and useful information for early prevention of type II diabetes mellitus.Bone mineral density (BMD) was measured and the correlation between abdominal fat distribution and vertebral bone mineral density (BMD) in T2DM patients was studied.MethodSixty-seven patients with early diabetes diagnosed by clinical history laboratory examination and related parameters and 65 healthy volunteers without diabetes were collected in the Department of Endocrinology in recent one year.To collect general data (age, sex, height, weight, blood lipid, blood sugar biochemical index).The area of abdominal visceral adiposeal adiposesia (VAA) and abdominal subcutaneous subcutaneous adiposeza were obtained by spiral CT scanning in patients with type II diabetes mellitus and volunteers, and the specific quantitative CT software system was used to determine the area of abdominal visceral adiposesia.The ratio of abdominal visceral fat to abdominal subcutaneous fat was calculated.To evaluate the characteristics of body fat distribution in type II diabetes mellitus patients, and to study the correlation between body fat distribution characteristics and blood lipid and blood glucose biochemical indexes in patients with type II diabetes mellitus.To analyze the correlation between abdominal fat changes and bone mineral density (BMD) in type 2 diabetic patients.Result1. There was no significant difference in average age, sex, height and weight ratio between diabetic group and normal control group (P 0.05).2. The abdominal visceral fat area and the ratio of abdominal visceral fat area to abdominal subcutaneous fat area were measured by quantitative CT in patients with type II diabetes mellitus (P < 0.005).3. The correlation between visceral fat area and TCG-TGG HDL-CnLDL-Cfi-FBG was 0.270 ~ 0.270 ~ 0.241 ~ 0.247 ~ 0.246) > 0.264 ~ 0.264 ~ 0.313r-0.027 ~ (0.140) ~ (0.161) ~ (1) ~ (0.161) ~ 0.161 ~ (1)).4. There was a positive correlation between VASA and bone mineral density in patients with type II diabetes mellitus (P < 0.01).Conclusion1. Quantitative CT measurement can reflect the changes of abdominal fat distribution in patients with early type 2 diabetes mellitus. The abdominal fat distribution characterized by cardiac obesity in patients with type II diabetes is obviously accumulated in abdominal visceral fat, and when the ratio of inner wall fat to fat is 0.685,The incidence of diabetes was about 95%, so it was clear that the risk of type 2 diabetes was significantly increased when the abdominal visceral fat was mainly increased and the ratio of inner wall fat to internal fat was 0.685 in the obese subjects.It is of great significance for clinical practice and provides beneficial basis for early prevention of type 2 diabetes mellitus.2. The correlation between the content of visceral fat and subcutaneous fat and metabolic index was different in patients with type 2 diabetes mellitus by quantitative CT.There was a positive correlation between visceral adipose tissue and HDL-C, but a negative correlation with HDL-C, indicating that the more abdominal visceral adipose tissue, the more harmful to metabolism.There was also a positive correlation between abdominal subcutaneous adipose tissue and TCG-TGG LDL-C- FBG, but the correlation was weaker than that of abdominal visceral adipose tissue.The change of abdominal fat distribution can reflect the blood lipids better. The change of blood glucose biochemical index. The increase of abdominal fat content in the early stage of the disease course is accompanied with the increase of bone mineral density. It can provide reference value for the development of the course of T2DM patients.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R816.8

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相關(guān)期刊論文 前10條

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