本文選題：2型糖尿病 + 胎球蛋白A�。� 參考：《南京中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:探討在2型糖尿病中血清胎球蛋白A(fetuinA)和胎球蛋白B(fetuinB)與糖脂代謝等指標(biāo)的相關(guān)性,為臨床2型糖尿病的防治提供新的思路;同時(shí)探討在2型糖尿病中fetuin A和fetuin B與中醫(yī)痰濕證的相關(guān)性,為糖尿病中醫(yī)證型的客觀化提供新的參考依據(jù)。方法:本研究收集32例正常人和93例2型糖尿病患者的血清,同時(shí)根據(jù)中醫(yī)辨證分型將93例糖尿病患者分為51例痰濕證組和42例非痰濕證組。分別在不同組中測(cè)定血清fetuinA和fetuinB的水平,并分析其與性別、年齡、血壓(SBP、DBP)、體重指數(shù)(BMI)、C反應(yīng)蛋白(CRP)以及糖脂代謝指標(biāo),包括空腹血糖(FPG)、糖化血紅蛋白(HbA1c)、空腹胰島素(FINS)、空腹C肽(FCP)、胰島素抵抗指數(shù)(HOMA-IR)、甘油三酯(TG)、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)、尿酸(UA)的相關(guān)性。結(jié)果:1、糖尿病組的年齡、SBP、DBP、BMI、FPG、TG均高于正常人組(均p0.01),HDL-C低于正常人組(p0.01),兩組間性別、UA、TC、LDL-C、fetuinA、fetuinB無(wú)顯著性差異;2、在正常人組中行單因素相關(guān)分析,顯示fetuinA與HDL-C、UA呈負(fù)相關(guān)(均p0.05),與fetuin B呈正相關(guān)(p0.01),逐步回歸結(jié)果顯示fetuin B與fetuin A呈獨(dú)立相關(guān)(p0.01);3、在糖尿病患者中行單因素相關(guān)分析,顯示fetuinA與BMI、FPG、UA呈正相關(guān)(均p0.05),與TC、LDL-C呈負(fù)相關(guān)(均p0.05),單因素相關(guān)分析顯示fetuinB與TG、HbA1c呈正相關(guān)(均p0.05),逐步回歸顯示CRP、BMI、TG、LDL-C與fetuin A呈獨(dú)立相關(guān)(均p0.05),FCP與fetuinB呈獨(dú)立相關(guān)(p0.05);4、糖尿病痰濕證組的BMI、FPG、UA、TG、FCP及fetuinA顯著高于糖尿病非痰濕證組(均p0.05),其余指標(biāo)無(wú)顯著性差異;5、在痰濕證組中行單因素相關(guān)分析,顯示fetuinA與BMI呈正相關(guān)(p0.01),與LDL-C呈負(fù)相關(guān)(p0.01),單因素相關(guān)分析顯示fetuinB與SBP呈負(fù)相關(guān)(p0.05),逐步回歸顯示BMI與fetuin A呈獨(dú)立相關(guān)(p0.01),UA與fetuinB呈獨(dú)立相關(guān)(p0.05)。結(jié)論:1、在2型糖尿病中,患者血清fetuin A和fetuinB的水平與BMI、糖脂代謝等指標(biāo)具有一定的相關(guān)性,可見fetuin A和fetuinB分別參與體內(nèi)糖脂代謝,二者有望成為監(jiān)測(cè)和干預(yù)糖尿病患者治療的新指標(biāo);2、2型糖尿病中痰濕證組的fetuinA水平顯著高于非痰濕證組,提示fetuinA在中醫(yī)痰濕證中具有重要作用,是糖尿病痰濕證區(qū)別于非痰濕證的客觀指標(biāo)之一;3、FetuinB在痰濕與非痰濕證組間無(wú)顯著性差異,且在痰濕證中和糖脂代謝指標(biāo)之間無(wú)顯著聯(lián)系,fetuinB在痰濕證中的作用有待后續(xù)進(jìn)一步研究。
[Abstract]:Objective: to explore the correlation between serum fetal protein A (FEA) and fetal globulin (FG) and glucose and lipid metabolism in type 2 diabetes mellitus (T2DM), and to provide a new idea for the prevention and treatment of type 2 diabetes mellitus (T2DM).At the same time, the relationship between fetuin A and fetuin B and phlegm dampness syndrome in type 2 diabetes mellitus was discussed, which provided a new reference for the objectivity of TCM syndrome type of diabetes mellitus.Methods: the serum samples of 32 normal subjects and 93 patients with type 2 diabetes were collected and divided into 51 phlegm dampness syndrome group and 42 non-phlegm dampness syndrome group according to TCM syndrome differentiation.The serum levels of fetuinA and fetuinB were measured in different groups, and their correlation with sex, age, blood pressure, body mass index (BMI) and carbohydrate metabolism were analyzed.These include FBG FPGN, HbA1cU, FINSN, FCPP, HOMA-IRN, TGN, TCU, HDL-CU, LDL-CU, UAA.Results at 1: 1, the levels of TG in the age group of diabetes mellitus group were higher than those in the normal control group (P 0.01) and HDL-C was lower than that in the normal group (P 0.01). There was no significant difference between the two groups in terms of gender, and there was no significant difference between the two groups. The single factor correlation analysis was carried out in the normal control group, and there was no significant difference between the two groups.The results showed that there was a negative correlation between fetuinA and HDL-Con UA (all p0.05, positive correlation with fetuin B, p0.01a), and stepwise regression analysis showed that fetuin B and fetuin A were independent correlation (P 0.01), and univariate correlation analysis was performed in diabetic patients.The results showed that there was a positive correlation between fetuinA and fetuin A (all p0.05) and a negative correlation with TCU LDL-C (all p0.05%). Univariate correlation analysis showed that fetuinB was positively correlated with TGV HbA1c (all p0.05%). Stepwise regression analysis showed that there was an independent correlation between fetuinB and fetuin A (all p0.05% FCP and fetuinB were significantly correlated with fetuinB (p0.05%), and diabetes mellitus (DM) had a positive correlation (p0.05%).The FCP and fetuinA of TGG and fetuinA in the dampness syndrome group were significantly higher than those in the non-phlegm dampness syndrome group (all p0.05), and there was no significant difference in the other indexes. The single factor correlation analysis was performed in the phlegm dampness syndrome group.The results showed that fetuinA was positively correlated with BMI and negatively correlated with LDL-C (p0.01a). Univariate correlation analysis showed that fetuinB was negatively correlated with SBP (p0.05). Stepwise regression analysis showed that BMI and fetuin A had independent correlation (P 0.01U) and fetuinB (P 0.05).Conclusion: in type 2 diabetes mellitus, the levels of serum fetuin A and fetuinB are correlated with BMI, glucose and lipid metabolism. It can be seen that fetuin A and fetuinB are involved in the metabolism of glucose and lipid, respectively.It is expected that the fetuinA level of phlegm dampness syndrome group is significantly higher than that of non-phlegm dampness syndrome group, suggesting that fetuinA plays an important role in TCM phlegm dampness syndrome.There was no significant difference between phlegm dampness syndrome and non-phlegm dampness syndrome group, and there was no significant difference between phlegm dampness syndrome and non-phlegm dampness syndrome group.And there is no significant relationship between phlegm dampness syndrome and glucose and lipid metabolism indexes. The role of fetuinB in phlegm dampness syndrome needs further study.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R259

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