【作者】 瞿华；

【导师】 邓华聪；

【作者基本信息】 重庆医科大学 ， 内科学， 2013， 硕士

【摘要】 目的：检测2型糖尿病患者及肥胖患者血浆颗粒蛋白前体（PGRN）水平，探讨血浆PGRN水平与慢性炎症、胰岛素抵抗的关系。方法：80例2型糖尿病（T2DM）患者和88例正常糖耐量（NGT）个体以BMI≥25kg/m2为切点分别分为正常体重（NW）亚组和肥胖(OB)亚组，检测空腹血糖（FPG），口服葡萄糖耐量试验2h血糖（2hPG），糖化血红蛋白（HbA1c），血脂四项，空腹胰岛素（FINS）水平，计算腰臀比（WHR）和体重指数（BMI），并以稳态模型评估胰岛素抵抗指数（HOMA-IR）及胰岛β细胞功能(HOMA-β)。采用ELISA法检测血浆PGRN及白介素6（IL-6）水平。结果：血浆PGRN水平在T2DM组高于NGT组（P<0.01），在T2DM组和NGT组内， OB亚组PGRN水平高于对应NW亚组(225.22±34.39ng/mL vs195.59±50.47ng/mL和183.79±61.63ng/mL vs148.69±55.27ng/mL, P<0.05)，相关性分析提示血浆PGRN水平与体重、腰围、BMI、收缩压（SBP）、FPG、2hPG、HbA1c、甘油三酯（TG）、IL-6、FINS、HOMA-IR呈正相关（P<0.05或P<0.01)，与HOMA-β呈负相关（P<0.05)。多元线性回归分析提示BMI、HbA1c、IL-6及TG是血浆PGRN水平的独立影响因素（P<0.05)。结论：2型糖尿病及肥胖患者血浆PGRN水平均高于正常对照人群，其升高程度与糖脂代谢紊乱、慢性炎症及胰岛素抵抗的程度密切相关。更多还原

【Abstract】 Objective：To detect plasma PGRN levels in healthy, obesity and newly diagnosedtype2diabetes mellitus(T2DM) subjects and to investigate the relationshipbetween plasma PGRN levels and glycolipid metabolism, inflammation andinsulin resistance.Methods：Eighty patients with newly diagnosed type2diabetes (T2DM) and88subjects with normal glucose tolerance (NGT) were recruited in the study.Both of them were divided into two subgroups respectively: normal weight(NW) subgroup and obesity (OB) subgroup. Obesity was defined as bodymass index(BMI)≥25kg/m2according to the World HealthOrganization-Western Pacific Region diagnostic criteria(2000). Body fatparameters were measured and BMI, waist-to-hip were evaluated.Meanwhile the levels of fasting plasma PGRN and IL-6were measured byELISA, fasting plasma glucose (FPG),2h plasma glucose (2hours after 75g OGTT test,2hPG), HbA1c, fasting insulin (FINS), and lipids were alsodetected. Insulin resistance (IR) and pancreas beta-cell function wereassessed by homeostasis model assessment (HOMA).Results:Plasma PGRN levels were significantly higher in T2DM group thanthose in NGT group（P<0.01）. Within groups of T2DM and NGT, plasmaPGRN levels in OB subgroup were significantly higher than those in NWsubgroup (225.22±34.39ng/mL vs195.59±50.47ng/mL and183.79±61.63ng/mL vs148.69±55.27ng/mL, P<0.05). Bivariate correlationanalysis showed that the plasma PGRN levels were positively correlatedwith weight, waist circumference, BMI, SBP, FPG,2hPG, HbA1c, TG, IL-6,FINS and HOMA-IR （P<0.05or P<0.01)，and were negatively correlatedwith HOMA-β (P<0.05). Multiple linear regression analysis showed thatBMI, HbA1c, IL-6and TG were independently related to plasma PGRNlevels(P<0.05).Conclusions：Plasma PGRN levels were higher in type2diabetes patients and obesitypatients respectively, and were closely related with glycolipid metabolism,chronic inflammation and insulin resistance.更多还原