【作者】 陈萍；

【导师】 刘东方；

【作者基本信息】 重庆医科大学 ， 临床医学（专业学位）， 2017， 硕士

【摘要】 目的:检测不同糖耐量人群血浆血管内皮生长因子B(VEGF-B)水平变化,探讨其与糖脂代谢、肥胖及胰岛素抵抗(IR)的关系。方法:纳入新诊断2型糖尿病患者(T2DM组)、糖耐量异常者(IGT组)、糖耐量正常者(NGT)组共261例。行葡萄糖耐量试验,并同时检测血糖、胰岛素、糖化血红蛋白(Hb A1C)、血脂等指标,计算HOMA-β、HOMA-IR评估胰岛功能及胰岛素抵抗;再以BMI=25kg/m2为切点将其分为非肥胖组(包括正常体重者和超重者)和肥胖组。ELISA测定不同糖耐量者血浆VEGF-B水平,分析血浆VEGF-B水平与相关代谢指标及胰岛素抵抗的关系。结果:T2DM组、IGT组血浆VEGF-B水平高于NGT组[(194.87±61.80)vs(148.46±45.68)vs(111.64±32.49)pg/ml,P<0.01]。总人群中肥胖组血浆VEGF-B水平高于非肥胖组[(169.39±60.58)vs(118.91±48.88)pg/ml,P<0.01]。相关性分析显示,血浆VEGF-B水平与BMI、WHR、TG、FFA、FPG、FIns、HOMA-IR呈正相关(P<0.01),进一步矫正BMI、WHR后,血浆VEGF-B水平与HOMA-IR仍呈正相关。多元线性逐步回归分析表明,T2DM组HOMA-IR、BMI是血浆VEGF-B水平的独立影响因素(R2=0.405、0.432,P<0.05)。结论:血浆VEGF-B水平在新诊断T2DM、IGT及肥胖人群中升高,且其与糖脂代谢、IR有关,可能参与2型糖尿病的发生与发展。更多还原

【Abstract】 Objective: To investigate the changes of plasma vascular endothelial growth factor-B(VEGF-B)levels in different glucose tolerance subjects,and to explore the correlation between VEGF-B and glucolipid metabolism,obesity,insulin resistance.Methods : The VEGF-B levels in 261 subjects including normal glucose tolerance(NGT),impaired glucose tolerance(IGT),and newly diagnosed cases with type 2 diabetes mellitus(T2DM),were determined by ELISA.Take the glucose tolerance test,and the Blood glucose,insulin,glycosylated hemoglobin(Hb A1C),blood lipid and other indicators were detected,calculated HOMA-β,HOMA-IR assessment of islet function and insulin resistance.All groups were further divided into no-obese and obese subgroups and the correlation between plasma VEGF-B and metabolic index,IR were also analyzed.Results: The plasma VEGF-B levels in T2 DM and IGT groups were higher than that in NGT group [(194.87 ± 61.80)vs(148.46 ± 45.68)vs(111.64± 32.49)pg / ml,P< 0.01].The plasma VEGF-B levels in obese subjects were higher than that in no-obese individuals [(169.39±60.58)vs(118.91 ± 48.88)pg/ml P<0.01].Circulating VEGF-B levels were correlated positively with body mass index,waist hip ratio,triglyceride,free fatty acid,fasting blood glucose,fasting insulin,2h-insulin,and homeostasis model assessment for insulin resistance(HOMA-IR)(P<0.01).After further adjust BMI and WHR,plasma VEGF-B levels were positively correlated with HOMA-IR.Multiple stepwise regression analysis showed that HOMA-IR,BMI were independent risk factors of plasma VEGF-B in T2 DM group(R2 =0.405,0.432,P<0.05).Conclusion: plasma VEGF-B levels were increased significantly in newly diagnosed T2 DM,IGT and obese subjects.and were associated with glycolipid metabolism and IR,which may be involved in the development and progression of type 2 diabetes mellitus.更多还原