论文标题:血浆PAI-1与胰岛素抵抗及脂质紊乱的相关性研究
Study of Correlation between Plasma Plasminogen Activator Inhibitor-1 Level and Insulin Resistance with Dyslipidemia
论文作者 万惠
论文导师 郭常辉,论文学位 硕士,论文专业 内科学
论文单位 重庆医科大学,点击次数 146,论文页数 47页File Size525k
2005-05-01论文网 http://www.lw23.com/lunwen_20295517/ 纤溶酶原激活物抑制物1,2 型糖尿病;胰岛素抵抗;肥胖
plasminogen activator inhibitor-1; type 2 diabetes mellitus;insulin resistance;obesity
目的 观察单纯肥胖、2 型糖尿病非肥胖及 2 型糖尿病肥胖者血浆纤溶酶原激活抑制物 1(PAI-1)水平,探讨 PAI-1 与胰岛素抵抗、血糖、空腹胰岛素、血脂等的相关性。 方法 用酶联免疫吸附法(ELISA)测定单纯肥胖、2 型糖尿病非肥胖和 2 型糖尿病肥胖者及正常对照组的血浆 PAI-1 水平,并测定其体重指数(BMI)、腰臀比(WHR)、血糖、空腹胰岛素及血脂,以稳态模型(Homa Model)公式评估 IR(胰岛素抵抗),并计算 ISI(胰岛素敏感指数)。 结果 (1)2 型糖尿病(DM)非肥胖组、2 型糖尿病肥胖组和单纯肥胖组的血浆 PAI-1 与正常组相比,均显著升高,差异有显著性(P<0.05～P<0.001),其中 2 型 DM 肥胖组、非肥胖组均显著高于单纯肥胖组(均 P﹤0.05),DM 非肥胖组与 DM 肥胖组的 PAI-1 差异无显著性。(2)HOMA-IR 在三组中显著高于正常对照组,差异有显著性(P<0.05～P<0.001),其中 DM 肥胖组高于 DM 非肥胖组及单纯肥胖组,差异有显著性(均 P﹤0.05)。(3)多元逐步回归分析提示血浆 PAI-1与 HOMA-IR、空腹胰岛素、BMI、血甘油三酯、低密度脂蛋白胆固醇具
Objective To detect the plsma plasminogen activator inhibitor 1(PAI-1) levels in obesity and type 2 diabetes mellitus(DM) without obesity and type 2 diabetes mellitus with obesity,and explore the correlation between PAI-1 and insulin resistance,blood glucose,insulin,lipids etc. Methods To assay plasma PAI-1 of obesity and type 2 diabetes mellitus without obesity and type 2 diabetes mellitus with obesity and normal control with enzyme-linked immunosurbent assay(ELISA),and messure body mass index(BMI), waist hip ratio(WHR),blood glucose,fasting insulin and lipids.To evaluate insulin resistance with Homa Momel and measure insulin sensitivity index(ISI). Results (1)The plasma level of PAI-1 was significantly increased in obesity,type 2 DM without obesity and type 2 DM with obesity compared with normal control(P<0.05～P<0.001). There was no difference between type 2 DM without obesity and type 2 DM with obesity,and the plasma PAI-1 in type 2 DM with obesity and type 2 DM without obesity was significantly higher than obesity (allP<0.05).(2)HOMA-IR in 3 groups was significantly higher than nomal control ( P<0.05 ～ P<0.001 ) , HOMA-IR in type 2 DM with obesity was significantly higher than obesity and type 2 DM without obesity.(3)In a general multivariate regression ,HOMA-IR,fasting insulin,BMI,serum triglyceride and low density lipoprotein cholesterol were significantly independent determinants for plasma PAI-1(all P<0.001). Conclusion (1)Plasma PAI-1 is significantly increased in obesity,type 2 DM without obesity and type 2 DM with obesity.(2)Plasma PAI-1 is positively correlated to HOMA-IR,and is correlated with BMI,serum triglyceride,fasting insulin and low density lipoprotein cholesterol.The increasing of PAI-1 is the result of metabolism disorder with hyperinsulinism,high triglyceride and hyperglycemia.PAI-1 is the bridge between obesity and insulin resistance.PAI-1 is one of evalution marker of insulin resistance.(3)Anti-PAI-1 study maybe a new way to prevent obesity and insulin resistance.
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