超重肥胖2型糖尿病患者腹部脂肪分布与胰腺功能及血清同型半胱氨酸的关系内科学专业论文.docxVIP

山西 山西医科大学硕士学位论文 PAGE PAGE III 均有上升趋势，同时 HDL、HOMA-IS、HOMA-β、△I △ / G30 / G 有下降趋势。超 重/肥胖的 T2DM 中有 44 人为内脏型肥胖，52 人为皮下型肥胖（占 T2DM 的 45.83%），无 T2DM 的超重/肥胖人群中有 38 人为内脏型肥胖（占非 T2DM 的 33.92%），74 人为皮下型肥胖。在同一大组中，VO 亚组的 VS 及 VA 均高于 NVO 亚组，两大组间，患 T2DM 的两亚组的 VA 高于无 T2DM 的两亚组。血清 hcy 与 VA、SA、HOMA-IR、TC、TG、LDL 呈正相关，与 HDL、HOMA-IS、HOMA- 30β、△ 30 △ / G / G 呈负相关。VA 与 TC、TG、LDL、SA、HOMA-IR、hcy 呈正相关， 与 HDL、HOMA-IS、HOMA-β、△I30/△G30 呈负相关。T2DM 大组 hcy 多元逐 步回归分析显示 VA 的上升与 HOMA-IS 损害共同作用影响血清 hcy 升高。 【结论】1.超重/肥胖人群，无论是否患有 2 型糖尿病，腹部脂肪主要堆积 在腹内时会使机体胰岛素抵抗上升，胰岛素的敏感性下降，胰岛功能受损，血 清 hcy 升高。2.腹内脂肪堆积会加剧胰岛素抵抗，从而干扰 hcy 代谢通路，产 生高 hcy 血症。3.超重/肥胖人群在未患 2 型糖尿病时已有胰岛素早相分泌受损 情况，且内脏型肥胖较皮下型肥胖者胰岛素早相分泌受损严重。患 T2DM 的超 重/肥胖者早相分泌受损情况较无 T2DM 者严重，且内脏肥胖者早相分泌受损更 甚。可能与腹内脂肪积聚使肝脏产生大量 FFA 进入外周血循环有关。 【关键词】：超重；肥胖；2 型糖尿病；腹内脂肪面积；同型半胱氨酸 PAGE PAGE IV overweight / obese patients with type 2 diabetes,relationship with Abdominal fat distribution and pancreatic function and homocysteine Gao ying ABSTRACT For nearly 30 years, the prevalence of diabetes in China has increased significantly. In 2007-2008, under the organization of the Chinese Diabetes Society (CDS), the 14 provinces and cities nationwide epidemiological survey of diabetes, adults over the age of 20 in China is estimated diabetes prevalence rate of 9.7%, the Chinese adult diabetes a total of 92.4 million, China has become the prevalence of diabetes in the world, the largest number of countries. Lifestyle changes as well as significant increase in the proportion of overweight and obesity, diabetes epidemic in China has become one of the reasons. Obesity is recognized as diabetes, coronary heart disease, hypertension, independent risk factors. The accumulation of abdominal fat is a variety of metabolic abnormalities initiating factor. [0bject]This paper discusses the overweight / obesity, type 2 diabetes patients with abdominal fat distribution and pancreatic function and homocysteine relations. [Methods]Shanxi Provincial Peoples Hospital from December 2011 to