本文選題：脂聯素　切入點：胰島素抵抗　出處：《重慶醫(yī)科大學》2012年碩士論文　論文類型：學位論文

【摘要】：背景：老年性黃斑變性是全世界范圍內最常見的致盲疾病之一，而且其發(fā)病率不斷升高。特別是濕性老年性黃斑變性，以脈絡膜新生血管為病理特征，是導致嚴重的不可逆性視力損傷的主要原因。當前的治療措施，包括光動力學治療和抗新生血管藥物，都集中于逆轉血管新生的過程。鑒于即便聯合當前的治療措施也只能得到有限療效的現狀和最近研究的結果顯示，人體系統(tǒng)的其他因素可能在該疾病的嚴重程度和預后情況中起到重要作用。脂聯素是一新型的蛋白質激素，由脂肪細胞專一分泌然后進入血流從而調節(jié)一系列新陳代謝過程，，包括血糖水平的調節(jié)和脂肪酸的分解代謝。已有報道證實了脂聯素的抗新生血管作用。因此，本研究從脂聯素入手，進行相關的研究。 目的：觀察濕性老年性黃斑變性患者的血漿脂聯素水平。同時，還觀察了這些患者的外周血單個核細胞脂聯素受體1、受體2的表達水平。 方法：15個患者（平均年齡69.07±6.71歲）和15個健康對照（平均年齡64.2±7.46歲）納入本研究。所有人都不患有糖尿病、高脂血癥、腎臟疾病、冠心病、心衰、腎衰等疾病。血漿脂聯素水平由ELISA測定。外周血單個核細胞的脂聯素受體表達水平由Real-time PCR測定。采用Pearson相關分析處理兩變量相關性分析，包括血漿脂聯素，脂聯素受體1、受體2，內環(huán)境穩(wěn)態(tài)模型評估的胰島素抵抗指數(HOMA-IR)。 結果：病例組的血漿脂聯素水平明顯低于對照組(病例組：1.18±0.65μg/ml, n=15;對照組：2.00±0.63μg/ml, n=15; P=0.002)。還發(fā)現病例組的血糖水平明顯高于對照組(病例組：5.42±0.64mmol/l, n=15;對照組：4.79±0.39mmol/l, n=15; P=0.003)。但是，兩組的外周血單個核細胞的脂聯素受體的mRNA表達水平差異無統(tǒng)計學意義(P0.05)。 結論：我們的結果顯示血漿脂聯素濃度在濕性老年性黃斑變性患者中是降低的，提示與脂聯素相關的胰島素抵抗可能存在于濕性老年性黃斑變性的病理性血管新生過程中。
[Abstract]:Background: age-related macular degeneration is one of the most common causes of blindness worldwide, and its incidence is increasing. Especially, wet age-related macular degeneration is characterized by choroidal neovascularization. Is the main cause of severe irreversible visual impairment. Current treatment measures, including photodynamic therapy and anti-angiogenic drugs, Both focus on reversing the process of angiogenesis. Given the limited efficacy of even combined current treatment measures, recent studies have shown that, Other factors in the human system may play an important role in the severity and prognosis of the disease. Adiponectin, a new type of protein hormone, is secreted by adipocytes and enters the bloodstream to regulate a series of metabolic processes. The regulation of blood glucose and the catabolism of fatty acids have been reported to confirm the antiangiogenic effect of adiponectin. Aim: to observe the plasma adiponectin levels and the expression of adiponectin receptor 1 and receptor 2 in peripheral blood mononuclear cells from patients with wettable age-related macular degeneration. Methods: fifteen patients (mean age 69.07 鹵6.71 years) and 15 healthy controls (mean age 64.2 鹵7.46 years) were included in the study. Renal failure and other diseases. Plasma adiponectin level was measured by ELISA. Adiponectin receptor expression in peripheral blood mononuclear cells was measured by Real-time PCR. Two variables correlation analysis was performed by Pearson correlation analysis, including plasma adiponectin. Adiponectin receptor 1, receptor 2, homeostasis assessment of insulin resistance index (Homa-IRN). Results: the plasma adiponectin level in the case group was significantly lower than that in the control group (1. 18 鹵0. 65 渭 g / ml, n = 15; control group: 2. 00 鹵0. 63 渭 g / ml, n = 15; P = 0. 002). It was also found that the blood glucose level in the case group was significantly higher than that in the control group (5. 42 鹵0. 64 mmol / r, n = 15; control group: 4. 79 鹵0. 39 mmol / L, n = 15; P 0.0033). There was no significant difference in mRNA expression of adiponectin receptor between the two groups. Conclusion: our results suggest that plasma adiponectin concentration is decreased in patients with wettable age-related macular degeneration, suggesting that adiponectin related insulin resistance may exist during pathological angiogenesis of wet age-related macular degeneration.
【學位授予單位】：重慶醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2012
【分類號】：R774.5

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