體檢人群幽門螺桿菌感染對(duì)胰島素抵抗及糖脂代謝的影響
發(fā)布時(shí)間：2018-12-16 06:48
【摘要】：目的目前,幽門螺桿菌(Heliobacter pylori,H.pylori,Hp)在我國(guó)普通人群的感染率高達(dá)50%-80%,并且以每年1%~2%的速度增加。H.pylori感染參與了體內(nèi)許多疾病的發(fā)生、發(fā)展。隨著對(duì)H.pylori研究的越來(lái)越深入,發(fā)現(xiàn)H.pylori與胰島素抵抗和糖脂代謝密切相關(guān)。目前關(guān)于H.pylori感染與胰島素抵抗之間關(guān)系的研究,大多是針對(duì)臨床上已確診的疾病如糖尿病、心血管疾病等。而本研究針對(duì)健康人群或者未出現(xiàn)疾病前期的體檢人群中就H.pylori感染對(duì)于機(jī)體胰島素抵抗和其他代謝指標(biāo)的影響做了詳細(xì)的研究,探討H.pylori感染對(duì)于血糖、血脂及胰島素抵抗的影響。方法在2016年1月至2016年11月于天津醫(yī)科大學(xué)總醫(yī)院保健醫(yī)療部健康體檢中心隨機(jī)選取體檢者620例,根據(jù)研究的排除標(biāo)準(zhǔn)及剔除其中數(shù)據(jù)不全者,最終選取594例體檢者,年齡20-83周歲,平均年齡為52.2±12.7歲,其中男性273例,女性321例。抽取靜脈血檢測(cè)血糖、血脂及肝、腎功能等指標(biāo),采用~(13)C-尿素呼氣試驗(yàn)(~(13)C-UBT試驗(yàn))檢測(cè)判定Hp感染情況,采用穩(wěn)態(tài)模型(HOMA-IR)評(píng)估胰島素抵抗的情況胰島素抵抗指數(shù)(HOMA-IR)=空腹血糖FPG(mmol/L)×空腹血漿胰島素FINS(m IU/L)/22.5。將研究對(duì)象按Hp感染情況分為Hp陽(yáng)性組和Hp陰性組,從而分析人群中H.pylori感染情況及對(duì)比兩組之間血糖、血脂及胰島素抵抗情況的不同;根據(jù)化驗(yàn)血糖的結(jié)果,分為糖代謝異常組(包括糖耐量受損者及糖尿病者)及健康對(duì)照組,分析兩組人群中H.pylori感染情況,及探討糖代謝異常人群合并H.pylori感染時(shí)的胰島素抵抗水平、血糖和血脂等水平;用Logistic回歸模型分析H.pylori感染是否是胰島素抵抗的危險(xiǎn)因素。結(jié)果1.在594例體檢人員中,Hp感染率為61.1%,經(jīng)統(tǒng)計(jì)學(xué)分析發(fā)現(xiàn),Hp感染在性別及年齡之間均無(wú)統(tǒng)計(jì)學(xué)差異(p=0.675,p=0.770)。將所有受試者根據(jù)年齡分層后分析發(fā)現(xiàn),在每個(gè)年齡層中Hp感染率均在60%左右,并且隨著年齡增加Hp感染率沒有顯著變化。2.根據(jù)Hp不同感染情況分組發(fā)現(xiàn),Hp陽(yáng)性組中的FBG、Hb A1c明顯升高,HDL明顯降低,差異具有統(tǒng)計(jì)學(xué)意義(p=0.037,p=0.035,p=0.004),并且HOMA-IR在Hp陽(yáng)性組明顯高于Hp陰性組(p0.05),通過采用不同HOMA-IR上限值進(jìn)行研究發(fā)現(xiàn),三種情況下Hp感染者中均存在IR。進(jìn)一步根據(jù)糖代謝受損情況進(jìn)行分組分析發(fā)現(xiàn),糖代謝異常組Hp陽(yáng)性者胰島素抵抗較Hp陰性者明顯,差異有統(tǒng)計(jì)學(xué)意義,在健康對(duì)照組中Hp陽(yáng)性者胰島素抵抗雖有增高,但差別沒有統(tǒng)計(jì)學(xué)意義。3.Logistic回歸分析Hp感染是增加胰島素抵抗的危險(xiǎn)因素之一。結(jié)論在體檢人群中,尤其是在糖代謝異常者中,Hp感染與胰島素抵抗及糖脂代謝之間的確存在著密切聯(lián)系。Hp感染是增加胰島素抵抗的危險(xiǎn)因素。
[Abstract]:Objective at present, the infection rate of Helicobacter pylori (Heliobacter pylori,H.pylori,Hp) in the general population in China is as high as 50-80%, and it increases at a rate of 1% or 2% per year. H.pylori infection is involved in the occurrence and development of many diseases in the body. With the further study of H.pylori, it is found that H.pylori is closely related to insulin resistance and glycolipid metabolism. At present, the research on the relationship between H.pylori infection and insulin resistance is focused on clinically confirmed diseases such as diabetes mellitus, cardiovascular disease and so on. In this study, the effects of H.pylori infection on insulin resistance and other metabolic parameters were studied in the healthy population or those who did not have pre-disease, and the effect of H.pylori infection on blood glucose was discussed. Effects of serum lipids and insulin resistance. Methods from January 2016 to November 2016, 620 patients were randomly selected from the Health examination Center of the Department of Health Care, General Hospital of Tianjin Medical University. According to the exclusion criteria of the study and excluding the incomplete data, 594 medical examiners were selected. The average age was 52.2 鹵12.7 years, including 273 males and 321 females. Blood glucose, blood lipids, liver and kidney function were measured in venous blood samples, and Hp infection was determined by ~ (13) C-urea breath test (~ (13) C-UBT test). Insulin resistance index (HOMA-IR) = fasting blood glucose FPG (mmol/L) 脳 fasting plasma insulin FINS (m IU/L / 22.5 was evaluated by steady-state model (HOMA-IR). The subjects were divided into Hp positive group and Hp negative group according to the Hp infection, so as to analyze the prevalence of H.pylori infection and compare the differences of blood glucose, blood lipid and insulin resistance between the two groups. According to the results of blood glucose test, the patients with abnormal glucose metabolism (including impaired glucose tolerance and diabetes mellitus) and the healthy control group were divided into two groups. The levels of insulin resistance, blood glucose and lipids in patients with abnormal glucose metabolism complicated with H.pylori infection were discussed. Logistic regression model was used to analyze whether H.pylori infection was a risk factor of insulin resistance. Result 1. The infection rate of Hp was 61.1 in 594 people. The results of statistical analysis showed that there was no significant difference between sex and age in Hp infection (p0. 675 / 0. 770). According to the age stratification analysis, the Hp infection rate was about 60% in each age group, and there was no significant change in Hp infection rate with the increase of age. 2. According to the different infection status of Hp, the FBG,Hb A1c in Hp positive group was significantly increased, and HDL was significantly decreased (p0.037%, 0.035%, p0.004), the difference was statistically significant (p0. 037%, p0. 035%, p0. 004). HOMA-IR was significantly higher in the Hp positive group than in the Hp negative group (p0.05). By using different HOMA-IR upper limit values, it was found that there was IR. in all the Hp infected persons under all three conditions. According to the group analysis of impaired glucose metabolism, it was found that the insulin resistance of Hp positive group was significantly higher than that of Hp negative group, and the insulin resistance of Hp positive group in healthy control group was higher than that of Hp negative group. But the difference was not statistically significant. 3.Logistic regression analysis showed that Hp infection was one of the risk factors to increase insulin resistance. Conclusion there is a close relationship between Hp infection and insulin resistance and glycolipid metabolism in physical population, especially in patients with abnormal glucose metabolism. Hp infection is a risk factor to increase insulin resistance.
【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R57
本文編號(hào)：2381956
[Abstract]:Objective at present, the infection rate of Helicobacter pylori (Heliobacter pylori,H.pylori,Hp) in the general population in China is as high as 50-80%, and it increases at a rate of 1% or 2% per year. H.pylori infection is involved in the occurrence and development of many diseases in the body. With the further study of H.pylori, it is found that H.pylori is closely related to insulin resistance and glycolipid metabolism. At present, the research on the relationship between H.pylori infection and insulin resistance is focused on clinically confirmed diseases such as diabetes mellitus, cardiovascular disease and so on. In this study, the effects of H.pylori infection on insulin resistance and other metabolic parameters were studied in the healthy population or those who did not have pre-disease, and the effect of H.pylori infection on blood glucose was discussed. Effects of serum lipids and insulin resistance. Methods from January 2016 to November 2016, 620 patients were randomly selected from the Health examination Center of the Department of Health Care, General Hospital of Tianjin Medical University. According to the exclusion criteria of the study and excluding the incomplete data, 594 medical examiners were selected. The average age was 52.2 鹵12.7 years, including 273 males and 321 females. Blood glucose, blood lipids, liver and kidney function were measured in venous blood samples, and Hp infection was determined by ~ (13) C-urea breath test (~ (13) C-UBT test). Insulin resistance index (HOMA-IR) = fasting blood glucose FPG (mmol/L) 脳 fasting plasma insulin FINS (m IU/L / 22.5 was evaluated by steady-state model (HOMA-IR). The subjects were divided into Hp positive group and Hp negative group according to the Hp infection, so as to analyze the prevalence of H.pylori infection and compare the differences of blood glucose, blood lipid and insulin resistance between the two groups. According to the results of blood glucose test, the patients with abnormal glucose metabolism (including impaired glucose tolerance and diabetes mellitus) and the healthy control group were divided into two groups. The levels of insulin resistance, blood glucose and lipids in patients with abnormal glucose metabolism complicated with H.pylori infection were discussed. Logistic regression model was used to analyze whether H.pylori infection was a risk factor of insulin resistance. Result 1. The infection rate of Hp was 61.1 in 594 people. The results of statistical analysis showed that there was no significant difference between sex and age in Hp infection (p0. 675 / 0. 770). According to the age stratification analysis, the Hp infection rate was about 60% in each age group, and there was no significant change in Hp infection rate with the increase of age. 2. According to the different infection status of Hp, the FBG,Hb A1c in Hp positive group was significantly increased, and HDL was significantly decreased (p0.037%, 0.035%, p0.004), the difference was statistically significant (p0. 037%, p0. 035%, p0. 004). HOMA-IR was significantly higher in the Hp positive group than in the Hp negative group (p0.05). By using different HOMA-IR upper limit values, it was found that there was IR. in all the Hp infected persons under all three conditions. According to the group analysis of impaired glucose metabolism, it was found that the insulin resistance of Hp positive group was significantly higher than that of Hp negative group, and the insulin resistance of Hp positive group in healthy control group was higher than that of Hp negative group. But the difference was not statistically significant. 3.Logistic regression analysis showed that Hp infection was one of the risk factors to increase insulin resistance. Conclusion there is a close relationship between Hp infection and insulin resistance and glycolipid metabolism in physical population, especially in patients with abnormal glucose metabolism. Hp infection is a risk factor to increase insulin resistance.
【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R57
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