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The Changes of Serum Visfatin, Omentin and TNF-α in Newly Diagnosed Type2Diabetic Patients with Hypertension

Author: XiongHaiLiang
Tutor: TianFengShi
School: Tianjin Medical University
Course: Internal Medicine
Keywords: diabetes mellitus type2 hypertension nicotinamidephosphoribosyltransferase tumor necrosis factor-alpha insulin uric acid visfatin omentin
CLC: R587.1
Type: Master's thesis
Year: 2013
Downloads: 1
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Abstract


Background and objectiveDiabetes mellitus and hypertension are important risk factors of cardiovascular disease, which often existed at the same time, its risk of cardio-cerebral infarction increased by more than50%and prevalence of microalbuminuria was as high as42.9%, significantly higher than the single one. Therefore, it’s very important for making clear the mechanism of type2diabetes mellitus with hypertension. More and more researches have shown that adipokines played an important role in the development process of diabetes and hypertension. But, the study on the changes of serum visfatin, omentin and TNF-a in type2diabetic patients with hypertension was few, whose influence factors were also not clear. Thus, this research was to investigate the changes of visfatin. omentin and TNF-a level and other clinical data in newly diagnosed type2diabetic patients with hypertension and to explore relativity between the adipokines and glucose, insulin resistance and hypertension.ContentThe study on the changes of serum visfatin. omentin and TNF-a in newly diagnosed type2diabetic patients with hypertension and the possible internal mechanism of adipokines to influence blood pressure.Methods106out-patients screening for diabetes from March.2012to July,2012. were selected randomly from Tianjin Gong-an Hospital, male64, female42. All subjects underwent an oral glucose tolerance test (OGTT) and insulin challenge test. According to1999WHO Diabetes Mellitus diagnosis standard, they were newly diagnosed type2diabetes mellitus (T2DM). The patients were divided into two groups:52T2DM patients with hypertension (DM+H group), male28. female24. average age59.54±10.38years;54T2DM patients without hypertension (T2DM group), male36, female18, average age56.00±8.00years. The serum level of fasting insulin (FINS), fasting plasma glucose (FPG), hemoglobin Alc(HbA1c), total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-c),low density lipoprotein cholesterol (LDL-c), blood uric acid (UA), blood urea nitrogen (BUN), creatinine (Cr), OGTT120min glucose (2hPG),120min insulin (2hINS) and120min uric acid (2hUA) were measured. Systolic blood pressure (SBP), diastolic blood pressure (DBP), height, weight and waist circumference were also assayed. BMI was calculated by BMI=weight(kg)/height(m)2, MAP was calculated by MAP=(SBP+2*DBP)/3, and homeostasis model assessment insulin resistance index (HOMA-IR) was calculated by HOMA-IR=FPG*FINS/22.5. Serum visfatin. omentin and TNF-a concentrations were detected by enzyme-linked ommunosobent assay (ELISA). Using IBM SPSS19.0software, data were analyzed.Results1.The level of BMI, SBP, DBP, Map,waist circumference and2hUA was significantly higher in DM+H group than in T2DM group, but the difference of age, gender composition, HOMA-IR, UA, blood glucose, lipids, insulin and HbA1c between DM+H group and T2DM group were not significant.2. The serum levels of fasting and glucose-stimulated visfatin and TNF-α in group DM+H were significantly increased, on the contrary, omentin was significantly decreased, as compared with group T2DM. Besides, compared with fasting visfatin. omentin and TNF-α, after being stimulated by high concentrations of glucose for120minutes, serum level of them did not change significantly.3. Pearson analysis shows:the level of fasting visfatin was found to be positively correlated with SBP, DBP, MAP, waist circumference, FINS and HOMA-IR(r were0.281,0.209,0.283,0.197,0.377and0.344respectively,P<0.05); fasting omentin was negatively correlated with DBP, MAP, waist circumference, FINS and HOMA-IR (r were-0.352,-0.323,-0.349,-0.197and-0.286respectively. P<0.05); fasting TNF-α was positively correlated with SBP, MAP, waist circumference. FINS2hINS and HOMA-IR (r were0.195.0.199,0.224,0.233,0.211and0.230respectively, P<0.05).4. Multivariate linear regression analysis demonstrated that the serum level of fasting visfatin may be affected by FINS (P<0.001) and SBP (P=0.005),the regression equation was Y=-2.142+0.206XFINS+0.089XSBP;the level of glucose-stimulated visfatin may be affected by FINS (P=0.007), the regression equation was Y=11.261+0.194XFINS; the serum level of fasting omentin may be affected by DBP (P=0.004) and HOMA-IR (P=0.023), the regression equation was Y=121.800-0.558XDBP-7.180X HOMA-IR; the level of glucose-stimulated omentin may be affected by waist circumference (W)(P=0.009), HOMA-IR (P=0.031) and UA (P=0.044), the regression equation was Y=187.131-0.948XW-8.416X HOMA-IR-0.083XUA; the serum level of fasting TNF-α may be affected by BMI (P=0.013), the regression equation was Y=13.980+2.993XBMI; the level of glucose-stimulated TNF-α may be affected by FINS (P=0.044). the regression equation was Y=86.036+1.060XFINS.Conclusion1. Compared with single T2DM, serum levels of visfatin. omentin and TNF-α changed significantly in newly diagnosed type2diabetic patients with hypertension, which were correlated with insulin resistance and may be involved in the pathological process of hypertension through aggravating insulin resistance, affecting vasomotor function, causing endothelial damage, promoting the formation of atherosclerosis and many other ways.2. Compared with fasting visfatin. omentin and TNF-α, after being stimulated by high concentrations of glucose for120minutes, serum level of them did not change significantly. Short-term changes of blood glucose had no impact on visfatin, omentin and TNF-α. suggesting that they may not be changed dramatically over changes of body energy metabolism.

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CLC: > Medicine, health > Internal Medicine > Endocrine diseases and metabolic diseases > Islet disease > Diabetes
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