中华检验医学杂志
中華檢驗醫學雜誌
중화검험의학잡지
CHINESE JOURNAL OF LABORATORY MEDICINE
2015年
8期
543-547
,共5页
汪明东%孙立山%宗明%陆柳%鹿麟%范列英
汪明東%孫立山%宗明%陸柳%鹿麟%範列英
왕명동%손립산%종명%륙류%록린%범렬영
胰高血糖素样肽1%阿尔茨海默病%糖尿病,2型
胰高血糖素樣肽1%阿爾茨海默病%糖尿病,2型
이고혈당소양태1%아이자해묵병%당뇨병,2형
Glucagon-like peptide1%Alzheimer disease%Diabetes mellitus,type 2
目的：探讨检测晚发型阿尔茨海默病（LOAD）患者血清中胰高血糖素样肽1（GLP-1）的水平及其临床意义。方法病例对照研究。收集2012年10月至2014年3月期间上海市东方医院和浦东新区部分老年医院诊断为脑血管病（CVD）55例、LOAD 61例、2型糖尿病（T2DM）51例、T2DM合并LOAD 37例；以及2013年9月至2014年2月上海市东方医院体检中心40名健康体检者作为正常对照（ NC）。采用本实验室自建的ELISA方法检测NC、CVD、LOAD、T2DM以及T2DM合并LOAD患者GLP-1的含量，同时测定β淀粉样蛋白（1-42）（β-amyloid，Aβ）、Tau蛋白以及其他常规生化指标；并测定LOAD组、T2DM组以及T2DM合并LOAD组、NC组的研究对象空腹、服糖后1 h、2 h三个时间点患者血清中GLP-1的含量。多组间血清GLP-1的浓度比较采用单因素方差分析，两组间血清GLP-1的浓度比较采用LSD-t检验；并采用Pearson 相关分析研究GLP-1与其他指标的相关性。结果 LOAD组空腹GLP-1水平（123.4±20.8） nmol／L，高于 NC组（78.6±6.0） nmol／L和CVD 组（89.0±8.7）nmol／L（F值分别为3.46和1.98，P均＜0.05）；T2DM合并LOAD组空腹GLP-1水平（157.9±28.6）nmol／L高于LOAD组（123.4±20.8）nmol／L（t＝1.63，P＜0.05）；T2DM合并LOAD组空腹GLP-1水平（157.9±28.6）nmol／L与T2DM组空腹GLP-1水平（153.8±18.0）nmol／L比较差异无统计学意义（t＝0.96，P＞0.05）。服糖后1 h T2DM合并LOAD组GLP-1水平（99.1±14.2）nmol／L、LOAD组GLP-1水平（73.9±6.6） nmol／L和T2DM组GLP-1水平（96.3±7.0）nmol／L均出现GLP-1分泌不足情况；服糖后2 h T2DM合并LOAD组GLP-1水平为（115.4±18.6）nmol／L，高于正常对照2 h水平（63.3±6.2）nmol／L（t＝4.49，P＜0.05）；而服糖后2 h LOAD组GLP-1水平为（73.6±5.8） nmol／L与正常对照2 h 水平（63.3±6.2） nmol／L 比较差异无统计学意义（t ＝0.94，P ＞0.05）。Pearson相关分析显示空腹GLP-1与Aβ（1-42）、腹糖后1 h、2 h GLP-1水平成明显的正相关，相关系数依次为0.401、0.436、0.722。结论 LOAD与T2MD相似，患者均存在服糖后机体GLP-1分泌不足的现象，监测服糖后GLP-1的动态变化可能有助于辅助诊断LOAD。（中华检验医学杂志，2015，38：543-547）
目的：探討檢測晚髮型阿爾茨海默病（LOAD）患者血清中胰高血糖素樣肽1（GLP-1）的水平及其臨床意義。方法病例對照研究。收集2012年10月至2014年3月期間上海市東方醫院和浦東新區部分老年醫院診斷為腦血管病（CVD）55例、LOAD 61例、2型糖尿病（T2DM）51例、T2DM閤併LOAD 37例；以及2013年9月至2014年2月上海市東方醫院體檢中心40名健康體檢者作為正常對照（ NC）。採用本實驗室自建的ELISA方法檢測NC、CVD、LOAD、T2DM以及T2DM閤併LOAD患者GLP-1的含量，同時測定β澱粉樣蛋白（1-42）（β-amyloid，Aβ）、Tau蛋白以及其他常規生化指標；併測定LOAD組、T2DM組以及T2DM閤併LOAD組、NC組的研究對象空腹、服糖後1 h、2 h三箇時間點患者血清中GLP-1的含量。多組間血清GLP-1的濃度比較採用單因素方差分析，兩組間血清GLP-1的濃度比較採用LSD-t檢驗；併採用Pearson 相關分析研究GLP-1與其他指標的相關性。結果 LOAD組空腹GLP-1水平（123.4±20.8） nmol／L，高于 NC組（78.6±6.0） nmol／L和CVD 組（89.0±8.7）nmol／L（F值分彆為3.46和1.98，P均＜0.05）；T2DM閤併LOAD組空腹GLP-1水平（157.9±28.6）nmol／L高于LOAD組（123.4±20.8）nmol／L（t＝1.63，P＜0.05）；T2DM閤併LOAD組空腹GLP-1水平（157.9±28.6）nmol／L與T2DM組空腹GLP-1水平（153.8±18.0）nmol／L比較差異無統計學意義（t＝0.96，P＞0.05）。服糖後1 h T2DM閤併LOAD組GLP-1水平（99.1±14.2）nmol／L、LOAD組GLP-1水平（73.9±6.6） nmol／L和T2DM組GLP-1水平（96.3±7.0）nmol／L均齣現GLP-1分泌不足情況；服糖後2 h T2DM閤併LOAD組GLP-1水平為（115.4±18.6）nmol／L，高于正常對照2 h水平（63.3±6.2）nmol／L（t＝4.49，P＜0.05）；而服糖後2 h LOAD組GLP-1水平為（73.6±5.8） nmol／L與正常對照2 h 水平（63.3±6.2） nmol／L 比較差異無統計學意義（t ＝0.94，P ＞0.05）。Pearson相關分析顯示空腹GLP-1與Aβ（1-42）、腹糖後1 h、2 h GLP-1水平成明顯的正相關，相關繫數依次為0.401、0.436、0.722。結論 LOAD與T2MD相似，患者均存在服糖後機體GLP-1分泌不足的現象，鑑測服糖後GLP-1的動態變化可能有助于輔助診斷LOAD。（中華檢驗醫學雜誌，2015，38：543-547）
목적：탐토검측만발형아이자해묵병（LOAD）환자혈청중이고혈당소양태1（GLP-1）적수평급기림상의의。방법병례대조연구。수집2012년10월지2014년3월기간상해시동방의원화포동신구부분노년의원진단위뇌혈관병（CVD）55례、LOAD 61례、2형당뇨병（T2DM）51례、T2DM합병LOAD 37례；이급2013년9월지2014년2월상해시동방의원체검중심40명건강체검자작위정상대조（ NC）。채용본실험실자건적ELISA방법검측NC、CVD、LOAD、T2DM이급T2DM합병LOAD환자GLP-1적함량，동시측정β정분양단백（1-42）（β-amyloid，Aβ）、Tau단백이급기타상규생화지표；병측정LOAD조、T2DM조이급T2DM합병LOAD조、NC조적연구대상공복、복당후1 h、2 h삼개시간점환자혈청중GLP-1적함량。다조간혈청GLP-1적농도비교채용단인소방차분석，량조간혈청GLP-1적농도비교채용LSD-t검험；병채용Pearson 상관분석연구GLP-1여기타지표적상관성。결과 LOAD조공복GLP-1수평（123.4±20.8） nmol／L，고우 NC조（78.6±6.0） nmol／L화CVD 조（89.0±8.7）nmol／L（F치분별위3.46화1.98，P균＜0.05）；T2DM합병LOAD조공복GLP-1수평（157.9±28.6）nmol／L고우LOAD조（123.4±20.8）nmol／L（t＝1.63，P＜0.05）；T2DM합병LOAD조공복GLP-1수평（157.9±28.6）nmol／L여T2DM조공복GLP-1수평（153.8±18.0）nmol／L비교차이무통계학의의（t＝0.96，P＞0.05）。복당후1 h T2DM합병LOAD조GLP-1수평（99.1±14.2）nmol／L、LOAD조GLP-1수평（73.9±6.6） nmol／L화T2DM조GLP-1수평（96.3±7.0）nmol／L균출현GLP-1분비불족정황；복당후2 h T2DM합병LOAD조GLP-1수평위（115.4±18.6）nmol／L，고우정상대조2 h수평（63.3±6.2）nmol／L（t＝4.49，P＜0.05）；이복당후2 h LOAD조GLP-1수평위（73.6±5.8） nmol／L여정상대조2 h 수평（63.3±6.2） nmol／L 비교차이무통계학의의（t ＝0.94，P ＞0.05）。Pearson상관분석현시공복GLP-1여Aβ（1-42）、복당후1 h、2 h GLP-1수평성명현적정상관，상관계수의차위0.401、0.436、0.722。결론 LOAD여T2MD상사，환자균존재복당후궤체GLP-1분비불족적현상，감측복당후GLP-1적동태변화가능유조우보조진단LOAD。（중화검험의학잡지，2015，38：543-547）
Objective To explore the serum level of Glucagon like peptide-1 in late-onset Alzheimer′s patients and its clinical significance.Methods Case control study.Collecting cerebral vascular disease fifty-five cases, diagnosed with late-onset Alzheimer′s disease sixty-one cases, type 2 diabetes mellitus fifty-one cases , type 2 diabetic patients combined with late-onset Alzheimer′s disease thirty-seven patients from the Shanghai East Hospital and partly Pudong area elderdly hospital during October 2013 to March 2014, and forty healthy persons as normal control from physical examination center of Shanghai East Hospital during September 2013 to February 2014.Measuring the concentrations of GLP-1,β-amyloid, Tau protein and other routinely used clinical tests in the serum of patients from the normal controls , cerebrovascular disease , late-onset Alzheimer′s disease, type 2 diabetes and type 2 diabetes mellitus combined with late-onset Alzheimer′s disease by ELISA method developed in our laboratory.The blood samples were also collected at three fixed time including fasting time ,1 hour after taking glucose , 2 hour after taking glucose, the concentrations of GLP-1 were determined in the LOAD group , T2DM group and the T2DM combined with LOAD group and normal control group.The concentrations of serum GLP-1 among groups were compared with single factor analysis of variance , and the concentrations of serum GLP-1 between the two groups were compared using LSD-t test.Analysing the correlation between GLP-1 and other indicators with Pearson analysis.Results The fasting GLP-1 levels of LOAD group were ( 123.4 ±20.8 ) nmol/L, and they were highest between the normal control group (78.6 ±6.0) nmol/L and the cerebral blood vessel disease group(89.0 ±8.7)nmol/L (F values were 3.46 and 1.98, P<0.05).The fasting GLP-1 levels of T2DM combined with LOAD group (157.9 ±28.6) nmol/L were higher than the LOAD group (123.4 ± 20.8) nmol/L (t =1.63,P <0.05), but there were no difference of the fasting GLP-1 levels between T2DM combined with LOAD group (157.9 ±28.6) nmol/L and T2DM group(153.8 ±18.0)nmol/L(t=0.96,P>0.05).Deficient secretion of GLP-1 after taking glucose 1 hour in most of the patients of T2DM combined with LOAD group (99.1 ±14.2) nmol/L, LOAD group(73.9 ±6.6 ) nmol/L and T2DM group (96.3 ±7.0 ) nmol/L could be concluded .The GLP-1 levels of T2DM combined with LOAD group after taking sugar 2 hour were (115.4 ±18.6)nmol/L ,and were higher than that of normal levels (63.3 ±6.2) nmol/L after taking sugar 2 hour(t=4.49,P<0.05).There were no difference between the GLP-1 levels of the LOAD group (73.6 ±5.8 )nmol/L and the GLP-1 levels of the normal group(63.3 ±6.2)nmol/L after taking sugar 2 hour (t=0.94,P>0.05).Pearson correlation analysis showed that the relationship of the levels of GLP-1 with Aβ( 1-42 ) and the levels of GLP-1 after taking glucose 1 h and 2 h were positively relative, and its coefficients of correlation were 0.401,0.436,0.722.Conclusions LOAD and T2MD are similar, and they have GLP-1 secretion shortage phenomenon after taking glucose , so monitoring dynamic change of GLP-1 after taking glucose may contribute to the auxiliary diagnosis of LOAD.
