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研究生:吳世竹
研究生(外文):Shih-Chu Wu
論文名稱:糖尿病病患與健康人血漿中同半胱胺酸、脂質過氧化產物以及C反應蛋白含量的比較:台中縣和平鄉為對象之研究
論文名稱(外文):Comparison of plasma hemocysteine, malondialdehyde and C-reactive protein between diabetic patients and healthy controls: studies in Ho-Ping City, Taichung County
指導教授:胡淼琳胡淼琳引用關係
指導教授(外文):Miao-Lin Hu , Ph. D.
學位類別:碩士
校院名稱:國立中興大學
系所名稱:食品科學系
學門:農業科學學門
學類:食品科學類
論文種類:學術論文
論文出版年:2004
畢業學年度:92
語文別:英文
論文頁數:60
中文關鍵詞:糖尿病同半胱胺酸C反應蛋白脂質過氧化物
外文關鍵詞:Diabetes MellitusHomocysteineC reactive proteinMalondialdehyde
相關次數:
  • 被引用被引用:3
  • 點閱點閱:300
  • 評分評分:
  • 下載下載:62
  • 收藏至我的研究室書目清單書目收藏:2
中文摘要
糖尿病以血糖升高為表徵,但事實上是一個複雜的疾病,且可能與同半胱胺酸(Homocysteine,Hcy)代謝不良和氧化壓力升高有關。本研究為利用地理環境較受限制以及就醫較為專一的和平鄉民眾為研究對象,來比較糖尿病患和健康人血漿中的Hcy、C-反應蛋白(C-reactive protein,CRP)以及丙二醛(Malondialdehyde , MDA)含量,並探討彼此之間的相關性。
本實驗以民國九十二年九月、十月間參加台中縣和平鄉參加成人健檢之民眾為對象,抽樣共184人。除了成人健康檢查檢測血清生化學及全血血液學及尿液檢測外,分別檢測HbA1c、Hcy、CRP、MDA等項目。經資料校正與核對後共取得112人為對象(男性55人,女性58人,平均年齡53.1 ± 9.8歲);分病例組30人(男性15人,女性15人,平均年齡59.1 ± 10.6歲)對照組82人(男性40人,女性42人,平均年齡50.9 ± 8.6歲)。檢測數據皆以平均值加減標準差表示,統計結果以獨立樣本T檢定方式來檢測兩組之差異,並以pearson correlation coefficients 來評估Hcy與CRP與MDA之相關性。以及以邏輯迴歸分析(Logistic linear regression analysis)評估血漿中Hcy濃度與CRP、MDA之相關性。
檢測結果顯示:糖尿病患的年齡顯著高於對照組(59.1 ± 10.6 vs 50.9 ± 8.6;P≦0.05),血糖空腹顯著高於對照組(166.2 ± 59.8 vs 83.8 ± 7.2;P≦0.05)。HbA1c顯著高於對照組(7.5 ± 2.5 vs 4.8 ± 0.3;P≦0.05)。MDA顯著低於對照組(1.4 ± 0.3 vs 1.8 ± 0.4;P≦0.05)。糖尿病患的CRP、Hcy皆略高於對照組,但兩組間無顯著性的差異。而糖尿病患其他檢測值皆與對照組檢測值無顯著性的差異。以pearson相關係數檢測相關性,再以單分子變異數分析,發現年齡、HbA1c、CRP、MDA、空腹血糖有顯著相關。以Logistic迴歸係數檢測,發現年齡、CRP呈現正相關,而MDA呈現負相關,Hcy則無相關性。綜合以上結果可知:糖尿病人的Hcy、MDA含量高於健康成人,但只有CRP含量之間呈現正相關,而在MDA方面呈現負相關。
結論
本研究以和平鄉鄉民為對象的研究發現糖尿病人CRP的濃度顯著高於健康人;糖尿病人的Hcy含量雖高於健康人,但是兩者皆高於正常值且未達顯著水準。一個意外的發現是病人血漿MDA顯著低於對照組,但兩組之MDA值均顯著高於正常值。推測前者能與病人接受藥物控制有關;後者則可能與偏遠地區之疾病的發生率較高有關。然而真正原因不明,有待更多研究來釐清。

Abstract
Diabetes mellitus(DM)is a complex disease characterized by elevated blood glucose and is thought to be associated with elevated homocysteine(Hcy)and oxidative stress. Because of the prevalence of DM and cardiovascular and cerebrovascular disease in mountainous areas of Taiwan, we designed a cross-sectional study by comparing the levels of Hcy, malondialdehyde (MDA, a marker of lipid peroxidation)and C-reactive protein (CRP, a marker of inflammation)between diabetic patients and healthy controls in Ho-Ping City, a mountainous city in Taichung County. The relationships of these parameters were also investigated.
A total of 112 adults(58 females and 55 males , means age 53.1±9.8) aged 40 or above was selected based on levels of serum glucose and HbA1c from an Annual Physical Check-up from September to October 2003 by Ho-Ping Town Health Centers, Taichung County. The subjects consisted of 30 typeⅡdiabetic patients(15 females and 15 males , means age 59.1±10.6)and 82 healthy controls(40 females and 42 males , means age 50.9±8.6). Blood samples were collected after overnight fasting, and plasma Hcy , CRP , HbA1c and MDA were measured. Data were expressed as mean ± standard deviation(SD). Differences in measured parameters between control and patient groups were assessed by T test. Correlation analysis was performed by using pearson correlation coefficient. The significant influences of variables on Hcy , CRP , MDA were evaluated with Logistic linear regression analyses.The statistical significance was defined as P<0.05.
We found that the CRP levels in diabetic patients were significantly high than those found in the normal subjects(P<0.05). The plasma Hcy levels from both groups were higher than the national average levels, but the Hcy levels of diabetes patients was only slightly, but not significantly, higher than that of healthy controls. An unexpected finding was that diabetic patients had a significantly lower MDA level than the controls and that the MDA levels of both groups were higher than normal readings.
Thus , the present studt shows that the diabetics in Ho-Ping Area have significantly highter plasma CRP levels than the healthy controls , plasma Hcy levels are not significantly different between the patients and controls. However , the patient have significantly lower MDA levels than the controls , and the MDA levels in both groups are highters are than normal readings . More research is needed to investigate the factors behind these findings and the possible relationship of these factors with some fatal diseases in Ho-Ping area.

目錄
中文摘要 3
英文摘要 5
縮寫表 7
壹、 文獻回顧 8
一、 研究背景 8
二、 台中縣和平鄉簡介 9
三、 糖尿病DM 10
四、 同半胱胺酸Hemocysteine 15
五、 脂質過氧化產物MDA 18
六、 C反應蛋白CRP 20
貳、 研究動機與目的 22
參、 材料與方法 23
一、 研究對象 23
二、 檢測項目分析 23
三、 血液常規檢查 25
四、 統計分析: 27
肆、 結果 28
一、 研究對象基本資料分析: 28
二、 研究對象檢測資料分析: 28
三、 研究對象檢測項目相關情形 29
伍、 討論 31
一、 糖尿病人和正常人血液Hcy,MDA,CRP值之比較 31
二、 糖尿病人和正常人的血液中Hcy,MDA與CRP之間的相關性 32
陸、 總結 34
柒、 參考文獻 36
捌、 表圖及附件 44
圖一 台中縣和平鄉地圖 44
圖二 同半胱胺酸代謝途徑 45
表一 研究對象基本資料分析 46
表二 研究對象人員檢測資料分佈 47
表三 研究對象人員檢測資料分佈 48
表四 研究對象人員分組檢測資料 49
表五 以pearson 相關係數檢測資料與其他變項相關分析 50
表六 Logistic迴歸係數分析 51
附錄一 檢驗報告: 52
附錄二 民國92年十大死因依序 53
附錄三 91年台中縣主要死亡原因 54
附錄四 91年和平鄉主要十大死因 55
附錄五 91年主要疾病就診率比較分析 56
附錄六 ANOVA單因子變異數分析 57

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