CAJ | 학술논문

目的了解无糖尿病家族史、糖代谢正常的脾虚痰湿型、气滞痰阻型肥胖女性体脂改变及β细胞功能变化,分析两者之间的关系.方法 60例入选对象按体重指数(BMI)分为非肥胖者和肥胖者,肥胖者按中医辨证分为脾虚痰湿型、气滞痰阻型.采用双能X线骨密度仪(DEXA)检测体脂,通过静脉葡萄糖耐量试验(IVGTT)评估急性相胰岛素分泌(AIR)、胰岛素曲线下面积(AUCins)、胰岛素曲线下面积/血糖曲线下面积(AUCins/AUCglu)等β细胞功能指标.结果与非肥胖者比较,脾虚痰湿型、气滞痰阻型肥胖者BMI、腰围(W)、脂肪含量增加,但两种证型肥胖者间BMI、W差异无统计学意义.与脾虚痰湿型肥胖者比较,气滞痰阻型肥胖者躯干、总体脂肪含量、躯干脂肪质量/总质量比增加,AIR、AUCins、AUCins/AUCglu亦明显增加.AIR、AUCins、AUCins/AUCglu与BMI、W、躯干和总体脂肪含量呈良好相关.多元线性回归分析显示躯干脂肪含量是影响AIR的重要因素.结论气滞痰阻型肥胖者具有更高的体脂(尤其是躯干脂肪)含量和伴胰岛素抵抗的AIR增加,该人群是临床干预的重点对象.
목적 료해무당뇨병가족사、당대사정상적비허담습형、기체담조형비반녀성체지개변급β세포공능변화,분석량자지간적관계.방법 60례입선대상안체중지수(BMI)분위비비반자화비반자,비반자안중의변증분위비허담습형、기체담조형.채용쌍능X선골밀도의(DEXA)검측체지,통과정맥포도당내량시험(IVGTT)평고급성상이도소분비(AIR)、이도소곡선하면적(AUCins)、이도소곡선하면적/혈당곡선하면적(AUCins/AUCglu)등β세포공능지표.결과 여비비반자비교,비허담습형、기체담조형비반자BMI、요위(W)、지방함량증가,단량충증형비반자간BMI、W차이무통계학의의.여비허담습형비반자비교,기체담조형비반자구간、총체지방함량、구간지방질량/총질량비증가,AIR、AUCins、AUCins/AUCglu역명현증가.AIR、AUCins、AUCins/AUCglu여BMI、W、구간화총체지방함량정량호상관.다원선성회귀분석현시구간지방함량시영향AIR적중요인소.결론 기체담조형비반자구유경고적체지(우기시구간지방)함량화반이도소저항적AIR증가,해인군시림상간예적중점대상.
Objective To analyze the relationship between body fat and β-cell function in obesity women of Pi-deficiency with phlegm-dampness type (PDPD) and qi-stagnancy with phlegm-blcking type (QSPB). Methods Sixty women, who had normal blood glucose level and without family history of diabetes, were enrolled. They were classified into non-obesity group and obesity group depending on their body mass index (BMI), and subjects of obesity group were differentiated into the PDPD type and QSPB type according to Chinese medicine syndrome differentiation. The body fat was detected using double energy X-ray absorptiometry, and the β-cell function was assessed by measuring the acute insulin response (AIR), the under insulin curve area (AUCins), the under glucose curve area (AUCglu), and their ratio (AUCins/AUCglu), through intravenous glucose tolerance test (IVGTT). Results BMI, body fat and waist circumference (Wf) were higher in obesity subjects than those in non-obesity subjects, but showed no significant difference between the two obesity types. Comparisons between obesity women of different types showed that the fat content of trunk and total body, the ratio of trunk fat/total mass, AIR, AUCins, and AUCins/AUCglu were all higher in QSPB than those in PDPD. AIR, AUCins, AUCins/AUCglu showed good correlation with BMI, Wf, trunk fat and total body fat contents. Multiple linear regression analysis demonstrated the increasing of trunk fat content was an influencing factor of AIR. Conclusion Obesity women of QSPB type possess higher body fat (especially the trunk fat) content and insulin resistance with high acute insulin response, so clinical intervention should dominantly pay attention to subjects with QSPB type of obesity.