中华糖尿病杂志
中華糖尿病雜誌
중화당뇨병잡지
CHINES JOURNAL OF DLABETES MELLITUS
2011年
2期
121-125
,共5页
张雅萍%赵曦乐%严孙杰%沈喜妹%黄凌宁%杨立勇%张松菁%易如海
張雅萍%趙晞樂%嚴孫傑%瀋喜妹%黃凌寧%楊立勇%張鬆菁%易如海
장아평%조희악%엄손걸%침희매%황릉저%양립용%장송정%역여해
肥胖%体成分%静脉葡萄糖耐量试验%胰岛功能状态%血压
肥胖%體成分%靜脈葡萄糖耐量試驗%胰島功能狀態%血壓
비반%체성분%정맥포도당내량시험%이도공능상태%혈압
Obesity%Body composition%Intravenous glucose tolerance test%Islet function condition%Blood pressure
目的 探讨肥胖女性血压水平与胰岛功能状态的相关性.方法 选取2006年1月至2009年6月于福建医科大学附属第一医院内分泌科就诊的88例女性肥胖(体质指数≥25.0 kg/m2)患者为研究对象,年龄20～59岁.根据血压将患者分为:正常血压组30例、高血压前期组27例、高血压组31例.双能X线骨密度仪(DEXA)检测身体脂肪和瘦组织质量,分别计算体成分构成比指标(全身、躯干、四肢等部位的脂肪和瘦组织含量);通过静脉葡萄糖耐量试验(IVGTT)计算胰岛素曲线下面积(AUGins)、胰岛素急性分泌时相(AIR),利用稳态模型计算β细胞功能指数(HOMA2-%B)、胰岛素敏感指数(HOMA2-%S)及胰岛素抵抗指数(HOMA2-IR),分别建立高血压、高血压前期的数据模型,各组间均数比较应用One-way ANOVA方法进行统计分析,应用Binary Logistic回归分析多种因素的疾病危险.结果 正常血压组、高血压前期组、高血压组年龄、空腹血糖、BMI、腰臀比、体成分构成比指标、HOMA2-%B、AUCins、AIR差异无统计学意义(均P＞0.05);3组中随血压升高,口服葡萄糖耐量试验(OGTT)2 h血糖(2 h PG)、甘油三酯(TG)、0 min IVGTY胰岛素(IVGGT ins0)、HOMA2-IR递增(F值分别为5.782,14.173,5.578,5.501,均P＜0.05),而HOMA2-%S递减(F=15.937,P＜0.05);收缩压与2 h PG、胆固醇、TG、IVGGT ins0、HOMA2-IR呈正相关(r值分别为0.352,0.320,0.312,0.229,0.226,均P＜0.05),与HOMA2-%S呈负相关(r=-0.213,P＜0.05);舒张压与2 h PG、TG呈正相关(r值分别为0.363,0.256,均P＜0.05),与HOMA-%S呈负相关(r=0.213,P＜0.05).Logistic同归分析显示,进入高血压及高血压前期数据模型的因素均为2 h PG和HOMA2-IR(模型1 OR值分别为1.649,1.869,95%CI分别为1.011～2.688,1.144～3.054,模型2OR值分别为1.042～3.929,1.464～5.634,均P＜0.05).结论 在相同肥胖程度及体成分构成比女性,胰岛素抵抗仍是高血压乃至高血压前期重要的相关危险因素.
目的 探討肥胖女性血壓水平與胰島功能狀態的相關性.方法 選取2006年1月至2009年6月于福建醫科大學附屬第一醫院內分泌科就診的88例女性肥胖(體質指數≥25.0 kg/m2)患者為研究對象,年齡20～59歲.根據血壓將患者分為:正常血壓組30例、高血壓前期組27例、高血壓組31例.雙能X線骨密度儀(DEXA)檢測身體脂肪和瘦組織質量,分彆計算體成分構成比指標(全身、軀榦、四肢等部位的脂肪和瘦組織含量);通過靜脈葡萄糖耐量試驗(IVGTT)計算胰島素麯線下麵積(AUGins)、胰島素急性分泌時相(AIR),利用穩態模型計算β細胞功能指數(HOMA2-%B)、胰島素敏感指數(HOMA2-%S)及胰島素牴抗指數(HOMA2-IR),分彆建立高血壓、高血壓前期的數據模型,各組間均數比較應用One-way ANOVA方法進行統計分析,應用Binary Logistic迴歸分析多種因素的疾病危險.結果 正常血壓組、高血壓前期組、高血壓組年齡、空腹血糖、BMI、腰臀比、體成分構成比指標、HOMA2-%B、AUCins、AIR差異無統計學意義(均P＞0.05);3組中隨血壓升高,口服葡萄糖耐量試驗(OGTT)2 h血糖(2 h PG)、甘油三酯(TG)、0 min IVGTY胰島素(IVGGT ins0)、HOMA2-IR遞增(F值分彆為5.782,14.173,5.578,5.501,均P＜0.05),而HOMA2-%S遞減(F=15.937,P＜0.05);收縮壓與2 h PG、膽固醇、TG、IVGGT ins0、HOMA2-IR呈正相關(r值分彆為0.352,0.320,0.312,0.229,0.226,均P＜0.05),與HOMA2-%S呈負相關(r=-0.213,P＜0.05);舒張壓與2 h PG、TG呈正相關(r值分彆為0.363,0.256,均P＜0.05),與HOMA-%S呈負相關(r=0.213,P＜0.05).Logistic同歸分析顯示,進入高血壓及高血壓前期數據模型的因素均為2 h PG和HOMA2-IR(模型1 OR值分彆為1.649,1.869,95%CI分彆為1.011～2.688,1.144～3.054,模型2OR值分彆為1.042～3.929,1.464～5.634,均P＜0.05).結論 在相同肥胖程度及體成分構成比女性,胰島素牴抗仍是高血壓迺至高血壓前期重要的相關危險因素.
목적 탐토비반녀성혈압수평여이도공능상태적상관성.방법 선취2006년1월지2009년6월우복건의과대학부속제일의원내분비과취진적88례녀성비반(체질지수≥25.0 kg/m2)환자위연구대상,년령20～59세.근거혈압장환자분위:정상혈압조30례、고혈압전기조27례、고혈압조31례.쌍능X선골밀도의(DEXA)검측신체지방화수조직질량,분별계산체성분구성비지표(전신、구간、사지등부위적지방화수조직함량);통과정맥포도당내량시험(IVGTT)계산이도소곡선하면적(AUGins)、이도소급성분비시상(AIR),이용은태모형계산β세포공능지수(HOMA2-%B)、이도소민감지수(HOMA2-%S)급이도소저항지수(HOMA2-IR),분별건립고혈압、고혈압전기적수거모형,각조간균수비교응용One-way ANOVA방법진행통계분석,응용Binary Logistic회귀분석다충인소적질병위험.결과 정상혈압조、고혈압전기조、고혈압조년령、공복혈당、BMI、요둔비、체성분구성비지표、HOMA2-%B、AUCins、AIR차이무통계학의의(균P＞0.05);3조중수혈압승고,구복포도당내량시험(OGTT)2 h혈당(2 h PG)、감유삼지(TG)、0 min IVGTY이도소(IVGGT ins0)、HOMA2-IR체증(F치분별위5.782,14.173,5.578,5.501,균P＜0.05),이HOMA2-%S체감(F=15.937,P＜0.05);수축압여2 h PG、담고순、TG、IVGGT ins0、HOMA2-IR정정상관(r치분별위0.352,0.320,0.312,0.229,0.226,균P＜0.05),여HOMA2-%S정부상관(r=-0.213,P＜0.05);서장압여2 h PG、TG정정상관(r치분별위0.363,0.256,균P＜0.05),여HOMA-%S정부상관(r=0.213,P＜0.05).Logistic동귀분석현시,진입고혈압급고혈압전기수거모형적인소균위2 h PG화HOMA2-IR(모형1 OR치분별위1.649,1.869,95%CI분별위1.011～2.688,1.144～3.054,모형2OR치분별위1.042～3.929,1.464～5.634,균P＜0.05).결론 재상동비반정도급체성분구성비녀성,이도소저항잉시고혈압내지고혈압전기중요적상관위험인소.
Objective To investigate the correlation between blood pressure and islet function condition in obese women with the same body composition. Methods First 88 obese women ( BMI ≥25.0 kg/m2) were divided into 3 groups according to their blood pressure: normal blood pressure group,prehypertension group,and hypertension group. Then,dual energy X-ray absorptiometry(DEXA) was used to measure their fat and lean mass,and calculate indexes of body composition( the fat and lean content of the whole body,trunk and four limbs). Next we calculated the area under the curve of insulin (AUCins) and acute insulin response (AIR) phase by intravenous glucose tolerance test (IVGTF). HOMA was used to calculate homeostasis model β-cell function index (HOMA2-% B ),homeastasis model insulin sensitivity index (HOMA2-%S)and homeostasis model insulin resistance index (HOMA2-IR). Next,we built data models of hypertension and prehypertension,and used Binary Logistic regression to analyse risk factors.Results There was no significant difference either among age,FPG,BMI,WHR and indexes of body composition of these three groups or among the HOMA2-% B,AUCins,and AIR. When increasing of blood pressure,2 h PG,IVGTT ins0,TG,HOMA2-IR increased ( P ＜ 0. 05 ),but HOMA2-% S decreased ( P ＜0. 05 ),SBP showed a positive correlation with 2 h PG,TC,TG,IVGGT ins0,and HOMA2-IR,but a negative correlation with HOMA2-% S. DBP showed a positive correlation with 2 h PG,TG,and negative correlation with HOMA2-% S. Results of Logistic regression analysis showed that 2 h PG,HOMA2-IR,TG were in the equation in both models. Conclusion Insulin resistance is an important related risk factor for hypertension and even prehypertension in obese women with the same body composition.
