中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2014年
7期
724-726
,共3页
刘德丰%陆强%丁伟利%马宁%刘兰祥
劉德豐%陸彊%丁偉利%馬寧%劉蘭祥
류덕봉%륙강%정위리%마저%류란상
腹型肥胖%腹部脂肪面积%胰岛素抵抗%糖代谢
腹型肥胖%腹部脂肪麵積%胰島素牴抗%糖代謝
복형비반%복부지방면적%이도소저항%당대사
Abdominal obesity%Abdominal fat area%Insulin resistance%Glucose metabolism
目的:探讨男性腹型肥胖患者腹部脂肪面积与糖代谢指标的关系。方法选择21~62岁肥胖男性94例,其中腹围≥90 cm(腹型肥胖组)70例,<90 cm(均匀肥胖组)24例,登记两组患者的一般资料,测量身高、体质量、腹围、臀围,计算体质量指数(BMI);受试者空腹行口服葡萄糖耐量试验,检测血糖(0、1、2 h)及胰岛素(0、1、2 h),计算胰岛素抵抗指数;应用 MRI 测量腹部内脏脂肪面积;比较两组患者血糖、胰岛素及胰岛素抵抗指数的差异,并分析腹型肥胖患者糖代谢相关指标与腹部脂肪面积的相关性。结果腹型肥胖组 BMI、腰围、臀围、胰岛素抵抗指数及腹部脂肪面积均高于均匀肥胖组[(28.67±4.20)、(21.80±1.97)kg/ m2,(99.75±4.07)、(79.50±10.05)cm,(104.42±7.62)、(91.86±4.49)cm,2.60±1.80、1.52±0.73,(153.06±53.23)、(71.78±25.48)cm2],差异均有统计学意义(t值分别为-7.704、-9.583、-7.618、-2.877、-7.184,P 均<0.05);腹型肥胖组0、1、2 h 血糖和胰岛素高于均匀肥胖组[(5.89±1.36)、(5.29±0.53)mmol/ L,(10.55±3.07)、(8.76±1.96)mmol/ L,(8.41±3.63)、(6.54±1.50)mmol/ L,(9.71±5.05)、(6.42±2.96)mU/ L,(83.29±64.51)、(33.00±19.82) mU/ L,(27.93±14.98)、(63.56±21.09)mU/ L],差异均有统计学意义(t 值分别为-2.098、-2.671、-2.447,-3.010、-3.784、-3.089,P 均<0.05);腹型肥胖患者腹部脂肪面积与年龄、BMI、腹围、臀围、血糖(0、1、2 h)、胰岛素(0、2 h)及胰岛素抵抗指数均呈正相关( r 值分别为0.254、0.533、0.521、0.615、0.245、0.315、0.294、0.273、0.249、0.225,P 均<0.05),校正混杂因素后,年龄(x1)、腹围(x2)及胰岛素抵抗指数(x 3)与腹部内脏脂肪面积成正相关相关(y =1.369x1+4.472x2+25.072x3-333.626)。结论与均匀肥胖相比较,腹型肥胖患者的腹部脂肪面积大小与胰岛素抵抗相关。
目的:探討男性腹型肥胖患者腹部脂肪麵積與糖代謝指標的關繫。方法選擇21~62歲肥胖男性94例,其中腹圍≥90 cm(腹型肥胖組)70例,<90 cm(均勻肥胖組)24例,登記兩組患者的一般資料,測量身高、體質量、腹圍、臀圍,計算體質量指數(BMI);受試者空腹行口服葡萄糖耐量試驗,檢測血糖(0、1、2 h)及胰島素(0、1、2 h),計算胰島素牴抗指數;應用 MRI 測量腹部內髒脂肪麵積;比較兩組患者血糖、胰島素及胰島素牴抗指數的差異,併分析腹型肥胖患者糖代謝相關指標與腹部脂肪麵積的相關性。結果腹型肥胖組 BMI、腰圍、臀圍、胰島素牴抗指數及腹部脂肪麵積均高于均勻肥胖組[(28.67±4.20)、(21.80±1.97)kg/ m2,(99.75±4.07)、(79.50±10.05)cm,(104.42±7.62)、(91.86±4.49)cm,2.60±1.80、1.52±0.73,(153.06±53.23)、(71.78±25.48)cm2],差異均有統計學意義(t值分彆為-7.704、-9.583、-7.618、-2.877、-7.184,P 均<0.05);腹型肥胖組0、1、2 h 血糖和胰島素高于均勻肥胖組[(5.89±1.36)、(5.29±0.53)mmol/ L,(10.55±3.07)、(8.76±1.96)mmol/ L,(8.41±3.63)、(6.54±1.50)mmol/ L,(9.71±5.05)、(6.42±2.96)mU/ L,(83.29±64.51)、(33.00±19.82) mU/ L,(27.93±14.98)、(63.56±21.09)mU/ L],差異均有統計學意義(t 值分彆為-2.098、-2.671、-2.447,-3.010、-3.784、-3.089,P 均<0.05);腹型肥胖患者腹部脂肪麵積與年齡、BMI、腹圍、臀圍、血糖(0、1、2 h)、胰島素(0、2 h)及胰島素牴抗指數均呈正相關( r 值分彆為0.254、0.533、0.521、0.615、0.245、0.315、0.294、0.273、0.249、0.225,P 均<0.05),校正混雜因素後,年齡(x1)、腹圍(x2)及胰島素牴抗指數(x 3)與腹部內髒脂肪麵積成正相關相關(y =1.369x1+4.472x2+25.072x3-333.626)。結論與均勻肥胖相比較,腹型肥胖患者的腹部脂肪麵積大小與胰島素牴抗相關。
목적:탐토남성복형비반환자복부지방면적여당대사지표적관계。방법선택21~62세비반남성94례,기중복위≥90 cm(복형비반조)70례,<90 cm(균균비반조)24례,등기량조환자적일반자료,측량신고、체질량、복위、둔위,계산체질량지수(BMI);수시자공복행구복포도당내량시험,검측혈당(0、1、2 h)급이도소(0、1、2 h),계산이도소저항지수;응용 MRI 측량복부내장지방면적;비교량조환자혈당、이도소급이도소저항지수적차이,병분석복형비반환자당대사상관지표여복부지방면적적상관성。결과복형비반조 BMI、요위、둔위、이도소저항지수급복부지방면적균고우균균비반조[(28.67±4.20)、(21.80±1.97)kg/ m2,(99.75±4.07)、(79.50±10.05)cm,(104.42±7.62)、(91.86±4.49)cm,2.60±1.80、1.52±0.73,(153.06±53.23)、(71.78±25.48)cm2],차이균유통계학의의(t치분별위-7.704、-9.583、-7.618、-2.877、-7.184,P 균<0.05);복형비반조0、1、2 h 혈당화이도소고우균균비반조[(5.89±1.36)、(5.29±0.53)mmol/ L,(10.55±3.07)、(8.76±1.96)mmol/ L,(8.41±3.63)、(6.54±1.50)mmol/ L,(9.71±5.05)、(6.42±2.96)mU/ L,(83.29±64.51)、(33.00±19.82) mU/ L,(27.93±14.98)、(63.56±21.09)mU/ L],차이균유통계학의의(t 치분별위-2.098、-2.671、-2.447,-3.010、-3.784、-3.089,P 균<0.05);복형비반환자복부지방면적여년령、BMI、복위、둔위、혈당(0、1、2 h)、이도소(0、2 h)급이도소저항지수균정정상관( r 치분별위0.254、0.533、0.521、0.615、0.245、0.315、0.294、0.273、0.249、0.225,P 균<0.05),교정혼잡인소후,년령(x1)、복위(x2)급이도소저항지수(x 3)여복부내장지방면적성정상관상관(y =1.369x1+4.472x2+25.072x3-333.626)。결론여균균비반상비교,복형비반환자적복부지방면적대소여이도소저항상관。
Objective To investigate the relationship between intra-abdominal fat area(IAFA)in male with abdominal obesity and glycometabolism related indicators. Methods Ninety-four obesity males,aged from 21 to 62 years old,were selected as our subjects. They were divided into abdominal obesity group(n = 70)and non-abdominal obesity group( n = 24). The general information of all subjects was recorded. The indexes of height,weight,waist circumference,hip circumference,body mass index(BMI)were measured. The fasting oral glucose tolerance test was performed. The levels of blood glucose(0,1,2 h)and insulin(0,1,2 h)were measured,and insulin resistance index was calculated. MRI measurement was applied to calculate the IAFA. Compared the difference between the two groups in term of the level of blood glucose,insulin and insulin resistance index,and analyzed the correlation between glycometabolism related indicators and IAFA. Results BMI,waist circumference,hip circumference,insulin resistance index and IAFA in abdominal obesity group were (28. 67 ± 4. 20)kg/ m2 ,(99. 75 ± 4. 07)cm,(104. 42 ± 7. 62)cm,2. 60 ± 1. 80,(153. 06 ± 53. 23)cm2 respectively,higher than those in non-abdominal obesity group((21. 80 ± 1. 97)kg/ m2 ,(79. 50 ± 10. 05)cm, (91. 86 ± 4. 49)cm,1. 52 ± 0. 73,(71. 78 ± 25. 48)cm2 ),and the differences were statistically significant(t= - 7. 704,- 9. 583,- 7. 618,- 2. 877,- 7. 184,P < 0. 05). The level of blood glucose at 0,1,2 h of patient in abdominal obesity group were(5. 89 ± 1. 36)mmol/ L,(10. 55 ± 3. 07)mmol/ L,and(8. 41 ± 3. 63) mmol/ L,higher than that in non-abdominal obesity group((5. 29 ± 0. 53)mmol/ L,(8. 76 ± 1. 96)mmol/ L, (6. 54 ± 1. 50)mmol/ L). Meanwhile,The insulin at 0,1,2 h of man in abdominal obesity group were(9. 71 ± 5. 05)mU/ L,(83. 29 ± 64. 51)mU/ L,(63. 56 ± 21. 09)mU/ L),significantly higher than those in non-abdominal obesity group((6. 42 ± 2. 96)mU/ L,(33. 00 ± 19. 82)mU/ L,(63. 56 ± 21. 09)mU/ L),and the differences were significant( t = - 2. 098,- 2. 671;- 2. 447,- 3. 010;- 3. 784,- 3. 089;P < 0. 05). The IAFA in abdominal obesity was positively correlated with age,BMI,waist circumference,hip circumference,blood glucose(0,1,2 h)insulin(0,2 h)and insulin resistance index(r = 0. 254,0. 533,0. 521,0. 615,0. 245,0. 315, 0. 294,0273,0. 249,0. 225,P < 0. 05 ). After adjustment for confounding factors,age( x1 ),abdominal circumference(x2)and insulin resistance index(x3)were related to IAFA(y = 1. 369x1 + 4. 472x2 + 25. 072x3- 333. 626). Conclusion Compared with patients with non-abdominal obesity,the IAFA of patient with abdominal obesity with abdominal fat area size is associated with insulin resistance.