CAJ | 학술논문

目的旨在评估太原社区非糖尿病人群的维生素D水平状况,探讨血清25-羟基维生素D3[25(OH)D3]与肥胖、腹型肥胖的相关性.方法纳入2011年7至9月太原社区非糖尿病者417名[男225名,女192名,平均年龄(47.6±7.8)岁],所有对象均完成一般体格检查、病史询问及血糖、血脂、25(OH)D3、空腹胰岛素(Fins)检测,计算胰岛素抵抗指数(HOMA-IR),双能X线吸收测量法(DEXA)测定体脂含量(％),采集第4到第5腰椎间盘水平的MRI图像并计算腹内脂肪组织(IAAT)和腹部皮下脂肪组织(SCAT),IAAT≥ 80 cm2即为腹型肥胖.分析血清25(OH)D3与各生化指标及体脂的相关性.结果 417名研究对象平均血25 (OH) D3水平为44.5 nmoL/L,其中维生素D缺乏和不足分别为62.6％(261例)和26.1％(109例).维生素D缺乏和不足人群中,根据腹内脂肪面积,腹型肥胖(IAAT≥80 cm2)占77.6％.Pearson相关分析显示lg 25(OH) D3与lg Fins、lg HOMA-IR、腰围、收缩压、舒张压、腹部脂肪组织(TAAT)、IAAT呈显著负相关(均P＜0.05);与腰臀比、体质量指数及体脂含量(％)呈负相关,但差异无统计学意义(均P ＞0.05).逐步多元线性回归分析显示lg HOMA-IR(t=-4.278,P=0.001)、TAAT(t=-5.146,P=0.002)与lg 25 (OH) D3独立相关.结论太原社区非糖尿病人群约90％存在维生素D缺乏和不足,在维生素D缺乏和不足人群中约4/5为腹型肥胖.血清25 (OH) D3水平与腹部脂肪面积呈显著负相关,而与体质量指数无明显相关.HOMA-IR、TAAT是25 (OH) D3缺乏的独立危险因素.
목적 지재평고태원사구비당뇨병인군적유생소D수평상황,탐토혈청25-간기유생소D3[25(OH)D3]여비반、복형비반적상관성.방법 납입2011년7지9월태원사구비당뇨병자417명[남225명,녀192명,평균년령(47.6±7.8)세],소유대상균완성일반체격검사、병사순문급혈당、혈지、25(OH)D3、공복이도소(Fins)검측,계산이도소저항지수(HOMA-IR),쌍능X선흡수측량법(DEXA)측정체지함량(％),채집제4도제5요추간반수평적MRI도상병계산복내지방조직(IAAT)화복부피하지방조직(SCAT),IAAT≥ 80 cm2즉위복형비반.분석혈청25(OH)D3여각생화지표급체지적상관성.결과 417명연구대상평균혈25 (OH) D3수평위44.5 nmoL/L,기중유생소D결핍화불족분별위62.6％(261례)화26.1％(109례).유생소D결핍화불족인군중,근거복내지방면적,복형비반(IAAT≥80 cm2)점77.6％.Pearson상관분석현시lg 25(OH) D3여lg Fins、lg HOMA-IR、요위、수축압、서장압、복부지방조직(TAAT)、IAAT정현저부상관(균P＜0.05);여요둔비、체질량지수급체지함량(％)정부상관,단차이무통계학의의(균P ＞0.05).축보다원선성회귀분석현시lg HOMA-IR(t=-4.278,P=0.001)、TAAT(t=-5.146,P=0.002)여lg 25 (OH) D3독립상관.결론 태원사구비당뇨병인군약90％존재유생소D결핍화불족,재유생소D결핍화불족인군중약4/5위복형비반.혈청25 (OH) D3수평여복부지방면적정현저부상관,이여체질량지수무명현상관.HOMA-IR、TAAT시25 (OH) D3결핍적독립위험인소.
Objective To evaluate the serum 25-hydroxyvitamin D [25 (OH)D3] levels in non-diabetic people in Taiyuan community,and its relationship with obesity and abdominal obesity.Methods This crosssectional study enrolled 417 non-diabetic people in Tainyuan community from July to September in 2011 [225 males and 192 females,mean age (47.6 ±7.8) years].For all the enrolled subjects,we collected data about anthropometric indexes,medical history,blood glucose,lipid profile,25 (OH) D3,fasting insulin (Fins) level,homeostasis model assessement for insulin resistance (HOMA-IR),body fat content (％) measured with dualenergy X-ray absorptiometry (DEXA),and intra-abdominal adipose tissue (IAAT) and abdominal subcutaneous adipose tissue (SCAT) calculated based on magnetic resonance imaging at the 4th to 5th lumbar disc level (IAAT≥80 cm2 was considered abdominal obesity).Correlation analysis was performed to assess the relationships of serum 25 (OH) D3 levels with biochemical and body fat indexes.Results The average serum level of 25 (OH) D3 was 44.5 nmol/L in the 417 people,with vitamin D deficiency in 261 cases (62.6％) and vitamin D insufficiency in 109 cases (26.1％).Of the vitamin D deficient and insufficient people,77.6％ had abdominal obesity according to IAAT (IAAT ≥ 80 cm2).According to Pearson analysis result,lg 25 (OH)D3 was negatively correlated with lg Fins,lg HOMA-IR,waist circumference,systolic blood pressure,diastolic blood pressure,total abdominal adipose tissue (TAAT),IAAT (all P ＜0.05).It was also negatively correlated with waist-to-hip-ratio,body mass index (BMI),and body fat content (％),but without statistical significance (all P ＞0.05).In stepwise multiple linear regression model,lg HOMA-IR (t =-4.278,P =0.001) and TAAT (t =-5.146,P =0.002) were independently correlated with lg 25 (OH) D3.Conclusions About 90％ of all non-diabetic population in Taiyuan community have vitamin D deficiency or insufficiency,of whom 4/5 have abdominal obesity.Serum 25 (OH)D3 level is negatively correlated with abdominal adipose tissue,but not significantly associated with BMI.HOMA-IR and TAAT are independent risk factors for vitamin D deficiency.