人体测量指数和脂质代谢与胰岛素抵抗的相关性  

Anthropometric measures of obesity, dyslipidemia,and insulin resistance

作　　者：邵加庆[1] 于镔[2] 赵明[1] 王燕燕[1] 王坚[1] 田成功[3] 

机构地区：[1]南京军区南京总医院内分泌科,江苏南京210002 [2]山东省立医院急诊科,山东济南250021 [3]南京大学医学院附属鼓楼医院内分泌科,江苏南京210008

出　　处：《医学研究生学报》2005年第7期614-617,共4页Journal of Medical Postgraduates

摘　　要：目的:探讨江苏南京地区健康人群中体重指数(BMI)、腰臀围比(WHR)、腹围(AC)这三种人体测量值以及脂质代谢指标与胰岛素抵抗的相关性。方法:对3445例南京地区18～90岁长期居住汉族健康成人的BMI、WHR、AC进行流行病学调查,对受检者检测身高(m)、体重(kg)、腰围(cm)、AC(cm)、臀围(cm),并测定空腹血清总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL C)、低密度脂蛋白胆固醇(LDL C)、载脂蛋白A(apoA)、载脂蛋白B(apoB)和空腹血糖(FPG)、真胰岛素(TI)及免疫反应性胰岛素(IRI)。分别以Si1=1/(FPG×TI)和Si2=1/(FPG×IRI)作为胰岛素敏感指数(Si),对BMI、WHR、AC和脂质代谢指标与胰岛素抵抗的相关性进行分析。结果:在去除年龄、性别对血糖代谢的影响以及几种测量指标和脂质代谢指标之间的相互影响后,BMI与FPG、TI呈现显著正相关,与Si1呈现显著负相关(r=-0.261,P<0.001);TG与TI呈现显著正相关(r=0.170,P<0.01),而与Si1呈现显著负相关(r=-0.158,P=0.001),多元逐步回归也证实了Si1与BMI、TG呈显著负相关。所有指标与Si2均无相关性。结论:BMI和血清TG是评价胰岛素敏感性和胰岛素抵抗的最佳指标。TI与肥胖和脂质代谢紊乱相关性明显强于IRI,以TI计算的胰岛素敏感指数与肥胖和脂质代谢紊乱的相关性明显强于以IRI计算的胰岛素敏感指数。TI和以TI计算的胰岛素敏感指数是理想的胰岛素抵抗观测指标。Objective:To assess relationship of obesity,serum lipid levels and insulin resistance in healthy population of Nanjing,Jiangsu Province. Methods: BMI, WHR and abdomen circumference were studied on 3 445 healthy cases aged 18-90 in Nanjing.All cases had their height,weight,waist circumference, abdomen circumference and hip circumference measured.Total cholesterol,serum triglycerides,LDL-C,HDL-C,apoA,apoB,FPG,true insulin(TI) and immunoreactive insulin(IRI) were measured in part of them. Si_(1)=1/(FPG×TI) and Si_2=1/(FPG×IRI)were used to analysis relation between anthropometric variables,plasma lipids and insulin resistance. Results: After influence of sex and age and interaction of the nine measures themselves removed,BMI was positive connected with FPG,TI, and was inversely connected with Si_(1)(r=-0.261,P<0.001); TG was positive related to TI(r=0.170,P<0.01),and inversely related to Si_(1) (r=-0.158,P=(0.001)). Multiple Linear regression analysis also proved the results above. Conclusion: BMI and TG were the best indicators of insulin sensitivity and insulin resistance. True insulin and insulin sensitivity index calculated by true insulin were optimal indicators for insulin resistance.

关 键 词：体重指数 血脂 胰岛素抵抗 

分 类 号：R587[医药卫生—内分泌]