相同体成分构成比肥胖女性胰岛功能状态与血压相关性分析  

Correlation analysis between islet function condition and blood pressure in obese women with the same body composition

作　　者：张雅萍[1] 赵曦乐[1] 严孙杰[1] 沈喜妹[1] 黄凌宁[1] 杨立勇[1] 张松菁[1] 易如海[1] 

机构地区：[1]福建医科大学附属第一医院内分泌科,福州350005

出　　处：《中华糖尿病杂志》2011年第2期121-125,共5页CHINESE JOURNAL OF DIABETES MELLITUS

基　　金：福建省教育厅科技项目（JA05263）

摘　　要：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.

关 键 词：肥胖 体成分 静脉葡萄糖耐量试验 胰岛功能状态 血压 

分 类 号：R587.1[医药卫生—内分泌]