定量CT测量的腹部脂肪分布与血脂和血糖的关系  

Relationships between abdominal visceral and subcutaneous fat measured by Quantitative CT with blood glucose and lipid

作　　者：娄路馨[1] 王玲[1] 李娜[1] 徐黎[1] 邓薇[2] 刘桐希[1] 赵兴山[3] 高兴军 程晓光[1] 

机构地区：[1]北京大学北京积水潭医院放射科,北京100035 [2]北京大学北京积水潭医院内分泌科,北京100035 [3]北京大学北京积水潭医院心内科,北京100035 [4]信阳中心医院,河南省464000

出　　处：《中国骨质疏松杂志》2012年第11期1004-1007,共4页Chinese Journal of Osteoporosis

基　　金：北京市卫生系统高层次卫生技术人才培养项目(2009-02-03)

摘　　要：目的探讨腹部内脏脂肪面积(VFA)和皮下脂肪面积(SFA)与血脂、血糖代谢水平的关系。方法 2010年于我院行腰椎定量CT(QCT)检查患者277名,年龄范围14～90岁,中位年龄63岁。使用QCT脂肪测量软件测量脐水平层面VFA和SFA;同时获得患者静脉血总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)及空腹血糖(FBG)实验室检查结果。为了使正常组和异常组年龄匹配,取年龄40岁及以上病例(246例),根据TC、TG、HDL-C、LDL-C、FBG结果的正常、异常,将VFA和SFA数据分组进行独立样本非参数检验。计算全部病例(277例)正常、异常组VFA和SFA值的95%可信区间,并做VFA和SFA与各项实验室指标的相关性分析。结果 TC、TG、HDL-C、LDL-C正常、异常组间VFA值均有显著性差异(P<0.05);TG正常、异常组间SFA值有显著性意义(P<0.05)。VFA与TG、TC、FBG的相关性(r=0.247,0.326,0.190)大于SFA(r=0.210,0.151,0.111)。结论血脂代谢正常、异常人群腹部脂肪面积不同,异常人群大于正常人群。VFA与血糖、血脂的相关性更大,其中TG为最明显相关因素。根据血糖、血脂异常组脂肪面积的95%可信区间可知,本组研究中,高血脂患者的VFA大于140.3 cm2,SFA大于187.2 cm2;高血糖患者的VFA大于140.5 cm2。腹脂面积临界值的确定还有待做更大样本的测量。Objective To explore the relationships between abdominal visceral fat area （VFA）, subcutaneous fat area （SFA） measured by quantitative CT（QCT） and blood glucose and lipid. Methods Two hundreds and seventy-seven subjects were selected from the patients who underwent QCT exam of lumbar spine, aged 14 -90 years, median age 63 years. VFA and SFA in umbilicus level were measured by the QCT software. The total cholesterol （ TC）, triglyceride （ TG）, high derisity lipoprotein cholesterol （ HDL- C） , low-density lipoprotein cholesterol （LDL-C） and fasting blood glucose （FBG） of blood were obtained. According to TC, TG, HDL-C, LDL-C, FBG results, 246 subjects 〉40 years old were classified as normal group and abnormal group, nonparametric test was performed to determine the difference of VFA and SFA between groups. The 95% confidence interval of all normal and abnormal group of VFA and SFA （277 cases） were calculated. The Pearson correlation was performed between the VFA, SFA and laboratory parameters. Results There were significant differences between TC, TG, HDL-C, LDL-C to normal and abnormal group of the VFA values （P 〈 0.05）. Significant difference was also found between TG to normal and abnormal group of the SFA values （P 〈 0.05）. VFA and TG, TC, FBG correlation test （ r = 0. 247, 0.326, 0.190） is greater than the SFA （r =0.210, 0.151, 0.111）. Conclusion The normal and abnormal blood lipid metabolism populations have different abdominal fat area. The correlation between VFAand blood glucose, blood lipids are greater than others, in which TG is the most obvious factor. In our study, when VFA 〉 140.3 cm2 or SFA 〉 187.2 cm2 the subjects have high risk for high cholesterol and when VFA 〉 140. 5 cm2 the subjects have high risk for high blood glucose. Large sample study is warranted to validate the critical value.

关 键 词：腹内脂肪 皮下脂肪 定量CT 代谢 

分 类 号：R815[医药卫生—放射医学] R68[医药卫生—临床医学]