代谢综合征患者腹内脂肪面积与血清磷脂多不饱和脂肪酸谱的关系  

The relationship between area of intra-abdominal fat and serum phospholipids polyunsaturated fatty acids composition in patients with metabolic syndrome

作　　者：龚维坤[1] 童竑章 罗建平[3] 赖静波 楼大钧[4] 胡静艳 郭小芳[1] 王苏华[1] 罗滢[1] 

机构地区：[1]宁波大学医学院附属鄞州医院内分泌代谢科,315040 [2]宁波大学医学院附属鄞州医院影像科,315040 [3]宁波大学医学院附属鄞州医院中心实验室,315040 [4]绍兴市人民医院内分泌代谢科,312000

出　　处：《中华内分泌外科杂志》2015年第1期50-55,共6页Chinese Journal of Endocrine Surgery

基　　金：宁波市医学科研计划项目（2005105）;鄞州区农业与社会发展项目（2006）

摘　　要：目的 本研究拟探讨代谢综合征患者核磁共振测量的腹腔内脏脂肪面积（magnetic resonance imaging measured area of intra—abdominal fat，MRI—IAF）、腰围、体重指数（body mass index，BMI）和其他代谢指标与血清磷脂多不饱和脂肪酸（polyunsaturated fatty acid，PUFA）的关系。方法 比较36例代谢综合征及41例正常健康对照组MRI—IAF及其他体脂与代谢参数和血清磷脂多不饱和脂肪酸谱的差异，分析代谢综合征患者MRI—IAF及其他体脂与代谢参数与各多不饱和脂肪酸的相关性，且以相关的多不饱和脂肪酸为被筛选变量，逐步回归分析其对MRI—IAF、腰围和BMI的影响。结果 代谢综合征组的MRI—IAF（t=18．96．P〈0．001）、腰围（t=11．24，P〈0．001）、BMI（t=7．492，P〈0．001）及空腹血糖（t=8．146，P〈0．001）和胰岛素（Z=-2．374，P=0．018，非参数检验）等较对照组差异有统计学意义，n-3多不饱和脂肪酸（n-3 PUFA）低于健康对照组（t=3．018，P=0．003），n-6 PUFA组间无差异（t=0．898，P=0．372）。总n-3 PUFA及C22：6n-3（DHA）等与MRI—IAF、腰围、BMI显著相关（P=0．012～〈0．001），总n-3 PUFA与胰岛素抵抗指数（r=-0．364，P=0．029）、甘油三酯（r=-0．526，P=0．001）、空腹血糖（r=-0．349，P=0．037）相关。总n-3 PUFA对MRI—IAF（R^2=0．410，P〈0．001）、BMI（R^2=0．179，P=0．031）及DHA对腰围（R^2=0．228，P=0．002）的预测作用较其他脂肪酸强。结论 代谢综合征患者腹内脏脂肪面积及其他体脂与代谢参数与血清磷脂总n-3 PUFA、DHA等负相关，n-6 PUFA没有显示这样的关系。总n-3 PUFA和DHA等是代谢的保护因素，对内脏脂肪的预测作用较大。Objective To investigate the relationship among the magnetic resonance imaging measured area of intra-abdominal fat （MRI-IAF） and serum phospholipids fatty acid composition of patients with metabolic syndrome. Methods We compared the differences of MRI-IAF and serum phospholipids polyunsaturated fatty acid composition of 36 cases with metabolic syndrome and 41 cases in the control group. We also investigated the relevance among MRI-IAF, waist circumference, body mass index （BMI） and the polyunsaturated fatty acids of patients with metabolic syndrome. A stepwise regression analysis was applied to determine which kind of fatty acid can predict body fat parameters more potent. Results MRI-IAF, other body fat or metabolic parameters and serum phospholipids fatty acid composition of the metabolic syndrome group were worse than those in the control group. Most of the n-3 PUFAs but not n-6 PUFAs decreased in the metabolic syndrome group. N-3 PUFA was related to homeostasis model of assessment for insulin resistance index（HOMA-IR） （r = -0. 364 ,P = 0. 029） , triglycerides（r = -0. 526,P =0. 001 ）, and fasting glucose（r = -0. 349,P =0. 037）. N-3 PUFA and C22：6 n-3 PUFA （DHA） were notably related to MRI-IAF, waist circumference and BMI （ P = 0. 012 - 〈 0. 001 ）. A stepwise regression analysis showed that n-3 PUFA （to MRI-IAF, R^2 = 0. 410, P 〈 0. 001; to BMI,R^2 =0. 179, P =0. 031 ） or DHA to waist circumference, R^2 =0. 228, P = 0. 002） was more potent to predict MRI-IAF and BMI or waist circumference than other PUFAs. Conclusions MRI-IAF and other body fat or metabolic parameters in patients with metabolic syndrome were inversely associated with n-3 PUFA and DHA, while n-6 PUFA did not show such a relation. N-3 PUFA and DHA were more potent than other PUFAs to predict visceral fat-related parameters.

关 键 词：代谢综合征 核磁共振 腹内脂肪 多不饱和脂肪酸 

分 类 号：R589[医药卫生—内分泌]