腹腔内脏脂肪面积与2型糖尿病及血清胰岛素的相关研究  

A association of visceral adipose area with type 2 diabetes and serum insulin

作　　者：谭擎缨[1] 姚佳琦[1] 王秀景[1] 王静[1] 阮勇[1] 阮芸[1] 

机构地区：[1]解放军117医院内分泌科,浙江杭州310013

出　　处：《东南国防医药》2015年第1期12-15,共4页Military Medical Journal of Southeast China

基　　金：南京军区医学科技创新课题面上项目(11MA124)

摘　　要：目的观察腹腔内脏脂肪面积(VA)与2型糖尿病及血清胰岛素的关系。方法 2型糖尿病患者273例,非糖尿病者122例,分为高脂肪组198例和低脂肪组197例。检测空腹血糖(FPG)、空腹胰岛素(FINS)、糖化血红蛋白(Hb A1C)、尿酸(UA)、游离脂肪酸(FFA)、血脂系列等相关指标,采用CT测定VA,计算胰岛素抵抗指数(HOMA-IR)、体质指数(BMI)。结果糖尿病组的VA显著高于非糖尿病组(P<0.05),高脂肪组的腰围、BMI、UA、FINS、TG、IR、FFA、舒张压、收缩压明显高于低脂肪组(P<0.05),HDL明显低于低脂肪组(P<0.05)。腰围、BMI、FINS、UA、IR、TG、舒张压、收缩压、FFA与腹腔内脏脂肪面积呈正相关(r=0.697、0.625、0.374、0.371、0.332、0.317、0.181、0.136、0.110,均P<0.05),HDL与VA呈负相关(r=-0.230,P<0.05)。腰围、FINS、UA为VA的独立危险因素(b=6.657、2.819、2.405,均P<0.05)。结论内脏脂肪增加伴有胰岛素水平增高,胰岛素抵抗加重,糖尿病风险增加,并出现血压、尿酸、脂肪酸、胰岛素等多项代谢指标的异常。Objective To evaluate the relationship between visceral adipose area （ VA） , type 2 diabetes and insulin .Meth-ods We collected the clinical data , VA, fasting blood glucose （ FPG） , serum fasting levels of insulin （ FINS） , glycosylated hemoglo-bin （HbA1C）, serum uric acid （UA）, free fat acid （FFA） and blood lipids of from totally 273 cases of type 2 diabetics and 122 non-diabetics in our hospital .Insulin resistance index （ HOMA-IR） and body mass index （ BMI） were calculated .Based on median of VA , patients were divided into high adipose group （VA≥144.21 cm2） and low adipose group （VA〈144.21 cm2）.Results VA was more increased in diabetes group （273 cases） compared with non-diabetes group （122 cases） （P〈0.05）.The waist, BMI, UA, FINS, TG, IR, DBP, FFA and SBP were more increased in more-fat group （198 cases） compared with little-fat group （197 cases） （both P〈0.05）.HDL were more decreased in more-fat group compared with little-fat group （P〈0.05）.VA was positively correla-ted with waist, BMI, FINS, UA, IR, TG, DBP, SBP and FFA （r=0.697, 0.625, 0.374, 0.371, 0.332, 0.317, 0.181, 0.136 and 0.110;all P〈0.05） and negatively correlated with HDL（r=-0.230, P〈0.05）.Stepwise multiple regression analysis indicated that waist, FINS and UA were independent risk factor for VA （b=6.657, 2.819 and 2.405, all P〈0.05）.Conclusion With the expansion of VA , the serum fasting levels of insulin , IR and risk of diabetes increase , blood pressure , UA, FA and FINS are abnor-mal.

关 键 词：腹内脂肪 2型糖尿病 胰岛素 

分 类 号：R587.1[医药卫生—内分泌]