BMI正常男性2型糖尿病患者腹腔内脏脂肪面积与胰岛素抵抗的关系  

Abdominal visceral fat area and its relationship with insulin resistance in male patients with type 2 diabetes and normal body mass index

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

机构地区：[1]解放军第一一七医院内分泌科,浙江省杭州310013

出　　处：《中华全科医师杂志》2015年第8期599-602,共4页Chinese Journal of General Practitioners

基　　金：南京军区医学科技创新课题面上项目

摘　　要：目的 探讨BMI正常的男性2型糖尿病患者腹腔内脏脂肪面积（VFA）及其与胰岛素抵抗的关系.方法 应用CT测量70例BMI正常的男性2型糖尿病患者的VFA,VFA≥100cm2的50例为内脏肥胖组,VFA＜100 cm2的20例为非内脏肥胖组,检测各项糖脂代谢指标,计算稳态模型评估的胰岛素抵抗指数（HOMA-IR）.结果 70例男性2型糖尿病患者中,内脏型肥胖者占71％（50/70）;腰围≤90 cm者59例,其中69％ （41/59）为内脏型肥胖.与非内脏肥胖组比较,内脏肥胖组的腰围[（86.4±5.6）与（81.2±4.8） cm,t=-2.980,P＜0.01]、HOMA-IR（2.83 ±2.31与2.01±1.30,t=-2.025,P ＜0.05）、TG[1.93（1.26-2.79）与1.11（0.75 - 1.46） mmol/L,Z=-3.777,P＜0.01]、VFA [（143.6±31.8）与（73.7±17.3）cm2,t=-11.456,P＜0.01]水平均明显增高,空腹胰岛素、空腹血糖、糖化血红蛋白水平也有增高趋势,但差异无统计学意义（均P＞0.05）.多元线性回归显示,在校正年龄、BMI后,VFA与lnHOMA-IR呈正相关（r=0.240,P＜0.05）.结论 BMI和腰围是评价肥胖的常用指标,但在BMI及腰围均正常的男性2型糖尿病患者当中,大部分仍存在内脏型肥胖,VFA与胰岛素抵抗密切相关.Objective To investigate abdominal visceral fat area and its relationship with insulin resistance in male patients with type 2 diabetes and normal body mass index （BMI）.Methods Seven male patients with type 2 diabetes and normal BMI were divided into two groups according to the abdominal visceral fat area （VFA） measured by CT：visceral obesity group （VFA ≥ 100 cm2） and non-visceral obesity group.Indicators of glucose and lipids metabolism were measured in two groups.Results Among 70 patients 50 （71%） had visceral obesity.In 59 patients who had normal BMI and normal waist circumference （≤90 cm）,41 presented visceral obesity （69%）.Compared with non-visceral obesity group,the waist circumference,homeostasis model assessment of insulin resistance （HOMA-IR）,triglyceride,and VFA were significantly higher in visceral obesity group [（86.4 ± 5.6） vs.（81.2 ± 4.8） cm,t =-2.980,P 〈 0.01;2.83±2.31 vs.2.01±1.30,t=-2.025,P〈0.05;1.93（1.26-2.79） vs.1.11（0.75-1.46） mmol/L,Z=-3.777,P〈0.01;（143.6 ±31.8）vs.（73.7 ±17.3）cm2,t =-11.456,P〈0.01].Fasting insulin,fasting plasma glucose and glycosylated hemoglobin tended higher in visceral obesity group but not significantly （P 〉 0.05）.Multiple linear regression analysis showed that after adjustment for age and body mass index,abdominal VFA was positively correlated with HOMA-IR （r =0.240,P 〈 0.05）.Conclusion Male type 2 diabetic patients have a high rate of visceral obesity even when their body mass index and waist circumference are normal.Abdominal visceral fat area is closely associated with insulin resistance.

关 键 词：糖尿病 2型 腹内脂肪 胰岛素抗药性 男性 肥胖症 

分 类 号：R587.1[医药卫生—内分泌]