趾臂指数与体脂在糖尿病下肢血管病变的研究  

The relationship between toe-brachial index and body fat and its role in diabetic lower extremity vascular disease risk assessment

作　　者：石静琳 史琳涛[3] 张美[3] 刘彦君[2,3] 范明[1] 

机构地区：[1]安徽医科大学军事医学科学院基础医学研究所,北京100850 [2]安徽医科大学解放军第306临床学院 [3]解放军第306医院内分泌科,北京100101

出　　处：《安徽医科大学学报》2016年第1期109-113,共5页Acta Universitatis Medicinalis Anhui

基　　金：国家科技重大专项子课题(编号:2011ZX09307-001)

摘　　要：目的通过分析2型糖尿病患者趾臂指数(TBI)与体脂之间的关系,了解体脂对2型糖尿病患者TBI的影响,探讨TBI及体脂在糖尿病下肢血管病风险评估中的意义。方法选择收集踝肱指数(ABI)及TBI均在正常范围内的2型糖尿病患者123例,收集患者一般资料、临床生化指标,应用人体成分分析仪定量测量身体不同部分的主要成分。将TBI按百分位数P50分为2组,TBI较高组:0.82≤TBI<1.12;TBI较低组:0.60<TBI<0.82。将各组间身体成分进行比较,分析体脂成分与TBI之间的关系。结果 TBI较低组患者的2型糖尿病病程、糖化血红蛋白(HbA 1c)、空腹血糖(FPG)、餐后血糖(PBG)、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(LDLC)、胰岛素抵抗指数(HOMA-IR)均无明显差异。而TBI较低组与TBI较高组相比,卧位收缩压、卧位血压差、体脂百分比(PBF)、身体年龄、内脏脂肪/躯干肌肉、上肢脂肪/上肢肌肉、下肢脂肪/下肢肌肉均升高。多元逐步回归分析提示身体年龄、立位压差、PBF为TBI降低的独立危险因素。结论在ABI正常的2型糖尿病患者中,TBI越低,体脂含量越多,身体年龄及脉压差越大,体脂含量增多与身体年龄及脉压差增大均为TBI降低的独立风险因素。重视TBI及体脂检测对于2型糖尿病患者下肢血管病变风险早发现及早干预有积极的作用。Objective By analyzing the correlation between toe-brachial index （TBI） and body fat in type 2 dia- betic patients （DM） , to understand the impact of body fat on TBI in DM, and explore significance of TBI and body fat in evaluating diabetic lower extremity vascular disease. Methods 123 cases of DM whose ankle-brachial index （ABI） and TBI were both within normal ranges,collected demographic characteristics, elincal and biochamical in- dicators were measured,the main components of the quantitative of different body parts were measured by BCA-2 type a body composition analyzer. TBI was divided into two groups by persantage 50, higher TBI group ： 0. 82 ≤ TBI 〈 1.12, lower TBI group：0.60 〈 TBI 〈0.82. We compared two groups of body composition,and analysed the relationship between the body fat and TBI. Results There were no significant differences of DM duration, ABI, hemoglobin A1 c （ HbA1 c ）, fasting plasma glucose （ FPG）, postprandial blood glucose （ PBG）, triglyceride （ TG）, total cholesterol （TC）, homeostasis model assessment for insulin resistance （HOMA-IR）, high-density lipoprotein- cholesterol （HDL-C）, low-density lipoprotein-cholesterol（LDL） were found between the two groups. Compared with lower TBI group, systolic blood pressure （SBP） of supine, pulse pressure of supine, percentage of body fat （PBF）, physical age, visceral fat/trunk muscles, fat/muscle of upper limbs, fat/muscle of lower limbs were sig- nificantly increased in higher TBI group. Multiple regression analysis showed that physical age, pulse pressure of orthostatic, percentage of body fat were independent risk factors for lowering TBI. Conclusion Our study finds that the lower the TBI, the more body fat content, physical age and pulse pressure in DM with normal ABI. In- creased body fat content, body age and pulse pressure are independent risk factors for TBI reduced. The result sug- gests that it is important to check TBI and body fat for detection and intervention earlier in the r

关 键 词：2型糖尿病 趾臂指数 体脂 糖尿病下肢血管病变 

分 类 号：R587.1[医药卫生—内分泌] R589.2[医药卫生—内科学]