老年2型糖尿病病人腹部脂肪分布特点及与代谢性因素的相关性研究  

Characteristics of abdominal fat distribution in elderly patients with type 2 diabetes measured by a dual bioelectrical impedance analyzer and the association with metabolic factors

作　　者：雷海燕[1] 滕磊[1] 柏晓勇[1] 叶小珍[1] 王瑞风[1] 王扬天[1] 邵加庆[1] LEI Hai-yan;TENG Lei;BAI Xiao-yong;YE Xiao-zhen;WANG Rui-feng;WANG Yang-tian;SHAO Jia-qing(Department of Endocrinology,Nanjing General Hospital of PLA,Nanfing 210002,China)

机构地区：[1]中国人民解放军南京军区南京总医院内分泌科,江苏省南京市210002

出　　处：《实用老年医学》2018年第9期852-855,共4页Practical Geriatrics

基　　金：中国人民解放军南京军区南京总医院院管课题(2017033)

摘　　要：目的研究老年2型糖尿病病人的腹部脂肪分布特点及与代谢性因素的相关性。方法入选年龄60~80岁的2型糖尿病病人168例,采用双重生物电阻抗法测量内脏脂肪面积(VFA),将体质量指数(BMI)<24,VFA<100 cm2病人分为A组;BMI<24,VFA≥100 cm2病人为B组;BMI≥24,VFA<100 cm2病人为C组;BMI≥24,VFA≥100 cm2病人为D组,分析VFA与代谢性因素的相关性。结果 D组合并高血压病史最长,血尿酸(UA)水平最高,空腹胰岛素(FINS)及餐后2 h胰岛素(PINS)水平较A组和C组显著升高(P<0.05)。Pearson相关分析显示,年龄、高血压病史、UA、甘油三酯(TG)、FINS及2h PINS、胰岛素抵抗指数(HOMA-IR)与VFA呈正相关(P<0.05),高密度脂蛋白胆固醇与VFA呈负相关(r=-0.369,P<0.05)。多重线性回归分析显示VFA为HOMAIR的独立危险因素(β=0.042,P=0.048)。结论老年2型糖尿病病人腹部内脏脂肪蓄积普遍存在,内脏脂肪蓄积与高血压、血脂紊乱、高胰岛素血症、胰岛素抵抗、高尿酸血症显著相关,增加代谢紊乱风险。Objective To investigate the characteristics of abdominal fat distribution and the correlation with metabolic factors in the elderly patients with type 2 diabetes mellitus（ T2 DM）. Methods A total of 168 cases（ aged 60-80 years） with T2 DM underwent the measurement of visceral fat area（VFA） by a dual bioelectrical impedance analyzer were recruited and divided into group A [body mass index（ BMI） 24,VFA 100 cm^2],group B（BMI 24,VFA≥100 cm^2）,group C（BMI≥24,VFA 100 cm^2） and group D（ BMI≥24,VFA≥100 cm^2）. The relationship between VFA and indexes of metabolic factors was analysed. Results Group A showed longest disease history of hypertension,and highest level of blood uric acid（ UA）. The levels of fasting insulin（ FINS） and postprandial insulin（PINS） in group D were higher than those in group A and group C（ P〈0. 05）. Pearson correlation analysis showed that age,history of hypertension,uric acid（ UA）,triglyceride（ TG）,FINS and2 h PINS,HOMA-IR were positively correlated with VFA（ P〈0. 05）,and high density lipoprotein choleslerol（ HDL-C） was negatively correlated with VFA（ r =-0. 369,P〈0. 05）. Multiple linear regression analysis showed that VFA was an independent risk factor of HOMA-IR（ β = 0. 042,P =0. 048）. Conclusions Abdominal visceral fat accumulation is prevalent in the elderly patients with T2 DM（63. 66%）. Visceral fat accumulation is significantly associated with hypertension,dyslipidemia,hyperinsulinemia,insulin resistance and hyperuricemia,and increases the risk of metabolic disorders.

关 键 词：内脏脂肪面积 双重生物电阻抗法 代谢性因素 老年人 2型糖尿病 

分 类 号：R587.1[医药卫生—内分泌]