中老年人内脏脂肪面积与颈动脉内中膜厚度的相关性  

A research on the correlation between visceral fat area and carotid intima-media thickness in the middle-aged and elderly people

作　　者：蓝薇[1] 谢帆慈 戴亚丽[2] 陈霞[1] 张季声[1] 叶敏[1] 刘佳[3] LAN Wei;XIE Fan - ci;DAI Ya - li;CHEN Xia;ZHANG Ji - sheng;YE Min;LIU Jia(Department of International Medical Treatment & Special Clinic,Peking University Shenzhen Hospital,Shenzhen 518036, Guangdong,China)

机构地区：[1]北京大学深圳医院国际医疗部特诊门诊,广东深圳518036 [2]北京大学深圳医院内分泌科,广东深圳518036 [3]广州医科大学附属第三医院临床营养科,广东广州510150

出　　处：《广东医学》2019年第10期1414-1418,共5页Guangdong Medical Journal

基　　金：广东省自筹经费类科技计划项目(编号:2017ZC0251)

摘　　要：目的探讨中老年人内脏脂肪面积(VFA)与颈动脉内中膜厚度(IMT)及相关代谢指标的关系,为中老年人健康管理提供新的理论依据。方法选取特诊门诊所有中老年体检人群。所有研究对象均完善问卷调查,并完成体格检查,应用生物电阻抗法测定VFA,应用彩超测定IMT,采集空腹静脉血测定血糖、血脂、血尿酸(UA)、糖化血红蛋白(HbA1C)、空腹胰岛素、血清脂蛋白相关磷脂酶A2(Lp-PLA2),计算稳态模型胰岛素抵抗指数(HOMA-IR)。结果 VFA异常组,男50例(68.49%),多于女23例(31.51%);VFA异常组和正常组比较,性别、年龄、收缩压、HbA1C、FINS、HOMA-IR、Lp-PLA2、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、体质指数(BMI)、腰臀比(WHR)、IMT差异有统计学意义(P<0.05);Pearson分析显示,VFA与年龄、FINS、HOMA-IR、TC、TG、LDL-C、Lp-PLA2、BMI、WHR、IMT(r=0.166、0.290、0.389、0.259、0.344、0.698、0.505、0.858、0.714、0.693,均P<0.05)呈正相关;将VFA、BMI、WHR分别与IMT比较,均呈正相关性,且差异有统计学意义(P<0.05),三者相关系数比较,VFA=0.693>BMI=0.558>WHR=0.555;多元线性回归分析发现VFA、HOMA-IR、TG、LDL-C、Lp-PLA2是影响颈动脉IMT的独立危险因素,且差异有统计学意义(P<0.05)。结论中老年男性更容易出现内脏脂肪堆积,VFA较常用人体测量学指标与IMT的增加关系更紧密,两者之间可能存在以炎症反应为基础,胰岛素抵抗为核心的机制。Objective To discuss the correlation between visceral fat area ( VFA),carotid intima - media thick- ness ( IMT) and related metabolic indicators,so as to provide a new theoretical basis for the health management in the middle - aged and elderly people. Methods All the middle - aged and elderly people in physical examination in VIP clinic were selected. After thorough questionnaires and physical examination,bioelectrical impedance test and carotid artery ultrasonography were performed to measure the visceral fat area and carotid artery intima - media thickness. Mean- while,fasting venous blood was collected for determining blood glucose,blood lipid,uric acid,glycated hemoglobin,fast- ing insulin,Lp - PLA2 and et al,and HOMA - IR was calculated. Results In the VFA abnormal group,males ( 50 ca- ses) were far more than females ( 23 cases),with the ratio of 68. 49% to 31. 51%. The difference of gender,age,systol- ic pressure,HbA1C,FINS,HOMA - IR,Lp - PLA2,total cholesterol ( TC),triglyceride ( TG),low density lipoprotein ( LDL - C),BMI,WHR and IMT between the abnormal group and the normal group were statistically significant ( P < 0. 05). Pearson analysis showed that VFA was positively correlated with age,FINS,HOMA - IR,TC,TG,LDL - C,Lp - PLA2,BMI,WHR and IMT ( r = 0. 166,0. 290,0. 389,0. 259,0. 344,0. 698,0. 505,0. 858,0. 714,0. 693,P < 0. 05). The results showed significantly positive correlation in the comparison between VFA,BMI,WHR and IMT ( P < 0. 05). Multiple linear regression analysis showed that VFA,HOMA - IR,TG,LDL - C and Lp - PLA2 were independent risk factors for carotid artery IMT. Conclusion Visceral fat accumulation is more likely to occur in the middle - aged and elderly males,and is more closely related to the increase of carotid intima - media thickness than the commonly used anthropometric indexes.

关 键 词：中老年人 内脏脂肪面积 颈动脉内中膜厚度 炎症反应 胰岛素抵抗 

分 类 号：R195[医药卫生—卫生统计学] R58[医药卫生—卫生事业管理]