心外膜脂肪组织厚度与糖尿病大血管病变相关性的观察  

The relationship between the thickness of epicardial adipose tissue and diabetic macroangiopathy

作　　者：谢程文 官滨斌[2] 周宇[2] 刘礼斌[2] XIE Chengwen;GUAN Binbin;ZHOU Yu;LIU Libin(Department of Ultrasonography,the First Hospital of Longyan Affiliated to Fujian Medical University,Longyan 364000,China)

机构地区：[1]福建医科大学附属龙岩市第一医院超声科,364000 [2]福建医科大学附属协和医院内分泌科、福建省内分泌研究所

出　　处：《中国糖尿病杂志》2019年第7期502-506,共5页Chinese Journal of Diabetes

摘　　要：目的探讨经超声测量的心外膜脂肪组织(EAT)厚度与糖尿病大血管病变的相关性。方法选取2016年8月至2018年2月于福建医科大学附属协和医院内分泌科住院的T2DM患者91例,依据肱-踝动脉脉搏波传导速度(baPWV)分为糖尿病无大血管病变组(N-MA,n=17)、糖尿病大血管病变组(E-MA,n=74);另选取40名健康人群为对照组(NC)。测量各组EAT厚度,观察EAT厚度与糖尿病大血管病变的关系;分析各组临床资料及生化指标,探讨EAT厚度与糖尿病大血管病变可能的相关机制。结果E-MA组EAT厚度高于NC、N-MA组(P<0.05)。Pearson相关性分析显示,EAT厚度与BMI、WC、臀围、WHR、SBP、DBP、TG、FFA、SUA、hsC-RP、同型半胱氨酸、纤维蛋白原、baPWV呈正相关(P<0.05),与HDL-C呈负相关(P<0.05)。多元逐步回归分析显示,EAT厚度与baPWV呈独立正相关(标准化回归系数=0.670,P<0.05);ROC曲线显示,曲线下面积为0.807(P<0.05)。将约登指数的最大值作为诊断分界点,EAT≥4.58 mm诊断糖尿病合并大血管病变的敏感性为0.703,特异性为0.941。结论超声测量EAT简便无创,可用于诊断糖尿病大血管病变。Objective To explore the correlation between epicardial adipose tissue(EAT)thickness and diabetic macroangiopathy.Methods A total of 91 hospitalized patients with type 2 diabetes mellitus(T2 DM)were enrolled in this study from Department of Endocrinology,Union Medical College Hospital Affiliated to Fujian Medical University from August 2016 to February 2018. All the participants were divided into two groups:T2 DM without macroangiopathy group(N-MA group,n=17)and T2 DM with macroangiopathy group(E-MA group,n=74)according to the results of brachial-ankle pulse wave velocity(baPWV). Healthy subjects were enrolled as control group(NC group,n=40). The thickness of EAT was measured. The relationship between EAT and diabetic macroangiopathy was evaluated. Clinical characteristics and blood test results were compared among the three groups in order to explore the possible mechanisms of EAT and diabetic macroangiopathy.ResultsThe thickness of EAT was significantly higher in E-MA group than in N-MA and NC group(P<0. 05). Association analysis showed that EAT was positively correlated with body mass index(BMI),waist circumference(WC),hip circumference(HP),systolic blood pressure(SBP),diastolic blood pressure(DBP),triglyceride(TG),free fatty acid(FFA),Uric acid(SUA),high-sensitivity C-reactive protein(hsC-RP),homocysteine(Hcy),fibrinogen(FIB),and baPWV(P<0. 05),while negatively correlated with HDL-C(P<0. 05). The multiple stepwise regression analysis showed that ETA was positively and independently correlated with baPWV(P<0. 05). The area under the curve(AUC)was 0. 807(P<0. 05). The maximum value of Jordan index was used as the diagnostic cut-off point,diabetic macroangiopathy can be diagnosed if the thickness of epicardial adipose tissue is greater than 4. 58,and the sensitivity and specificity were 0. 703 and 0. 941 respectively.Conclusion Ultrasonography measurement the thickness of EAT is convenient and non-invasive. It can be used to diagnose diabetic macroangiopathy.

关 键 词：心外膜脂肪组织 糖尿病 大血管病变 超声波检查 炎症因子 

分 类 号：R587.2[医药卫生—内分泌] R54[医药卫生—内科学]