原发性醛固酮增多症患者的腹部脂肪分布特点  

Characteristics of abdominal fat distribution in patients with primary aldosteronism

作　　者：朱贝贝 吴艳[2] 任高飞[1] 张鹏宇[1] 郭小青 高月 邢晶晶[1] 熊慧勤 栗夏莲[1] Zhu Beibei;Wu Yan;Ren Gaofei;Zhang Pengyu;Guo Xiaoqing;Gao Yue;Xing Jingjing;Xiong Huiqin;Li Xialian(Department of Endocrinology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Department of Radiology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院内分泌科,450052 [2]郑州大学第一附属医院放射科,450052

出　　处：《中华内分泌代谢杂志》2019年第10期834-837,共4页Chinese Journal of Endocrinology and Metabolism

摘　　要：目的比较原发性醛固酮增多症(primary aldosteronism,PA)和原发性高血压(essential hypertension,EH)患者的腹部脂肪分布,分析腹部脂肪面积与糖脂代谢及胰岛素抵抗等指标的相关性。方法收集郑州大学第一附属医院2016年9月至2019年2月以"高血压原因待查"入院最终确诊为PA患者45例及EH患者55例。所有研究对象在行肾上腺CT的同时行定量CT测定腹部总脂肪面积(TFA)、内脏脂肪面积(VFA)及皮下脂肪面积(SFA),以VFA≥130 cm2为内脏型肥胖,计算内脏脂肪面积占总脂肪面积百分比(V%=VFA/TFA)、内脏脂肪面积与皮下脂肪面积之比(V/S=VFA/SFA)和内脏型肥胖所占百分率。结果在年龄、性别和体重指数(BMI)匹配的条件下,EH组TFA和VFA高于PA组(均P<0.01),2组SFA、V%、V/S和内脏型肥胖所占百分率差异均无统计学意义。PA组TFA、VFA均与稳态模型评估的胰岛素抵抗指数(HOMA-IR)呈正相关(P<0.01),TFA与三酰甘油(TG)和低密度脂蛋白胆固醇呈正相关,SFA与TG呈正相关(P<0.05)。结论与年龄、性别和BMI匹配的EH患者相比,PA患者的TFA和VFA更低。PA患者的腹部脂肪面积与胰岛素抵抗和血脂相关,且VFA对胰岛素抵抗的影响大于TFA和SFA。Objective To compare the abdominal fat distribution in patients with primary aldosteronism(PA)and essential hypertension(EH),and to analyze the correlation between abdominal fat area and indexes such as glycolipid metabolism and insulin resistance.Methods Forty-five PA and 55 EH patients were collected from inpatients in the First Affiliated Hospital of Zhengzhou University for suspicious secondary hypertension,from September 2016 to February 2019.All patients received quantitative computed tomography to measure the total abdominal fat area(TFA),visceral fat area(VFA),and subcutaneous fat area(SFA)when receiving adrenal CT detection.Visceral obesity was defined as VFA≥130 cm2.The percentage of visceral fat area in total abdominal fat area(V%=VFA/TFA),the ratio of visceral fat area to subcutaneous fat area(V/S=VFA/SFA)and the percentage of visceral obesity were calculated.Results TFA and VFA in EH group were higher than those in PA group matched by age,gender,and body mass index(BMI,all P<0.01),and there were no statistically significant differences in SFA,V%,V/S,and the percentage of visceral obesity between the two groups.In PA group,TFA and VFA were positively correlated with homeostasis model assessment of insulin resistance index(P<0.01),TFA was positively correlated with triglycerides(TG)and low density lipoprotein-cholesterol,while SFA was positively correlated with TG(all P<0.05).Conclusion Compared with EH patients matched by age,gender,and BMI,TFA and VFA in PA patients are lower.Abdominal fat area is associated with insulin resistance and blood lipids in PA patients,while VFA exerts a greater effect on insulin resistance than that of TFA and SFA.

关 键 词：原发性醛固酮增多症 腹部脂肪面积 胰岛素抵抗 定量CT 

分 类 号：R58[医药卫生—内分泌]