男性糖尿病患者腹部脂肪与脑白质病变的相关性  

Correlation between abdominal fat and leukoencephalopathy in patients with diabetes mellitus

作　　者：沈慧玲 王静[1] 阮芸[1] 王秀景[1] 姚佳琦[1] 谭擎缨[1] Shen Huiling

机构地区：[1]浙江杭州中国人民解放军联勤保障部第903医院,310013

出　　处：《浙江临床医学》2020年第1期20-22,共3页Zhejiang Clinical Medical Journal

基　　金：南京军区医学科技创新经费资助项目重大专项(14ZX30);杭州市卫生科技计划(一般)项目(2016B59)。

摘　　要：目的探讨2型糖尿病男性患者腹部脂肪分布对脑白质病变发生的影响.方法使用口服降糖药治疗的2型糖尿病男性患者241例.测量患者身高、体重、腰围(WC)并采血测定空腹血糖、胰岛素及其他相关临床指标,计算身体质量指数(BMI)及胰岛素抵抗指数.所有患者均进行腹部CT测量腹部脂肪面积及头颅磁共振以评估脑白质病变情况,计算内脏脂肪与皮下脂肪面积比值(VSR).241例患者分别根据BMI、腰围、腹腔内脏脂肪面积(VA)、VSR用四分法分成4组,比较4组患者脑白质病变发生率的差异.结果2型糖尿病患者VSR越大,脑白质病变发生率越高(P=0.041).且VSR与患者空腹胰岛素(P=0.006,r=0.190)、胰岛素抵抗指数(P=0.023,r=0.182)呈正相关.BMI、WC及VA分组的统计中脑白质病变发生率差异无统计学意义(P>0.05).结论男性2型糖尿病患者VSR越大,越可能发生脑白质病变,其潜在原因可能与胰岛素抵抗增加有关.Objective To detect the influence of abdominal fat on the incidence of white matter lesions(WML)among male patients of type 2 diabetes mellitus(T2DM).Methods 241 males patients diagnosed with T2DM taking oral medications were enrolled in this study.The patients’height,weight,waist circle(WC),fasting blood glucose,fasting insulin and related clinical variables were collected.And the body mass index(BMI)and insulin resistant index were calculated.All patients had CT scans to measure abdominal fat area and ratios of visceral to subcutaneous fat(VSR)were calculated.And brain MRI to measure white matter lesions.They were divided into four groups according to their body mass index,waist circle(WC),visceral fat area(VA),visceral to subcutaneous fat ratio detected with CT.The incidence of WML were compared among the four groups and analysis the possible reasons.Results Patients with higher VSR had a higher incidence of WML than lower ones statistically(P=0.041).And VSR were positively related to levels of fasting insulin(P=0.006,r=0.190)and insulin resistant index(P=0.023,r=0.182).However,the incidences of WML among patients with different BMI,WC and VA were not different.Conclusions The higher the ratio of visceral to subcutaneous fat in male patient with T2DM,the more likely will white matter lesions occur,and it maybe associated with the increase of insulin resistance.

关 键 词：2型糖尿病 脑白质病变 内脏脂肪与皮下脂肪面积比值 胰岛素抵抗 

分 类 号：R58[医药卫生—内分泌]