2型糖尿病患者内脏脂肪面积和总脂肪面积与冠状动脉粥样硬化的关系  

Correlations of visceral fat area and total fat area with coronary atherosclerosis in patients with type 2 diabetes mellitus

作　　者：朱晓琴[1] 王丽萍[1] 马静[1] 邢英[1] ZHU Xiao-qin;WANG Li-ping;MA Jing;XING Ying(Department of General Internal Medicine the First Affiliated Hospital of Xinjiang Medical University,Urumqi,Xinjiang Uygur Autonomous Region 830054,China)

机构地区：[1]新疆医科大学第一附属医院综合内科,新疆维吾尔自治区乌鲁木齐830054

出　　处：《中华实用诊断与治疗杂志》2021年第4期387-390,共4页Journal of Chinese Practical Diagnosis and Therapy

基　　金：新疆维吾尔自治区自然科学基金(2018D01C299)。

摘　　要：目的探讨2型糖尿病患者冠状动脉粥样硬化与内脏脂肪面积和总脂肪面积的关系,为2型糖尿病患者冠状动脉粥样硬化情况的评估及预防提供依据。方法 294例2型糖尿病患者,根据是否合并冠状动脉粥样硬化分为合并组149例和未合并组145例,检测并比较2组内脏脂肪面积、皮下脂肪面积、总脂肪面积;绘制ROC曲线,评估内脏脂肪面积和总脂肪面积对2型糖尿病合并冠状动脉粥样硬化的预测价值;合并组根据冠状动脉粥样硬化程度分级分为Ⅰ级组52例、Ⅱ级组44例、Ⅲ级组38例和Ⅳ级组15例,比较4组患者内脏脂肪面积、皮下脂肪面积和总脂肪面积;采用双变量Pearson直线相关性分析内脏脂肪面积和总脂肪面积与冠状动脉粥样硬化程度的关系;采用线性回归分析2型糖尿病患者冠状动脉粥样硬化进展的影响因素。结果合并组内脏脂肪面积[(167.95±31.45)cm^(2)]、总脂肪面积[(367.62±45.02)cm^(2)]大于未合并组[(130.62±29.56)、(289.94±35.21)cm^(2)](P<0.05),皮下脂肪面积[(199.67±43.65)cm^(2)]与未合并组[(197.32±47.57)cm^(2)]比较差异无统计学意义(P>0.05);内脏脂肪面积、总脂肪面积最佳截断值分别为173.26、372.13 cm^(2)时,预测2型糖尿病合并冠状动脉粥样硬化的AUC分别为0.958(95%CI:0.929~0.987,P<0.001)、0.873(95%CI:0.833~0.913,P<0.001),灵敏度分别为96.6%、89.3%,特异度分别为99.3%、98.6%;Ⅳ级组、Ⅲ级组、Ⅱ级组和Ⅰ级组患者内脏脂肪面积和总脂肪面积均依次减小(P<0.05),4组皮下脂肪面积比较差异无统计学意义(P>0.05);2型糖尿病患者内脏脂肪面积、总脂肪面积与冠状动脉粥样硬化程度呈正相关(r=0.523,P<0.001;r=0.599,P<0.001);内脏脂肪面积、总脂肪面积是2型糖尿病患者冠状动脉粥样硬化进展的影响因素(t=4.017,95%CI:0.049~0.143,P<0.001;t=6.144,95%CI:0.081~0.158,P<0.001)。结论 2型糖尿病患者内脏脂肪面积、总脂肪面积增大提示可能存在�Objective To analyze the correlations of coronary atherosclerosis with visceral fat area and total fat area in patients with type 2 diabetes mellitus(T2DM) to provide a basis for the assessment and prevention of coronary atherosclerosis in patients with T2DM. Methods Totally 294 patients with T2DM were divided into combined group(n=149) and uncombined group(n=145) according to whether they were combined with coronary atherosclerosis or not. The visceral fat area, subcutaneous fat area and total fat area were detected and compared between two groups. ROC was drawn to evaluate the values of visceral fat area and total fat area to the prediction of coronary atherosclerosis in patients with T2DM. According to the different grades of coronary atherosclerosis, combined group was divided into grade Ⅰ group(n=52), grade Ⅱ group(n=44), grade Ⅲ group(n=38) and grade Ⅳ group(n=15). The visceral fat area, subcutaneous fat area and total fat area were compared among four groups. Bivariate Pearson linear correlation was used to analyze the relationships of visceral fat area and total fat area with the degree of coronary atherosclerosis. Linear regression analysis was used to analyze the influencing factors of the progression of coronary atherosclerosis in patients with T2DM. Results The visceral fat area and total fat area were larger in combined group((167.95±31.45),(367.62±45.02) cm^(2)) than those in uncombined group((130.62±29.56),(289.94±35.21) cm^(2))(P<0.05), and the subcutaneous fat area showed no significant difference between combined group and uncombined group((199.67±43.65) cm^(2) vs. 197.32±47.57) cm^(2))(P>0.05). When the optimal cut-off values of visceral fat area and total fat area were 173.26 and 372.13 cm^(2), the AUCs for predicting coronary atherosclerosis in T2 DM patients were 0.958(95%CI: 0.929-0.987, P<0.001) and 0.873(95%CI: 0.833-0.913, P<0.001), the sensitivities were 96.6% and 89.3%, and the specificities were 99.3% and 98.6%, respectively. The visceral fat area and total fat area decr

关 键 词：2型糖尿病 内脏脂肪面积 总脂肪面积 冠状动脉粥样硬化 相关性 

分 类 号：R543.3[医药卫生—心血管疾病] R587.2[医药卫生—内科学]