老年2型糖尿病合并高血压和(或)血脂异常患者腹部脂肪分布特点研究  

Distribution characteristics of abdominal fat in elderly with type 2 diabetes mellitus with hypertension and/or dyslipidemias

作　　者：杨燕英[1] 程钢[1] 张敬华[1] 徐莉莉[1] 聂圆圆[2] 高茂龙[3] Yang Yanying;Cheng Gang;Zhang Jinghua;Xu Lili;Nie Yuanyuan;Gao Maolong(Department of Radiology,Beijing Geriatric Hospial,Beijing 100095,China)

机构地区：[1]北京老年医院放射科,100095 [2]北京老年医院内分泌科,100095 [3]北京老年医院老年病临床与康复研究所,100095

出　　处：《北京医学》2021年第4期292-295,共4页Beijing Medical Journal

基　　金：首都卫生发展科研专项(首发2018-1-2191)。

摘　　要：目的探讨老年2型糖尿病(type 2 diabetes mellitus,T2DM)合并高血压和(或)血脂异常患者腹部脂肪的分布特点。方法选取2018年3月至2019年10月北京老年医院收治的老年T2DM患者190例,按照是否合并高血压和(或)血脂异常分为4组:A组(单纯糖尿病组,23例),B组(糖尿病合并高血压组,17例),C组(糖尿病合并血脂异常组,52例),D组(糖尿病合并高血压及血脂异常组,98例)。所有患者均行定量CT(quantitative computed tomography,QCT),测量腹部总脂肪面积(total adipose area,TAA)、内脏脂肪面积(visceral adipose area,VAA),两者相减计算皮下脂肪面积(subcutaneous adipose area,SAA),并计算VAA/TAA及VAA/SAA,分析比较各组间上述指标的差异。结果老年男性患者的VAA/TAA、VAA/SAA均大于老年女性患者,差异有统计学意义(P<0.05)。4组间TAA及SAA比较,差异无统计学意义,VAA比较差异有统计学意义(χ^(2)=9.277,P=0.024),其中A组明显小于B组,差异有统计学意义(Z=-2.77,P=0.005)。4组间VAA/TAA比较,差异有统计学意义(χ^(2)=9.815,P=0.019),其中A组明显小于D组,差异有统计学意义(Z=-2.67,P=0.006);VAA/SAA比较,差异有统计学意义(χ^(2)=8.433,P=0.037),其中A组明显小于C组和D组,差异有统计学意义(Z=-2.70,P=0.006;Z=-2.59,P=0.007)。结论老年糖尿病患者代谢综合征发生率高;老年男性内脏脂肪比例高于老年女性;合并代谢综合征的老年糖尿病患者更易发生内脏脂肪的沉积。Objective To investigate the distribution characteristics of abdominal fat in elderly with type 2 diabetes mellitus(T2DM)with hypertension and/or dyslipidemias.Methods One hundred and ninty elderly patients with T2DM were enrolled in this study,grouping according to whether hypertension and/or dyslipidemia were complicated.Quantitative computed tomography(QCT)was performed to measure the total adipose area(TAA),the visceral adipose area(VAA)and the subcutaneous adipose area(SAA)from the tissue composition module of QCT software.And the ratio of VAA and TAA,VAA and SAA were calculated.The differences of the above indicators among the groups were analyzed and compared.Results There were significant differences in VAA/TAA and VAA/SAA between elderly men and elderly women with T2DM.After the patients were divided into group A(simple diabetes group),group B(diabetes complicated with hypertension group),group C(diabetes complicated with dyslipidemia group),and group D(diabetes complicated with hypertension and dyslipidemia group),there were no significant differences between four groups in TAA and SAA.There were significant differences between four groups in VAA(χ^(2)=9.277,P=0.024),and VAA in group A was significantly less than that in group B(Z=-2.77,P=0.005).There were significant differences between four groups in VAA/TAA(χ^(2)=9.815,P=0.019),and VAA/TAA in group A was significantly less than that in group D(Z=-2.67,P=0.006).There were significant differences between four groups in VAA/SAA(χ^(2)=8.433,P=0.037),and VAA/SAA in group A was significantly less than those in group C(Z=-2.70,P=0.006)and group D(Z=-2.59,P=0.007).Conclusions The incidence of metabolic syndrome is high in elderly with T2DM.The proportion of VAA in elderly men is higher than that in elderly women with T2DM.Elderly diabetics with metabolic syndrome are more prone to deposit visceral adipose.

关 键 词：2型糖尿病 高血压 血脂异常 定量CT 腹部脂肪 老年 

分 类 号：R587.2[医药卫生—内分泌] R544.1[医药卫生—内科学] R589.2[医药卫生—临床医学]