胰岛素抵抗与甲状腺激素水平对代谢综合征老年患者内脏脂肪面积的影响  

Effects of insulin resistance and thyroid hormone levels on visceral fat area in elderly patients with metabolic syndrome

作　　者：田勇[1] 李进[1] 刘艳晓[1] TIAN Yong;LI Jin;LIU Yan-xiao(Department of Endocrinology,the First People's Hospital of Pingdingshan City,Pingdingshan 467000,Henan,CHINA)

机构地区：[1]平顶山市第一人民医院内分泌科,河南平顶山467000

出　　处：《海南医学》2022年第6期696-699,共4页Hainan Medical Journal

摘　　要：目的分析胰岛素抵抗与甲状腺激素水平对代谢综合征老年患者内脏脂肪面积的影响。方法回顾性分析2017年6月至2020年6月期间平顶山市第一人民医院收治的72例代谢综合征老年患者的临床资料,依据腹部内脏脂肪面积(VFA)水平分为A组(VFA≤68.6 cm^(2),n=38)、B组(68.6 cm^(2)<VFA≤91.9 cm^(2),n=16)、C组(91.9 cm^(2)<VFA≤119.0 cm^(2),n=10)和D组(VFA>119.0 cm^(2),n=8),比较各组患者的临床资料,单因素和Logistic多因素分析代谢综合征老年患者内脏脂肪面积增大的危险因素,并采用Spearman秩相关性分析各危险因素与代谢综合征老年患者内脏脂肪面积的相关性。结果单因素分析结果显示,各组患者的性别、病程、体质量指数(BMI)、腰围、收缩压、舒张压、SFA、胰岛素抵抗指数(HOMA-IR)、三酰甘油(TG)、糖化血红蛋白(HbA1c)、高密度脂蛋白胆固醇(HDL-C)、游离三碘甲腺原氨酸(FT3)、游离甲状腺素(FT4)、三碘甲腺原氨酸(T3)、β-抑制蛋白2水平比较差异具有统计学意义(P<0.05);Logistic多因素分析结果显示,BMI>35 kg/m^(2)、腰围>95 cm、收缩压>130 mm Hg、舒张压>80 mm Hg、SFA、HOMA-IR>190 cm^(2)、TG>1.70 mmol/L、FT3>5.70 pmol/L、T3>1.70 mmol/L、β-抑制蛋白2>12 ng/L,HbA1c<9%、HDL-C<1.20 mmol/L、FT4<12.50 pmol/L为代谢综合征老年患者内脏脂肪面积增大的危险因素(P<0.05);经Spearman秩相关性分析结果显示,BMI、腰围、收缩压、舒张压、SFA、HOMA-IR、TG、FT3、T3、β-抑制蛋白2水平与代谢综合征老年患者内脏脂肪面积呈正相关(P<0.05),而HbA1cC、HDL-C、FT4与与谢综合征老年患者内脏脂肪面积呈负相关(P<0.05)。结论胰岛素抵抗与甲状腺激素水平与代谢综合征老年患者内脏脂肪面积呈正相关,且两者为其危险因素,临床中可通过监测胰岛素抵抗与甲状腺激素水平了解患者内脏脂肪情况,及时给予干预,改善预后。Objective To analyze the effects of insulin resistance and thyroid hormone levels on visceral fat area in elderly patients with metabolic syndrome.Methods The clinical data of 72 elderly patients with metabolic syndrome admitted to the First People’s Hospital of Pingdingshan City from June 2017 to June 2020 A were retrospectively analyzed.According to the level of abdominal visceral fat area (VFA),the patients were divided into group A (VFA≤68.6 cm^(2),n=38),group B (68.6 cm^(2)<VFA≤91.9 cm^(2),n=16),group C (91.9 cm^(2)<VFA≤119.0 cm^(2),n=10),and group D(VFA>119.0 cm^(2),n=8).The clinical data were compared among the four groups.Univariate analysis and logistic multivariate analysis were used to analyze the risk factors for increased visceral fat area in elderly patients with metabolic syndrome.Spearman analysis was used to analyze the correlation between each risk factor and visceral fat area in elderly patients with metabolic syndrome.Results The results of univariate analysis showed that the gender,course of disease,body mass index (BMI),waist circumference,systolic blood pressure,diastolic blood pressure,SFA,insulin resistance index (HOMA-IR),triacylglycerol (TG),glycosylated hemoglobin (Hb A1c),high-density lipoprotein cholesterol (HDL-C),free triiodothyronine (FT3),free thyroxine (FT4),triiodothyronine (T3),β-arrestin 2 level comparison showed statistically significant difference among the four groups (P<0.05).Logistic multivariate analysis showed that BMI>35 kg/m^(2),waist circumference>95 cm,systolic blood pressure>130 mmHg (1 mmHg=0.133 kPa),diastolic blood pressure>80 mmHg,SFA,HOMA-IR>190 cm^(2),TG>1.70 mmol/L,FT3>5.70 pmol/L,T3>1.70 mmol/L,β-arrestin 2>12 ng/L,HbA1c<9%,HDL-C<1.20 mmol/L,FT4<12.50 pmol/L were the risk factors for increase of visceral fat area in elderly patients with metabolic syndrome (P<0.05).Spearman analysis showed that BMI,waist circumference,systolic blood pressure,diastolic blood pressure,SFA,HOMA-IR,TG,FT3,T3,β-arrestin 2 levels were positively correlated with viscer

关 键 词：代谢综合征 老年 胰岛素抵抗 甲状腺激素 内脏脂肪面积 相关性 

分 类 号：R442.8[医药卫生—诊断学]