兰州市中老年人群维生素D缺乏相关肥胖指标的比较分析  

Association analysis of various obesity-related indices and vitamin D deficiency in middle-aged and elderly population in Lanzhou

作　　者：闵行 杨芳[2] 甄东户[2] 汤旭磊[2] 车红霞 关聪会[2] 赵楠[2] 刘丽娟[2] 韩婕[2] 叶月 郭梦然 许晓双 Min Hang;Yang Fang;Zhen Donghu;Tang Xulei;Che Hongxia;Guan Conghui;Zhao Nan;Liu Lijuan;Han Jie;Ye Yue;Guo Mengran;Xu Xiaoshuang(Majoring in Internal Medicine,First College of Clinical Medical,Lanzhou University,Lanzhou 730000,China;Department of Endocrinology,First Hospital of Lanzhou University,Lanzhou 730000,China;Department of Endocrinology,The Third People's Hospital of Gansu Province,Lanzhou 730000,China)

机构地区：[1]兰州大学第一临床医学院,730000 [2]兰州大学第一医院内分泌科,730000 [3]甘肃省第三人民医院内分泌科,兰州730000

出　　处：《中华临床营养杂志》2023年第1期1-8,共8页Chinese Journal of Clinical Nutrition

基　　金：上海市医药卫生发展基金会糖尿病临床研究项目(Ⅰ期10研究);甘肃省自然科学基金(21JR1RA096);上海市医药卫生发展基金会国家标准化代谢性疾病管理中心专项研究基金(2018-mmczxjj-3);甘肃省内分泌疾病临床医学研究中心(20JR10FA667);兰州大学第一医院院内基金项目(ldyyyn2015-22);兰州大学第一医院院内基金项目(ldyyyn2021-23)。

摘　　要：目的:比较兰州市中老年人群不同肥胖指标与维生素D缺乏的相关性。方法:于2011年7月至2012年9月选取兰州市3个社区居民进行整群随机抽样调查,将调查资料完整的9437例年龄≥45岁的居民作为研究对象。将研究对象按照维生素D水平进行分组,并按不同性别进行亚组分析,比较各组不同肥胖指标的水平,采用Spearman相关性分析不同肥胖指标与维生素D缺乏严重程度的关系,采用多元有序Logistic回归分析不同肥胖指标对中老年人维生素D缺乏严重程度的影响。结果:在9437例研究对象中,维生素D缺乏症的患病率为97.7%。在总体和女性人群中,相较于低维生素D水平组中,高维生素D水平组体重指数、腰围、脂质蓄积指数(lipid accumulation product,LAP)、内脏脂肪指数(visceral adiposity index,VAI)、甘油三脂(triglyceride,TG)/高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)比值明显偏低,而在男性人群中,仅腰围、LAP、VAI、TG/HDL-C明显偏低(均为P<0.05)。Spearman相关性分析提示,在总体和女性人群中,这些肥胖指标与维生素D缺乏严重程度呈明显正相关,而在男性人群中,仅LAP、VAI、TG/HDL-C与严重程度呈正相关(均为P<0.05)。多元有序Logistic回归分析结果显示,在总体和女性人群中,随着这些肥胖指标增高,维生素D缺乏严重程度增高的风险增高,以LAP最为显著(均为P<0.05);而在男性人群中,仅当LAP、VAI、TG/HDL-C增高时,风险增高,尤以LAP最为显著(均为P<0.05)。结论:在中老年人群中,女性各种肥胖表型均与维生素D缺乏关系密切,而男性主要以内脏型肥胖和脂质代谢异常与维生素D缺乏相关,尤以评估内脏型肥胖的LAP最为显著。Objective To analyze and compare the association between different obesity-related indices and vitamin D deficiency in middle-aged and elderly population dwelled in Lanzhou city.Methods From May,2011 to September,2012,middle-aged and elderly individuals with complete baseline data were included via randomly cluster sampling from 3 communities in Lanzhou.The subjects were divided into 4 subgroups by vitamin D levels and various obesity-related indices were compared across subgroups with the same gender.The relationship between the obesity-related indices and the severity of vitamin D deficiency was analyzed using Spearman correlation analysis,and the effects of different obesity-related indices on the severity of vitamin D deficiency was analyzed using multivariate logistic regression analysis.Results A total of 9437 residents were included.The overall prevalence of vitamin D deficiency was 97.7%.Compared with the group with lower vitamin D level,participants in the group with higher vitamin D level showed evidently lower body mass index(BMI),waist circumference(WC),lipid accumulation product(LAP),visceral adiposity index(VAI)and triglyceride/high density lipoprotein cholesterol(TG/HDL-C)ratio in the total population and females,while only WC,LAP,VAI and TG/HDL-C in the males(all P<0.05).Spearman correlation analysis showed that BMI,WC,LAP,VAI and TG/HDL-C were positively correlated with the severity of vitamin D deficiency in the total population and the females,while only LAP,VAI and TG/HDL-C in the males(all P<0.05).Multivariate logistic regression analysis showed that higher levels of these obesity related indices were correlated with more severe vitamin D deficiency in the total population and the females,while only higher LAP,VAI and TG/HDL-C in the males(all P<0.05).The effects of higher LAP was the most prominant in the total population,the females and the males.Conclusion Various obesity phenotypes are closely related to vitamin D deficiency in middle-aged and elderly women,while only visceral obesity and

关 键 词：肥胖 维生素D缺乏 中老年人 

分 类 号：R589.2[医药卫生—内分泌] R591.44[医药卫生—内科学]