内脏脂肪与超重/肥胖病人代谢指标及脂肪因子的相关性  

The correlation study of visceral fat with metabolic indexes and adipokines in overweight/obese patients

作　　者：孙希 雷涛[1] 滕卉茹 徐碧林[1] SUN Xi;LEI Tao;TENG Huiru;XU Biin(Department of Endocrinology,Putuo Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 200062,China)

机构地区：[1]上海中医药大学附属普陀医院内分泌科,上海200062

出　　处：《安徽医药》2023年第8期1572-1576,共5页Anhui Medical and Pharmaceutical Journal

基　　金：国家自然科学基金(81774083);上海市医学重点专科建设(ZK2019B16);上海市普陀区卫生健康系统科技创新项目(ptkwws201911)。

摘　　要：目的探讨内脏脂肪面积与超重/肥胖病人代谢指标及脂肪因子的相关性。方法选取2020年6月至2021年11月就诊于上海中医药大学附属普陀医院的90例身体质量指数(BMI)>24 kg/m^(2)的超重/肥胖病人纳入研究,测量内脏脂肪面积(VFA)以及皮下脂肪面积(SFA)、腰围、腹围、臀围、身高、体质量、体脂率、基础代谢率(BMR),并根据病人的身高及体质量计算BMI;测定空腹血糖(FBG)、空腹胰岛素(FINS)、糖化血红蛋白(HbA1c)、游离脂肪酸(FFA)、碱性磷酸酶(ALP)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、尿酸(UA)等代谢指标以及成纤维细胞因子21(FGF-21)、瘦素、脂联素等脂肪因子,并计算稳态模型胰岛素抵抗指数(HOMA-IR)。根据内脏脂肪面积分为四组,分析其与上述指标的相关性。结果A、B、C、D四组体质量、BMI、腰腹臀围、SFA、BMR、FFA、ALT、AST、HbA1c、HOMA-IR、FGF-21[(119.90±52.50)、(182.32±61.58)、(198.65±71.13)、(209.44±70.00)ng/L]、脂联素[(6.73±0.60)、(6.86±1.08)、(7.32±0.95)、(7.58±0.96)µg/L]、瘦素[(0.85±0.36)、(1.22±0.44)、(1.34±0.41)、(1.41±0.39)µg/L]差异有统计学意义(P<0.05),VFA与体质量、BMI、腰腹臀围、SFA、BMR、FFA、ALT、AST、HbA1c、HOMA-IR呈正相关(r>0,P<0.05),与FGF-21、脂联素、瘦素呈负相关(r<0,P<0.05),即内脏脂肪面积越大,体质量、BMI、腰腹臀围、SFA、BMR、FFA、ALT、AST、HbA1c、HOMA-IR水平越高,成纤维细胞生长因子21、脂联素、瘦素水平越低。结论超重/肥胖病人内脏脂肪面积与肥胖程度(体质量、BMI、腰腹臀围、SFA、BMR)、胰岛素抵抗程度(HOMA-IR)、糖脂代谢(HbA1c、FFA)、肝功能受损程度(ALT、AST)均呈正相关,与成纤维细胞因子21、脂联素、瘦素成负相关。Objective To investigate the correlation between visceral fat area and metabolic indexes and adipokines in overweight/obese patients.Methods A total of 90 overweight/obese patients with BMI>24 kg/m^(2) treated in Putuo Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from June 2020 to November 2021 were included in the study.Visceral fat area(VFA),sub-cutaneous fat area(SFA),waist circumference,abdominal circumference,hip circumference,height,weight,body fat rate,and basal metabolic rate(BMR)were measured.The body mass index(BMI)was calculated.Metabolic indicators such as fasting blood glucose(FBG),hemoglobin glyc(HbA1c),fasting insulin(FINS),free fatty acid(FFA),alkaline phosphatase(ALP),alanine aminotransferase(ALT),aspartate aminotransferase(AST),uric acid(UA),as well as adipokines such as fibroblast growth factor 21(FGF-21),leptin and adiponectin were tested.The steady-state model insulin resistance index(HOMA-IR)was also calculated.The correlation with the above indexes was analyzed in four groups based on the visceral fat area.Results There were significant differences in body weight,BMI,waist,abdominal and hip circumference,SFA,BMR,FFA,ALT,AST,AST,HbA1c,HOMA-IR,FGF-21[(119.90±52.50),(182.32±61.58),(198.65±71.13),(209.44±70.00)ng/L],adiponectin[(6.73±0.60),(6.86±1.08),(7.32±0.95),(7.58±0.96)µg/L],and leptin[(0.85±0.36),(1.22±0.44),(1.34±0.41),(1.41±0.39)µg/L]among the four groups(P<0.05).VFA was positively associated with body weight,BMI,waist,abdominal and hip circumference,SFA,BMR,FFA,ALT,AST,AST,HbA1c,HOMA-IR(r>0,P<0.05)and negatively associated with FGF-21,adiponectin,and leptin(r<0,P<0.05).That is,the larger visceral fat area,the higher the levels of weight,BMI,waist,abdomen and hip circumference,SFA,BMR,FFA,ALT,AST,HbA1c,and HOMA-IR,and the lower the levels of fibroblast cytokine 21,adiponectin,and leptin.Conclusion The visceral fat area is positively associated with the degree of obesity(weight,BMI,waist abdomen and hip circumference,SFA,BMR),insulin resistance

关 键 词：腹内脂肪 肥胖症 游离脂肪酸 胰岛素抵抗指数 脂肪因子 

分 类 号：R589.2[医药卫生—内分泌]