2型糖尿病患者内脏脂肪指数与肾小球滤过率的相关性研究  

Correlation between visceral adipose index and glomerular filtration rate in patients with type 2 diabetes mellitus

作　　者：贾爱华[1,4] 徐静[1] 蔡艳云 李晓杰 孔颖[1] 厚荣荣 魏嘉 Jia Aihua;Xu Jing;Cai Yanyun;Li Xiaojie;Kong Ying;Hou Rongrong;Wei Jia(Department of Endocrinology,The Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710004,Shaanxi Province,China;Department of Internal Medicine,Huangling People's Hospital,Yan'an,727300,Shaanxi Province,China;Department of Internal Medicine,Fuping People's Hospital,Weinan 711700,Shaanxi Province,China)

机构地区：[1]西安交通大学第二附属医院内分泌科,西安710004 [2]黄陵县人民医院内科,延安727300 [3]富平县人民医院内科,渭南711700 [4]榆林市第一医院内分泌科

出　　处：《中国基层医药》2023年第7期961-966,共6页Chinese Journal of Primary Medicine and Pharmacy

基　　金：陕西省重点研发计划一般项目(2017SF-046)。

摘　　要：目的分析2型糖尿病患者内脏脂肪指数与肾小球滤过率的关系。方法选取西安交通大学第二附属医院2017年5月至2018年5月住院治疗的2型糖尿病患者1 036例,采用生物电阻抗法检测内脏脂肪指数。采用四分位法按照内脏脂肪指数将患者划分为四组,内脏脂肪指数 < 8.10为q1组(n=246),9.60 > 内脏脂肪指数≥ 8.10为q2组(n=64),11.10 > 内脏脂肪指数≥ 9.60为q3组(n=423),内脏脂肪指数≥ 11.10为q4组(n=233)。采用单因素方差分析比较各组间差异,采用偏相关及多元回归分析身体质量指数、腰围、腰高比、腰臀比、体脂含量、内脏脂肪指数、尿微量白蛋白与肾小球滤过率的相关性。结果随着内脏脂肪指数增加,肾小球滤过率逐渐降低,q1组、q2组、q3组、q4组肾小球滤过率分别为(112.19±31.74)mL·min^(-1)·1.73 m^(-2)、(106.14±28.26)mL·min^(-1)·1.73 m^(-2)、(104.73±23.63)mL·min^(-1)·1.73 m^(-2)、(103.40±27.51)mL·min^(-1)·1.73 m^(-2)。将总人群进行性别分组后,女性组随着内脏脂肪指数增加,肾小球滤过率呈逐渐降低趋势。控制年龄、性别、糖尿病和高血压病程后,内脏脂肪指数仍然与肾小球滤过率有相关性,差异有统计学意义(r=-0.10,P < 0.001)。多元回归分析显示,内脏脂肪指数、腰高比与肾小球滤过率关系密切(F=6.00,P < 0.001)。结论随着内脏脂肪指数上升,身体质量指数、腰围、腰高比、腰臀比、体脂含量和尿微量白蛋白逐渐增加。当内脏脂肪指数 > 9.60,肾小球滤过率明显降低,建议临床工作中采用多种手段评估肥胖,重视内脏脂肪指数,尤其是内脏脂肪指数 > 9.60时。Objectives To investigate the relationship between visceral adipose index and glomerular filtration rate in patients with type 2 diabetes mellitus.Methods A total of 1036 patients with type 2 diabetes mellitus who received treatment in The Second Affiliated Hospital of Xi'an Jiaotong University from May 2017 to May 2018 were included in this study.The visceral adipose index was detected using a bioresistance assay.These patients were divided into four groups using the quartile method:Visceral adipose index<8.10(q1 group,n=246),9.60>visceral adipose index≥8.10(q2 group,n=64),11.10>visceral adipose index≥9.60(q3 group,n=423),visceral adipose index≥11.10(q4 group,n=233).One-way analysis of variance was performed to compare the differences among groups.Partial correlation and multiple regression were used to analyze the correlation between body mass index,waist circumference,waist-to-height ratio,waist-to-hip ratio,body fat content,visceral adipose index,and urinary microalbumin and glomerular filtration rate.Results With the increase in the visceral adipose index,the glomerular filtration rate gradually decreased.The glomerular filtration rate in the q1,q2,q3,q4 groups was(112.19±31.74)mL·min^(-1)·1.73 m^(-2),(106.14±28.26)mL·min^(-1)·1.73 m^(-2),(104.73±23.63)mL·min^(-1)·1.73 m^(-2),(103.40±27.51)mL·min^(-1)·1.73 m^(-2),respectively.In the female group,with the increase in visceral adipose index,the glomerular filtration rate decreased gradually.After controlling for age,sex,diabetes,and hypertension,the visceral adipose index was significantly correlated with the glomerular filtration rate(r=-0.10,P<0.001).Multiple regression analysis showed that visceral adipose index and waist-to-height ratio were closely related to glomerular filtration rate(F=6.00,P<0.001).Conclusion With the increase of visceral adipose index,body mass index,waist circumference,waist-to-height ratio,waist-to-hip ratio,body fat content,and urinary microalbumin increased gradually.When the visceral adipose index is greater tha

关 键 词：糖尿病 2型 肥胖症 内脏脂肪指数 肾小球滤过率 身体质量指数 腰围 尿微量白蛋白 因素分析 统计学 

分 类 号：R587.1[医药卫生—内分泌]