2型糖尿病患者体脂分布情况及其与胰岛素抵抗的相关性研究  

Body fat distribution and its correlation with insulin resistance in patients with type 2 diabetes

作　　者：邓波 胡艺[1] 万思聪 DENG Bo;HU Yi;WAN Sicong(Department of Endocrinology,Nanchang First Hospital,Nanchang,Jiangxi 330008,China)

机构地区：[1]南昌市第一医院内分泌科,江西南昌330008

出　　处：《现代医药卫生》2024年第8期1267-1271,共5页Journal of Modern Medicine & Health

基　　金：江西省卫生健康委员会科技计划项目(202311215);江西省中医药管理局科技计划项目(2021A372);江西省重点研发计划项目(20203BBG73053)。

摘　　要：目的探讨2型糖尿病(T2DM)患者体脂分布情况及其与胰岛素抵抗(IR)的相关性。方法选取2019年1月至2020年12月该院内分泌科住院治疗的T2DM患者2790例,根据是否存在IR将其分为IR组(1915例)和非IR组(875例)。以甘油三酯葡萄糖(TyG)指数评估IR情况,分析内脏脂肪组织(VAT)、皮下脂肪组织(SAT)面积与其他临床指标[体重指数(BMI)、糖化血红蛋白(HbA1c)、甘油三酯(TG)、低密度脂蛋白(LDL)和高密度脂蛋白(HDL)等]的相关性,以及体脂分布面积对IR的影响。结果男性患者BMI、腰围、臀围、腰臀比、舒张压、TG、TyG指数、尿酸、肌酐水平及VAT面积高于女性患者,而年龄、腰高比、收缩压、胆固醇、HDL、LDL水平及SAT面积低于女性患者,差异有统计学意义(P<0.05)。VAT面积与BMI、收缩压、舒张压、腰围、腰臀比、TG、TyG指数、尿酸水平呈正相关(r>0,P<0.05),与HbA1c、HDL水平呈负相关(r<0,P<0.05)。SAT面积与BMI、腰围、腰臀比、胆固醇、LDL、TyG指数、尿酸水平呈正相关(r>0,P<0.05),与HDL水平呈负相关(r<0,P<0.05)。IR组舒张压、腰臀比、HbA1c、尿酸水平及VAT、SAT面积高于非IR组,而年龄、收缩压、HDL水平低于非IR组,差异有统计学意义(P<0.05)。VAT面积、舒张压、HbA1c是IR发生的独立危险因素(OR>1,P<0.05),而HDL是其保护因素(OR<1,P<0.05)。结论T2DM患者体脂分布存在性别差异,其中VAT是导致IR的危险因素。Objective To investigate the relationship between body fat distribution and insulin resistance(IR)in patients with type 2 diabetes mellitus(T2DM).Methods A total of 2790 T2DM patients hospitalized in the department of endocrinology of the hospital from January 2019 to December 2020 were selected and divided into the IR group(1915 cases)and the non-IR group(875 cases)according to the presence or absence of IR.IR status was assessed by TyG index,and the correlation between visceral adipose tissue(VAT),subcutaneous adipose tissue(SAT)area and other clinical indicators(body mass index(BMI),glycosylated hemoglobin(HbA1c),triglyceride(TG),low density lipoprotein(LDL)and high density lipoprotein(HDL),etc.),and the influence of body fat distribution area on IR were analyzed.Results BMI,waist circumference,hip circumference,waist-to-hip ratio,diastolic blood pressure,TG,TyG index,uric acid,creatinine level and VAT area in male patients were higher than those in female patients,while age,waist-to-height ratio,systolic blood pressure,cholesterol,HDL,LDL level and SAT area were lower than those in female patients,with statistical significance(P<0.05).VAT area were positively correlated with BMI,systolic blood pressure,diastolic blood pressure,waist circumference,waist-to-hip ratio,TG,TyG index,and uric acid level(r>0,P<0.05),and negatively correlated with HbA1c and HDL level(r<0,P<0.05).SAT area was positively correlated with BMI,waist circumference,waist-to-hip ratio,cholesterol,LDL,TyG index,and uric acid level(r>0,P<0.05),and negatively correlated with HDL level(r<0,P<0.05).Diastolic blood pressure,waist-to-hip ratio,HbA1c,uric acid level,VAT and SAT area in the IR group were higher than those in the non-IR group,while age,systolic blood pressure and HDL level were lower than those in the non-IR group,with statistical significance(P<0.05).VAT area,diastolic blood pressure and HbA1c were independent risk factors for IR(OR>1,P<0.05),while HDL was protective factor(OR<1,P<0.05).Conclusion There is gender difference in body f

关 键 词：2型糖尿病 体脂分布 胰岛素抵抗 甘油三酯葡萄糖指数 

分 类 号：R587.1[医药卫生—内分泌]