不同性别社区人群体成分与胰岛素抵抗关联研究  

Associations between body composition and insulin resistance in different gender communities

作　　者：施俊 葛志豪 任雅婷 王素芳[1] SHI Jun;GE Zhi-hao;REN Ya-ting;WANG Su-fang(Department of Nutrition and Food Hygiene,School of Public Health,Anhui Medical University,Hefei,Anhui 230001,China;不详)

机构地区：[1]安徽医科大学公共卫生学院营养与食品卫生学系,安徽合肥230001 [2]合肥市瑶海区疾病预防控制中心慢性病和健康教育科

出　　处：《现代预防医学》2024年第12期2253-2261,2286,共10页Modern Preventive Medicine

基　　金：国家自然科学基金(81102125)。

摘　　要：目的分析不同性别一般人群的体成分与胰岛素抵抗(Insulin Resistance,IR)之间的关系。方法本研究数据来源于2021年中国居民心血管病及其危险因素监测项目合肥地区数据,共纳入1144例研究对象,其中男性568人,女性576人。用甘油三酯(Triglyceride,TG)/高密度脂蛋白胆固醇(High Density Lipoprotein Cholesterol,HDL-C)作为IR的替代指标,采用卡方检验分析不同体成分(体质指数(Body Mass Index,BMI)、体脂百分比(Percentage Of Body Fat,PBF)、肌肉百分比(Percentage Of Body Muscle,PBM)、腰围(Waist Circumference,WC))和内脏脂肪等级(Visceral Fat Grade,VFG)组与TG/HDL-C之间的关系,采用logistic回归分析TG/HDL-C高于切点值的体成分影响因素,用限制性立方样条探究各体成分与TG/HDL-C之间的剂量反应关系。结果男性IR阳性检出率(TG/HDL-C高于切点值的率)为15.85%,女性为4.69%。在调整混杂因素后,logistic回归分析结果显示,与对照组相比,男性人群发生IR风险的体成分分组中,肥胖组是5.58倍(OR=5.58,95%CI:1.98~15.72),PBF第三四分位组是7.90倍(OR=7.90,95%CI:1.68~37.15),PBF第四四分位组是8.20倍(OR=8.20,95%CI:1.75~38.40),PBM第三四分位组是0.27倍(OR=0.27,95%CI:0.10~0.71),PBM第四四分位组是0.09倍(OR=0.09,95%CI:0.02~0.44),VFG偏高组是3.11倍(OR=3.11,95%CI:1.45~6.68),VFG高组是4.28倍(OR=4.28,95%CI:1.45~12.64),腹型肥胖是2.21倍(OR=2.21,95%CI:1.08~4.56);女性人群发生IR风险的体成分分组中,肥胖组是6.61倍(OR=6.61,95%CI:1.08~65.66),VFG高组是8.52倍(OR=8.52,95%CI:1.90~70.86)(P<0.05)。限制性立方样条显示,BMI、PBF、PBM、VFG、WC均与TG/HDL-C存在剂量反应关系和近似线性关系。结论社区居民的体成分与发生胰岛素抵抗风险密切相关,肥胖人群以及高内脏脂肪人群发生胰岛素抵抗风险较高,应加强生活方式干预,保持较高肌肉率。Objective To examine the correlation between body composition and insulin resistance(IR)within the general population of different genders.Methods The data for this study were sourced from the Hefei area data of the Chinese Residents Cardiovascular Disease and Risk Factors Monitoring Project conducted in 2021,with a total of 1144 subjects being included,including 568 males and 576 females.The ratio of triglycerides to high-density lipoprotein cholesterol(TG/HDL-C)was used as an alternative indicator of insulin resistance.A chi-square test was employed to analyze the association between body composition metrics—such as body mass index(BMI),percent body fat(PBF),percent body muscle(PBM),visceral fat area(VFG),and waist circumference(WC)—and the TG/HDL-C ratio.Logistic regression analysis was used to identify the factors influencing body composition in individuals with a TG/HDL-C ratio exceeding the tangent point value.The dose-response relationship between body components and the TG/HDL-C ratio was explored using restricted cubic splines,a statistical method that allows for the examination of nonlinear relationships.Results The positive detection rate of IR(the rate of TG/HDL-C above the cut point value)was 15.85%in men and 4.69%in women.After adjusting for confounding factors,logistic regression analysis showed that compared with the control group,the risk of IR in the male population was 5.58 times in the obese group(OR=5.58,95%CI:1.98-15.72),PBF was 7.90 times in the third quartile(OR=7.90,95%CI:1.68-37.15),the fourth quartile of PBF was 8.20 times(OR=8.20,95%CI:1.75-38.40),and the third quartile of PBM was 0.27 times(OR=0.27,95%CI:0.10-0.71),the PBM was 0.09 times in the fourth quartile group(OR=0.09,95%CI:0.02-0.44),3.11 times in the group with high VFG(OR=3.11,95%CI:1.45-6.68),and 4.28 times in the group with higher VFG(OR=4.28,95%CI:1.45-12.64).Abdominal obesity was 2.21 times(OR=2.21,95%CI:1.08-4.56).In the female population,the risk of IR was 6.61 times in the obese group(OR=6.61,95%CI:1.08-65.66)and 8

关 键 词：体成分 胰岛素抵抗 TG/HDL-C 剂量—反应关系 

分 类 号：R587.1[医药卫生—内分泌]