腰围与胰岛素抵抗的相关性研究
|
摘要
目的探讨腰围与胰岛素抵抗的相关性。方法以2008—2017年期间于深圳市南山区人民医院体检中心行健康体检的881例受试者为研究对象,记录性别、年龄及一般情况,收集腰围(WC)、体质量指数(BMI)、收缩压(SBP)、舒张压(DBP)等资料,根据2013年国家卫生与计划生育委员会《中华人民共和国卫生行业标准-成人体重判定》中的中心型肥胖的腰围切点(男性≥90 cm,女性≥85 cm)分为正常腰围组(n=457)和腹型肥胖组(n=424)。全部受试者根据口服葡萄糖耐量试验(OGTT)测定空腹血糖(FBG)、餐后2 h血糖、空腹胰岛素水平,计算胰岛素抵抗指数(HOMA-IR),采用单因素线性回归及多元线性回归法分析腰围与胰岛素抵抗的关系。结果两组受试者间2型糖尿病检出率、性别、年龄、BMI、WC、SBP、DBP、FBG、餐后2 h血糖的水平及胰岛素抵抗程度比较差异均有统计学意义(P<0.05);单因素线性回归分析结果显示,BMI、WC、SBP、DBP、FBG、餐后2 h血糖均与胰岛素抵抗程度密切相关(P<0.05);多元线性回归分析结果显示,WC (β=0.034,95%CI 0.011～0.058)、BMI (β=0.154,95%CI 0.096～0.213)、FBG (β=0.283,95%CI 0.267～0.300)是影响胰岛素抵抗的独立危险因素(P<0.05)。结论腹型肥胖者其胰岛素抵抗程度明显高于正常腰围者,WC是影响胰岛素抵抗的危险因素。
Objective To explore the correlation between waist circumference and insulin resistance.Methods A total of 881 patients who underwent physical examination in the physical examination center, the People's Hospital of Nanshan District of Shenzhen from 2008 to 2017 were selected as study subjects. The data were collected,such as gender, age, general information, waist circumference(WC), body mass index(BMI), systolic blood pressure(SBP), and diastolic blood pressure(DBP). According to the waist circumference point of the middle-central obesity(≥90 cm for males, ≥85 cm for females) in"the Health Industry Standard of the People's Republic of China-Adult Weight Determination"issued by the National Health and Family Planning Commission in 2013, the patients were divided into the normal waist group(n=457) and the abdominal obesity group(n=424). Fasting blood glucose(FBG), 2 h postprandial blood glucose levels were measured according to oral glucose tolerance test(OGTT), and insulin resistance index(HOMA-IR) was calculated. The relationship between waist circumference and insulin resistance was analyzed by single factor linear regression and multiple linear regression. Results There were significant differences in the detection rate of type 2 diabetes, gender, age, BMI, waist circumference, SBP, DBP, FBG, postprandial 2-hour blood glucose, and insulin resistance between the two groups(P<0.05). Single factor linear regression analysis showed that BMI, waist circumference, SBP, DBP, FBG, 2 h postprandial blood glucose were all correlated with the degree of insulin resistance(P<0.05). Multiple linear regression showed that waist circumference(β=0.034, 95%CI 0.011-0.058) and BMI(β=0.154,95%CI 0.096-0.213), FBG( β =0.283, 95% CI 0.267-0.300) were independent risk factors for insulin resistance(P<0.05). Conclusion The degree of insulin resistance in subjects with abdominal obesity is significantly higher than that in individuals with normal waist circumference. Waist circumference is a risk factor for insulin resistance.
Objective To explore the correlation between waist circumference and insulin resistance.Methods A total of 881 patients who underwent physical examination in the physical examination center, the People's Hospital of Nanshan District of Shenzhen from 2008 to 2017 were selected as study subjects. The data were collected,such as gender, age, general information, waist circumference(WC), body mass index(BMI), systolic blood pressure(SBP), and diastolic blood pressure(DBP). According to the waist circumference point of the middle-central obesity(≥90 cm for males, ≥85 cm for females) in"the Health Industry Standard of the People's Republic of China-Adult Weight Determination"issued by the National Health and Family Planning Commission in 2013, the patients were divided into the normal waist group(n=457) and the abdominal obesity group(n=424). Fasting blood glucose(FBG), 2 h postprandial blood glucose levels were measured according to oral glucose tolerance test(OGTT), and insulin resistance index(HOMA-IR) was calculated. The relationship between waist circumference and insulin resistance was analyzed by single factor linear regression and multiple linear regression. Results There were significant differences in the detection rate of type 2 diabetes, gender, age, BMI, waist circumference, SBP, DBP, FBG, postprandial 2-hour blood glucose, and insulin resistance between the two groups(P<0.05). Single factor linear regression analysis showed that BMI, waist circumference, SBP, DBP, FBG, 2 h postprandial blood glucose were all correlated with the degree of insulin resistance(P<0.05). Multiple linear regression showed that waist circumference(β=0.034, 95%CI 0.011-0.058) and BMI(β=0.154,95%CI 0.096-0.213), FBG( β =0.283, 95% CI 0.267-0.300) were independent risk factors for insulin resistance(P<0.05). Conclusion The degree of insulin resistance in subjects with abdominal obesity is significantly higher than that in individuals with normal waist circumference. Waist circumference is a risk factor for insulin resistance.
引文
[1]TANG Q,LI X,SONG P,et al.Optimal cut-off values for the homeostasis model assessment of insulin resistance(HOMA-IR)and pre-diabetes screening:Developments in research and prospects for the future[J].Drug Discov Ther,2016,9(6):380-385.
[2]REAVEN GM.Pathophysiology of insulin resistance in human disease[J].Physiol Rev,1995,75(3):473-486.
[3]REAVEN GM.Banting lecture 1988.Role of insulin resistance in human disease[J].Diabetes,1988,37(12):1595-1607.
[4]CHENG YH,TSAO YC,TZENG IS,et al.Body mass index and waist circumference are better predictors of insulin resistance than total body fat percentage in middle-aged and elderly Taiwanese[J].Medicine(Baltimore),2017,96(39):e8126.
[5]GONZALEZ-JIMENEZ E,SCHMIDT-RIOVALLE J,MON-TERO-ALONSO MA,et al.Influence of biochemical and anthropometric factors on the presence of insulin resistance in adolescents[J].Biol Res Nurs,2016,18(5):541-548.
[6]XIA C,LI R,ZHANG S,et al.Lipid accumulation product is a powerful index for recognizing insulin resistance in non-diabetic individuals[J].Eur J Clin Nutr,2012,66(9):1035-1038.
[7]LEVY-MARCHAL C,ARSLANIAN S,CUTFIELD W,et al.Insulin resistance in children:consensus,perspective,and future directions[J].J Clin Endocrinol Metab,2010,95(12):5189-5198.
[8]CAMHI SM,BRAY GA,BOUCHARD C,et al.The relationship of waist circumference and BMI to visceral,subcutaneous,and total body fat:sex and race differences[J].Obesity(Silver Spring),2011,19(2):402-408.
[9]MAZIDI M,KATSIKI N,MIKHAILIDIS DP,et al.The link between insulin resistance parameters and serum uric acid is mediated by adiposity[J].Atherosclerosis,2018,270:180-186.
[10]WEYER C,FUNAHASHI T,TANAKA S,et al.Hypoadiponectinemia in obesity and type 2 diabetes:close association with insulin resistance and hyperinsulinemia[J].J Clin Endocrinol Metab,2001,86(5):1930-1935.
[11]陈桂凤,王新亚,张明芝.体重指数、腰围与胰岛素抵抗相关性的Meta分析[J].中国血液流变学杂志,2016,26(1):41-44.
[12]JANISZEWSKI PM,JANSSEN I,ROSS R.Does waist circumference predict diabetes and cardiovascular disease beyond commonly evaluated cardiometabolic risk factors?[J].Diabetes Care,2007,30(12):3105-3109.
[13]WAHRENBERG H,HERTEL K,LEIJONHUFVUD BM,et al.Use of waist circumference to predict insulin resistance:retrospective study[J].BMJ,2005,330(7504):1363-1364.
[14]TABATA S,YOSHIMITSU S,HAMACHI T,et al.Waist circumference and insulin resistance:a cross-sectional study of Japanese men[J].BMC Endocr Disord,2009,9:1.
[15]SASAKI R,YANO Y,YASUMA T,et al.Association of waist circumference and body fat weight with insulin resistance in male subjects with normal body mass index and normal glucose tolerance[J].Intern Med,2016,55(11):1425-1432.
[16]SHALEV-GOLDMAN E,MCGUIRE KA,ROSS R.Waist circumference and cardiorespiratory fitness are independently associated with glucose tolerance and insulin resistance in obese women[J].Appl Physiol Nutr Metab,2014,39(3):358-362.
[17]ZADEH-VAKILI A,TEHRANI FR,HOSSEINPANAH F.Waist circumference and insulin resistance:a community based cross sectional study on reproductive aged Iranian women[J].Diabetol Metab Syndr,2011,3:18.
[18]LAVIE CJ,MILANI RV,VENTURA HO.Obesity and cardiovascular disease:risk factor,paradox,and impact of weight loss[J].J Am Coll Cardiol,2009,53(21):1925-1932.
[19]OKA R,KOBAYASHI J,INAZU A,et al.Contribution of visceral adiposity and insulin resistance to metabolic risk factors in Japanese men[J].Metabolism,2010,59(5):748-754.
[20]PARK K,LEE DH,ERICKSON DJ,et al.Association of long-term change in waist circumference with insulin resistance[J].Obesity(Silver Spring),2012,18(2):370-376.
[2]REAVEN GM.Pathophysiology of insulin resistance in human disease[J].Physiol Rev,1995,75(3):473-486.
[3]REAVEN GM.Banting lecture 1988.Role of insulin resistance in human disease[J].Diabetes,1988,37(12):1595-1607.
[4]CHENG YH,TSAO YC,TZENG IS,et al.Body mass index and waist circumference are better predictors of insulin resistance than total body fat percentage in middle-aged and elderly Taiwanese[J].Medicine(Baltimore),2017,96(39):e8126.
[5]GONZALEZ-JIMENEZ E,SCHMIDT-RIOVALLE J,MON-TERO-ALONSO MA,et al.Influence of biochemical and anthropometric factors on the presence of insulin resistance in adolescents[J].Biol Res Nurs,2016,18(5):541-548.
[6]XIA C,LI R,ZHANG S,et al.Lipid accumulation product is a powerful index for recognizing insulin resistance in non-diabetic individuals[J].Eur J Clin Nutr,2012,66(9):1035-1038.
[7]LEVY-MARCHAL C,ARSLANIAN S,CUTFIELD W,et al.Insulin resistance in children:consensus,perspective,and future directions[J].J Clin Endocrinol Metab,2010,95(12):5189-5198.
[8]CAMHI SM,BRAY GA,BOUCHARD C,et al.The relationship of waist circumference and BMI to visceral,subcutaneous,and total body fat:sex and race differences[J].Obesity(Silver Spring),2011,19(2):402-408.
[9]MAZIDI M,KATSIKI N,MIKHAILIDIS DP,et al.The link between insulin resistance parameters and serum uric acid is mediated by adiposity[J].Atherosclerosis,2018,270:180-186.
[10]WEYER C,FUNAHASHI T,TANAKA S,et al.Hypoadiponectinemia in obesity and type 2 diabetes:close association with insulin resistance and hyperinsulinemia[J].J Clin Endocrinol Metab,2001,86(5):1930-1935.
[11]陈桂凤,王新亚,张明芝.体重指数、腰围与胰岛素抵抗相关性的Meta分析[J].中国血液流变学杂志,2016,26(1):41-44.
[12]JANISZEWSKI PM,JANSSEN I,ROSS R.Does waist circumference predict diabetes and cardiovascular disease beyond commonly evaluated cardiometabolic risk factors?[J].Diabetes Care,2007,30(12):3105-3109.
[13]WAHRENBERG H,HERTEL K,LEIJONHUFVUD BM,et al.Use of waist circumference to predict insulin resistance:retrospective study[J].BMJ,2005,330(7504):1363-1364.
[14]TABATA S,YOSHIMITSU S,HAMACHI T,et al.Waist circumference and insulin resistance:a cross-sectional study of Japanese men[J].BMC Endocr Disord,2009,9:1.
[15]SASAKI R,YANO Y,YASUMA T,et al.Association of waist circumference and body fat weight with insulin resistance in male subjects with normal body mass index and normal glucose tolerance[J].Intern Med,2016,55(11):1425-1432.
[16]SHALEV-GOLDMAN E,MCGUIRE KA,ROSS R.Waist circumference and cardiorespiratory fitness are independently associated with glucose tolerance and insulin resistance in obese women[J].Appl Physiol Nutr Metab,2014,39(3):358-362.
[17]ZADEH-VAKILI A,TEHRANI FR,HOSSEINPANAH F.Waist circumference and insulin resistance:a community based cross sectional study on reproductive aged Iranian women[J].Diabetol Metab Syndr,2011,3:18.
[18]LAVIE CJ,MILANI RV,VENTURA HO.Obesity and cardiovascular disease:risk factor,paradox,and impact of weight loss[J].J Am Coll Cardiol,2009,53(21):1925-1932.
[19]OKA R,KOBAYASHI J,INAZU A,et al.Contribution of visceral adiposity and insulin resistance to metabolic risk factors in Japanese men[J].Metabolism,2010,59(5):748-754.
[20]PARK K,LEE DH,ERICKSON DJ,et al.Association of long-term change in waist circumference with insulin resistance[J].Obesity(Silver Spring),2012,18(2):370-376.
© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号 地址：北京市海淀区学院路29号 邮编：100083 电话：办公室：(+86 10)66554848；文献借阅、咨询服务、科技查新：66554700 |