内脏脂肪区域、体脂肪率及血脂异常与糖尿病前期的关系
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摘要
目的了解内脏脂肪区域(visceral fat area,VFA)、体脂肪率(body fat percentage,BFP)、血脂异常与糖尿病前期(impaired glucose regulation,IGR)的关系并探讨IGR的危险因素。方法采用病例-对照法,选择克拉玛依市中心医院健康管理中心确诊糖尿病前期组238人,血糖正常组292人进行体格测量、生化指标及人体成分检测,采用logistic回归分析糖尿病前期的危险因素。结果 IGR组的体重指数(body mass index,BMI)、甘油三酯(triglyceride,TG)、高密度脂蛋白(high density lipoprotein,HDL)、VFA均高于血糖正常组(P <0. 05),BFP与血糖正常组比较差异无统计学意义(P>0. 05); IGR组中高TG血症、高TC血症及高LDL血症的检出率分别为26. 50%、10. 90%、8. 80%,均高于血糖正常组(P <0. 05);二分类logistic回归分析显示,肥胖(OR=2. 035,95%CI:1. 183～3. 501),VFA≥111. 74 cm2(OR=1. 910,95%CI:1. 183～3. 501),高TG血症者(OR=2. 779,95%CI:1. 685～4. 582)为糖尿病前期的危险因素。结论糖尿病前期与肥胖、内脏脂肪区域及高TG血症有关,未发现体脂率水平与糖尿病前期有关系。
Objective To investigate the relationship between visceral fat area(VFA),body fat percentage(BFP),dyslipidemia and impaired glucose regulation(IGR),and to explore the risk factors for IGR. Methods Case-control method was used in this study. 238 patients with IGR and 292 subjects with normal blood glucose were selected from Health Management Center of Karamay Central Hospital. Physical examination,biochemical indexes and human body composition were tested. Logistic regression was used to analyze the risk factors of IGR. Results Body mass index,triglyceride and high density lipoprotein levels and visceral fat area of the IGR group were all higher than those of the normal blood glucose group(all P < 0.05),but no statistically significant difference was found in BFP between the two groups(P> 0.05). The detection rates of hypertriglyceridemia,hypercholesterolemia and low density lipoprotein hyperlipidemia in the IGR group were 26.50%,10.90 % and 8.80 % respectively,which were all higher than those of the normal blood glucose group(all P< 0.05). Binary logistic regression analysis showed that obesity(OR = 2.035,95%CI: 1.183-3.501),VFA≥ 111.74 cm2(OR = 1.910,95%CI: 1.183-3.501),and hypertriglyceridemia(OR =2.779,95% CI: 1.685-4.582) were risk factors for prediabetes. Conclusions Obesity,visceral fat area and hypertriglyceridemia are associated with prediabetes,whereas BFP level is not related to prediabetes.
Objective To investigate the relationship between visceral fat area(VFA),body fat percentage(BFP),dyslipidemia and impaired glucose regulation(IGR),and to explore the risk factors for IGR. Methods Case-control method was used in this study. 238 patients with IGR and 292 subjects with normal blood glucose were selected from Health Management Center of Karamay Central Hospital. Physical examination,biochemical indexes and human body composition were tested. Logistic regression was used to analyze the risk factors of IGR. Results Body mass index,triglyceride and high density lipoprotein levels and visceral fat area of the IGR group were all higher than those of the normal blood glucose group(all P < 0.05),but no statistically significant difference was found in BFP between the two groups(P> 0.05). The detection rates of hypertriglyceridemia,hypercholesterolemia and low density lipoprotein hyperlipidemia in the IGR group were 26.50%,10.90 % and 8.80 % respectively,which were all higher than those of the normal blood glucose group(all P< 0.05). Binary logistic regression analysis showed that obesity(OR = 2.035,95%CI: 1.183-3.501),VFA≥ 111.74 cm2(OR = 1.910,95%CI: 1.183-3.501),and hypertriglyceridemia(OR =2.779,95% CI: 1.685-4.582) were risk factors for prediabetes. Conclusions Obesity,visceral fat area and hypertriglyceridemia are associated with prediabetes,whereas BFP level is not related to prediabetes.
引文
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[11]Alberti KG,Zimmet P,Shaw J. Metabolic syndrome-a newworld-wide definition. A consensus statement from the International Diabetes Federation[J]. Diabet Med,2006,23(5):469-480.
[12] Tang LZ,Zhang F,Tong NW. The association of visceral adipose tissue and subcutaneous adipose tissue with metabolic risk factors in a large populationof Chinese adults[J]. Clin Endocrinol,2016,85(1):46-53.
[13] Rhee EJ. Diabetes in Asians[J]. Endocrinol Metab,2015,30(3):263-269.
[14]王佳丽,陈祚,张林峰,等.新疆、西藏地区35岁及以上人群身体脂肪率、内脏脂肪指数与心脏代谢危险因素聚集的关系[J].中华流行病学杂志,2017,38(6):727-730.
[15]苏齐,侯进.上海城郊中老年人群糖尿病前期影响因素分析[J].实用预防医学,2015,22(5):559-562.
[16]符艳,陈冬燕,刘璞瑜,等.海南省居民血脂比值与糖尿病的关系[J].中国热带医学,2018,18(11):1120-1122.
[2] Yang W,Lu J,Weng J,et al. Prevalence of diabetes among men and women in China[J]. N Engl Med,2010,362(12):1090-1101.
[3]陈颖,夏明锋,李小英.体脂分布与糖尿病风险[J].中华糖尿病杂志,2017,25(4):218-220.
[4] American Diabetes Association. Standards of medical care indiabetes2016[J]. Diabetes Care,2016,39(Suppl 1):S1-S112.
[5]中国成人血脂异常防治指南制订联合委员会.中国成人血脂异常防治指南[J].中华心血管病杂志,2007,35(5):390-419.
[6] Walsh EI,Shaw J,Cherbuin N. Trajectories of BMI change impact glucose and insulin metabolism[J]. Nutr Metab Cardiovasc Dis,2018,28(3):243-251.
[7] Neeland IJ,Turer AT,Ayers CR,et al. Dysfunctional adiposity and the risk of prediabetes and type 2 diabetes inobese adults[J]. JAMA,2012,308(11):1150-1159.
[8] Obata Y,Maeda N,Yamada Y,et al. Impact of visceral fat on gene expression profile in peripheral blood cells in obese Japanese subjects[J]. Cardiovasc Diabetol,2016,15(1):159-167.
[9] Item F,Konrad D. Visceral fat and metabolic inflammation:the portal theory revisited[J]. Obes Rev,2012,13(Suppl 2):30-39.
[10] Mainous AG,Tanner RJ,Jo A,et al. Prevalence of prediabetes and abdominal obesity among healthy-weight adults:18-year trend[J]. Ann Fam Med,2016,14(4):304-310.
[11]Alberti KG,Zimmet P,Shaw J. Metabolic syndrome-a newworld-wide definition. A consensus statement from the International Diabetes Federation[J]. Diabet Med,2006,23(5):469-480.
[12] Tang LZ,Zhang F,Tong NW. The association of visceral adipose tissue and subcutaneous adipose tissue with metabolic risk factors in a large populationof Chinese adults[J]. Clin Endocrinol,2016,85(1):46-53.
[13] Rhee EJ. Diabetes in Asians[J]. Endocrinol Metab,2015,30(3):263-269.
[14]王佳丽,陈祚,张林峰,等.新疆、西藏地区35岁及以上人群身体脂肪率、内脏脂肪指数与心脏代谢危险因素聚集的关系[J].中华流行病学杂志,2017,38(6):727-730.
[15]苏齐,侯进.上海城郊中老年人群糖尿病前期影响因素分析[J].实用预防医学,2015,22(5):559-562.
[16]符艳,陈冬燕,刘璞瑜,等.海南省居民血脂比值与糖尿病的关系[J].中国热带医学,2018,18(11):1120-1122.