不同糖代谢人群腹内脂肪面积与胰岛素抵抗相关性研究
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摘要
目的探讨不同糖代谢人群腹内脂肪面积与胰岛素抵抗的相关性。方法选择经口服葡萄糖耐量试验(OGTT)诊断为2型糖尿病患者(T2DM组)、糖调节受损患者(IGR组)及血糖正常(NC组)的门诊体检者,每组50例,登记3组患者的一般资料,测量身高、体重,计算体质量指数(BMI);受试者空腹行口服葡萄糖耐量试验,检测0、0.5、1、2、3 h血糖及胰岛素,计算胰岛素抵抗指数(HOMA-IR)及胰岛素敏感指数(ISI),由专人采用双重生物电阻抗法测定腹内脂肪面积。比较3组患者腹内脂肪面积、血糖、胰岛素及胰岛素抵抗指数、胰岛素敏感指数的差异,分析胰岛素抵抗指数与腹部脂肪面积的相关性,并分析糖代谢异常的危险因素。结果 3组间腹内脂肪面积随着血糖的升高而面积增大,NC组与血糖异常的2组(IGT及T2DM)组间差异有统计学意义(P<0.05)。HOMA-IR结果随血糖的升高而增大(P<0.05),ISI结果随血糖升高而减小(P<0.05),组间差异有统计学意义;腹内脂肪面积与胰岛素抵抗指数呈正相关(r=0.567,P<0.05);将3组分成血糖正常组和血糖异常组进行分析,以是否血糖异常为应变量,行Logistic回归分析结果显示,年龄、腹内脂肪面积、ISI是糖代谢异常的重要危险因素。结论腹内脂肪堆积与胰岛素抵抗密切相关,腹型肥胖和胰岛素抵抗是糖代谢异常的重要危险因素。
Objective To investigate the correlation between of the intra-abdominal fat area and insulin resistance in the individual with different glucose metabolism.Methods A total of 150 patients with type 2 diabetes mellitus(T2DM) who were diagnoaed by OGTT test were enrolled as T2DM group,and the patients with impaired glucose regulation(IGR) were enrolled as IGR group, and 50 healthy subjects with normal blood glucosewere enrolled as control group. The general indexes including body height,body weight,body mass index(BMI)were measured.The fasting oral glucose tolerance test was performed.The levels of blood glucose(0,0.5 h,1 h,2 h,3 h)and insulin(0,0.5 h,1 h,2 h,3 h)were detected, and insulin resistance index(HOMA-IR) and insulin sensitivity index(ISI) were calculated.Moreover the intra-abdominal fat area was measured by special person using dual bioelectrical impedance method.The differences of intra-abdominal fat area,blood glucose,insulin,HOMA-IR and ISI were observed and compared among the three groups.The correlation between insulin resistance index and abdominal fat area was analyzed,moreover, the risk factors for abnormal glucose metabolism abnormality were analyzed.Results The area of intra-abdominal fat in the three groups was increased with the increase of blood glucose,there was significant difference between control group and IGT group as well as T2DM group(P<0.05).The HOMA-IR was increased with the increase of blood glucose(P<0.05),however, the ISI was decreased with the increase of blood glucose(P<0.05),and there was significant difference between groups.Moreover there was a positive correlation between intra-abdominal fat area and insulin resistance index(P<0.05).Logistic regression analysis showed that age,intra-abdominal fat area,ISI were important risk factors for abnormal glucose metabolism abnormality.Conclusion The abdominal fat accumulation is closely related to insulin resistance,and abdominal obesity and insulin resistance are important risk factors for abnormal glucose metabolism abnormality.
Objective To investigate the correlation between of the intra-abdominal fat area and insulin resistance in the individual with different glucose metabolism.Methods A total of 150 patients with type 2 diabetes mellitus(T2DM) who were diagnoaed by OGTT test were enrolled as T2DM group,and the patients with impaired glucose regulation(IGR) were enrolled as IGR group, and 50 healthy subjects with normal blood glucosewere enrolled as control group. The general indexes including body height,body weight,body mass index(BMI)were measured.The fasting oral glucose tolerance test was performed.The levels of blood glucose(0,0.5 h,1 h,2 h,3 h)and insulin(0,0.5 h,1 h,2 h,3 h)were detected, and insulin resistance index(HOMA-IR) and insulin sensitivity index(ISI) were calculated.Moreover the intra-abdominal fat area was measured by special person using dual bioelectrical impedance method.The differences of intra-abdominal fat area,blood glucose,insulin,HOMA-IR and ISI were observed and compared among the three groups.The correlation between insulin resistance index and abdominal fat area was analyzed,moreover, the risk factors for abnormal glucose metabolism abnormality were analyzed.Results The area of intra-abdominal fat in the three groups was increased with the increase of blood glucose,there was significant difference between control group and IGT group as well as T2DM group(P<0.05).The HOMA-IR was increased with the increase of blood glucose(P<0.05),however, the ISI was decreased with the increase of blood glucose(P<0.05),and there was significant difference between groups.Moreover there was a positive correlation between intra-abdominal fat area and insulin resistance index(P<0.05).Logistic regression analysis showed that age,intra-abdominal fat area,ISI were important risk factors for abnormal glucose metabolism abnormality.Conclusion The abdominal fat accumulation is closely related to insulin resistance,and abdominal obesity and insulin resistance are important risk factors for abnormal glucose metabolism abnormality.
引文
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2 Hoenig MR,Cowin G,Buckley R,et al.Low density lipoprotein cholesterol is inversely correlated with abdominal visceral fat area:a magnetic resonance imaging study.Lipids Health Dis,2011,10:12.
3 Shields M,Tremblay MS,Connor Gorber S,et al.Abdominal obesity and cardiovascular disease risk factors within body mass index categories.Health Rep,2012,23:7-15.
4 Item F,Konrad D.Visceral fat and metabolic inflammation:the portal theory revisited.Obes Rev,2012,13:30-39.
5 Tillin T,Hughes AD,Godsland IF,et al.Insulin resistance and truncal obesity as important determinants of the greater incidence of diabetes in Indian Asians and African Caribbeans compared with Europeans:the Southall And Brent REvisited (SABRE)cohort.Diabetes Care,2013,36:383-393.
6 海德桑,徐焱成.体脂分布与心血管疾病危险因素的相关性研究.临床内科杂志,2012,29:533-534.
7 Neeland IJ,Turer AT,Ayers CR,et al.Dysfunctional adiposity and the risk of prediabetes and type 2 diabetes in obese adults.JAMA,2012,308:1150-1159.
8 Turker Y,Baltaci D,Turker Y,et al.Investigation of relationship of visceral body fat and inflammatory markers with metabolic syndrome and its components among apparently healthy individuals.Int J Clin Exp Med,2015,8:13067.
9 Graner M,Siren R,Nyman K,et al.Cardiac steatosis associates with visceral obesity in nondiabetic obese men.J Clin Endocrinol Metab,2013,98:1189-1197.
10 Kl? ting N,Fasshauer M,Dietrich A,et al.Insulin-sensitive obesity.Am J Physiol Endocrinol Metab,2010,299:E506-E515.
11 zLewandowski KC,Stojanovie N,Press M,et al.Study on the relationship of plasma visfatin,adiponectin and leptin with obesity and type 2 diabetes mellita.Chin J Diabetes,2010,18:883-885.
12 陈蕾,贾伟平,项坤三,等.肥胖者胰岛素抵抗与总体脂、局部体脂关系的研究.中华内分泌代谢杂志,200l,17:275-279.
2 Hoenig MR,Cowin G,Buckley R,et al.Low density lipoprotein cholesterol is inversely correlated with abdominal visceral fat area:a magnetic resonance imaging study.Lipids Health Dis,2011,10:12.
3 Shields M,Tremblay MS,Connor Gorber S,et al.Abdominal obesity and cardiovascular disease risk factors within body mass index categories.Health Rep,2012,23:7-15.
4 Item F,Konrad D.Visceral fat and metabolic inflammation:the portal theory revisited.Obes Rev,2012,13:30-39.
5 Tillin T,Hughes AD,Godsland IF,et al.Insulin resistance and truncal obesity as important determinants of the greater incidence of diabetes in Indian Asians and African Caribbeans compared with Europeans:the Southall And Brent REvisited (SABRE)cohort.Diabetes Care,2013,36:383-393.
6 海德桑,徐焱成.体脂分布与心血管疾病危险因素的相关性研究.临床内科杂志,2012,29:533-534.
7 Neeland IJ,Turer AT,Ayers CR,et al.Dysfunctional adiposity and the risk of prediabetes and type 2 diabetes in obese adults.JAMA,2012,308:1150-1159.
8 Turker Y,Baltaci D,Turker Y,et al.Investigation of relationship of visceral body fat and inflammatory markers with metabolic syndrome and its components among apparently healthy individuals.Int J Clin Exp Med,2015,8:13067.
9 Graner M,Siren R,Nyman K,et al.Cardiac steatosis associates with visceral obesity in nondiabetic obese men.J Clin Endocrinol Metab,2013,98:1189-1197.
10 Kl? ting N,Fasshauer M,Dietrich A,et al.Insulin-sensitive obesity.Am J Physiol Endocrinol Metab,2010,299:E506-E515.
11 zLewandowski KC,Stojanovie N,Press M,et al.Study on the relationship of plasma visfatin,adiponectin and leptin with obesity and type 2 diabetes mellita.Chin J Diabetes,2010,18:883-885.
12 陈蕾,贾伟平,项坤三,等.肥胖者胰岛素抵抗与总体脂、局部体脂关系的研究.中华内分泌代谢杂志,200l,17:275-279.