颈围与糖尿病胰岛素抵抗相关性研究
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摘要
目的:研究不同性别2型糖尿病(T2DM)中颈围(NC)与胰岛素抵抗(IR)相关性。方法:将糖尿病病人165例分为男女两个群体研究,分别测量体质量指数(BMI)、NC、腰围(WC)、臀围(HC)、腰臀比(WHR)及血生化指标,比较不同性别各参数有无差异。spearman线性相关分析NC与各参数相关性以及NC、WC与胰岛素抵抗指数(HOMA-IR)相关性。logistic回归分析NC是否为T2DM危险因素。结果:在男性组,仅年龄与NC无相关关系(P>0.05),高密度脂蛋白(HDL)与NC呈负相关关系(P<0.01),其余指标均与NC呈正相关关系(P<0.05~P<0.01);在女性组,年龄和臀围2个指标与NC无相关关系(P>0.05),HDL与NC呈负相关关系(P<0.01),其余指标均与NC呈正相关关系(P<0.05~P<0.01),尤其NC与BMI、WC有很强的正相关性;校正年龄及性别后,NC、WC、TG均是T2DM危险因素,HDL则是保护因素。结论:NC与IR呈正相关,是T2DM的危险因素,且相较于BMI、WC等其他人体测量参数有更多的优势,可作为评估T2DM更好的指标,临床意义重大。
Objective: To study the correlation between neck circumference( NC) and insulin resistance( IR) in different genders patients with type 2 diabetes mellitus( T2 DM). Methods: A total of 165 diabetic patients were divided into the male group and female group. The body mass index( BMI),NC,waist circunference( WC),waist-hip ratio( WHR),hip circumference( HC) and blood biochemical indicators in two groups were measured,and which was analyzed. The correlations between NC and each parameter,and between NC,WC and HOMA-IR were analyzed using spearman linear correlation analysis. Logistic regression was used to analyze that whether the NC was or not one of risk factor of T2 DM. Results: In male group,the age was not correlation with NC( P > 0. 05),the hight-density lipoprotein( HDL) was negatively correlated with NC( P < 0. 01),and other indicators were positively correlated with NC( P < 0. 05 to P < 0. 01). In female group,the age and hip circumference were not correlation with NC( P < 0. 05),the HDL was negatively correlated with NC( P < 0. 01),other indicators were positively correlated with NC( P < 0. 05 to P < 0. 01),and especially the NC was strongly positive correlation with BMI and WC( P < 0. 05). After adjusting age and gender,the NC,WC and TG were the risk factors of T2 DM,while the HDL was the protective factor of T2 DM. Conclusions: NC is positively related to IR,a risk factor of T2 DM,and which has more advantages than other parameters( such as BMI and WC). NC can be used as a better indicator in evaluating T2 DM,which has great clinical significance.
Objective: To study the correlation between neck circumference( NC) and insulin resistance( IR) in different genders patients with type 2 diabetes mellitus( T2 DM). Methods: A total of 165 diabetic patients were divided into the male group and female group. The body mass index( BMI),NC,waist circunference( WC),waist-hip ratio( WHR),hip circumference( HC) and blood biochemical indicators in two groups were measured,and which was analyzed. The correlations between NC and each parameter,and between NC,WC and HOMA-IR were analyzed using spearman linear correlation analysis. Logistic regression was used to analyze that whether the NC was or not one of risk factor of T2 DM. Results: In male group,the age was not correlation with NC( P > 0. 05),the hight-density lipoprotein( HDL) was negatively correlated with NC( P < 0. 01),and other indicators were positively correlated with NC( P < 0. 05 to P < 0. 01). In female group,the age and hip circumference were not correlation with NC( P < 0. 05),the HDL was negatively correlated with NC( P < 0. 01),other indicators were positively correlated with NC( P < 0. 05 to P < 0. 01),and especially the NC was strongly positive correlation with BMI and WC( P < 0. 05). After adjusting age and gender,the NC,WC and TG were the risk factors of T2 DM,while the HDL was the protective factor of T2 DM. Conclusions: NC is positively related to IR,a risk factor of T2 DM,and which has more advantages than other parameters( such as BMI and WC). NC can be used as a better indicator in evaluating T2 DM,which has great clinical significance.
引文
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[11]BYUN AR,SANG WL,HONG SL,et al.What is the most appropriate lipid profile ratio predictor for insulin resistance in each sex?A cross-sectional study in Korean populations(The Fifth Korea National Health and Nutrition Examination Survey)[J].Diabetol Metab Syndr,2015,7(1):1.
[12]CHANG ET,YANG MC,WANG HM,et al.Snoring in a sitting position and neck circumference are predictors of sleep apnea in Chinese patients[J].Sleep breath,2014,18(1):133.
[2]PREIS SR,MASSARO JM,HOFFMANN U,et al.Neck circumference as a novel measure of cardiometabolic risk:the Framingham heart study[J].J Clin Endocrinol Metab,2010,95(8):3701.
[3]STABE C,VASQUES AC,LIMA MM,et al.Neck circumference as a simple tool for identifying the metabolic syndrome and insulin resistance:results from the Brazilian Metabolic Syndrome Study[J].Clin Endocrinol(Oxf),2013,78(6):874.
[4]YANG L,SAMARASINGHE YP,KANE P,et al.Visceral adiposity is closely correlated with neck circumference and represents a significant indicator of insulin resistance in WHO gradeⅢobesity[J].Clin Endocrinol,2010,73(2):197.
[5]BIRKENFELD AL,SHULMAN GI.Nonalcoholic fatty liver disease,hepatic insulin resistance,and type 2 Diabetes[J].Hepatology,2014,59(2):713.
[6]KUMASHIRO N,ERION DM,ZHANG D,et al.Cellular mechanism of insulin resistance in nonalcoholic fatty liver disease[J].Proc Nati Acad Sci U S A,2011,108(39):16381.
[7]KOUTSARI C,SNOZEK CL,JENSEN MD.Plasma NEFA storage in adipose tissue in the postprandial state:sex-related and regional differences[J].Diabetologia,2008,51(11):2041.
[8]CHUNG S,YOON IY,SHIN YK,et al.Endothelial dysfunction and C-reactive protein in relation with the severity of obstructive sleep apnea syndrome[J].Sleep,2007,30(8):997.
[9]HSUEH WA,QUIONES MJ.Role of endothelial dysfunction in insulin resistance[J].Am J Cardiol,2003,92(4A):10.
[10]ROSENQUIST KJ,MASSARO JM,PENCINA KM,et al.Neck circumference,carotid wall intima-media thickness,and incident stroke[J].Diabetes Care,2013,36(9):e153.
[11]BYUN AR,SANG WL,HONG SL,et al.What is the most appropriate lipid profile ratio predictor for insulin resistance in each sex?A cross-sectional study in Korean populations(The Fifth Korea National Health and Nutrition Examination Survey)[J].Diabetol Metab Syndr,2015,7(1):1.
[12]CHANG ET,YANG MC,WANG HM,et al.Snoring in a sitting position and neck circumference are predictors of sleep apnea in Chinese patients[J].Sleep breath,2014,18(1):133.