超声测量内脏脂肪和心外膜脂肪组织厚度对代谢综合征的诊断预测价值

To evaluate the diagnostic predictive value of visceral adipose thickness and epicardial adipose thickness in the patients with metabolism syndrome

目的超声测量内脏脂肪厚度(VAT)和心外膜脂肪组织厚度(EAT),评价其对代谢综合征(MS)的诊断预测价值。方法对210例入选的健康体检者进行腰围、空腹血生化测定和经超声测量VAT、EAT。根据国际糖尿病联盟MS标准,分为MS组和非MS组,用SPSS12.0软件进行统计学分析。结果男女VAT在MS组均高于非MS组(P<0.01),而EAT在男性MS组高于非MS组(P<0.05),女性两组比较无差异;无论男女VAT和EAT均和腰围成正相关;经年龄、性别、腰围调整后,VAT和收缩压、舒张压、甘油三酯、载脂蛋白B、空腹胰岛素、胰岛素抵抗指数成正相关,胰岛素敏感指数成负相关;EAT和空腹胰岛素、胰岛素抵抗指数成正相关,胰岛素敏感指数成负相关。经超声测量的VAT、EAT诊断MS的ROC曲线下面积分别为男性0.74、0.73,女性为0.79、0.63,诊断切点值分别为男性43.5mm、5.53mm,女性23.8mm、7.95mm。两种方法ROC曲线下面积比较,无论男女均无显著性差异。结论由超声测量的VAT和EAT指标均可作为内脏型肥胖简便、可靠和实用的评价指标,与MS关系密切,可作为MS患者无创的协同诊断方法之一。

Objective To evaluate the diagnostic predictive value of two non-invasive detections ,visceral adipose thickness（VAT） and epicardial adipose thickness（EAT） in the patients with metabolism syndrome（MS）.Methods Two hundreds and ten study subjects who were from health examination center were enrolled.According to the new standard of MS issued by international diabetes federation,they were divided into two groups：MS group and control group.Each subject was measured in waist circumference,blood biochemical index and was estimated in cardiac parameters、VAT and EAT by ultrasonagraphy,data was analyzed by software of SPSS 12.0.Results VAT was significantly higher in MS group than that in control group（P〈0.01）,but EAT in men was significantly higher in MS group than that of control group（P〈0.05） and EAT in women there was no significant difference between the two groups.VAT and EAT in men and women were both positive correlated with waist circumference.One non-invasive way in the diagnosis for MS is VAT measured by ultrasonography,the area under ROC curve of VAT in the diagnosis of MS is 0.74 in men,0.79 in women,appropriate cut-offs of VAT for men is 43.5mm,for women is 23.8 mm.Another non-invasive way in the diagnosis for MS is EAT measured by ultrasonography,the area under ROC curve is 0.73 in men,0.63 in women,appropriate cut-offs for men is 5.53 mm,for women is 7.95 mm.Compared these two ways,there were no significant differences（P〈0.05）.Conclusion These two ways seem to be a simple and practical method for the assessment of visceral obesity,They both are closely associated with MS and can be one of noninvasive ways in the collaborative diagnosis for MS.