腹膜透析患者内脏脂肪与代谢综合征的关系

Visceral fat mass and metabolic syndrome in patients with peritoneal dialysis

目的:探讨内脏脂肪水平与腹膜透析(PD)患者代谢综合征及大动脉僵硬度的关系。方法:用体成分测量仪测定186例PD患者的身体脂肪分布状况,对内脏脂肪水平的相关因素及其与代谢综合征及大动脉僵硬度的关系进行分析。结果:127例代谢综合征患者的内脏脂肪水平明显高于59例非代谢综合征患者(t=-2.135,P<0.05),而年龄(t=-0.496,P>0.05)、性别(κ2=3.360,P>0.05)、透析时间(Z=-1.236,P>0.05)在两组中无明显差异。PD患者内脏脂肪水平与年龄正相关(r=0.424,P<0.01),与腰围正相关(r=0.757,P<0.01),与血HDL-C负相关(r=-0.376,P<0.01),与高血糖正相关(r=0.225,P<0.01),未发现其与透析时间、高血压、血三酰甘油水平、总尿素清除指数的相关性。内脏脂肪水平与血超敏C反应蛋正相关(r=0.209,P<0.01),颈股动脉脉搏波速度与内脏脂肪水平正相关(r=0.314,P<0.01)。结论:内脏脂肪水平与PD患者的代谢综合征及动脉硬化密切相关;PD患者的炎症状态与其内脏脂肪水平密切相关;内脏脂肪主要与糖脂代谢联系紧密。

Objective：To investigate the relationship between visceral fat mass and metabolic syndrome （MS） , arterial stiffness in patients with peritoneal dialysis （PD）. Methodology ： The body fat distributions of one hundred and eighty six PD patients were measured by body composition analyzer using bioelectrical impendence analysis （BIA） technology. The relationship between visceral fat, MS and arterial stiffness was analyzed. SPSS11.5 software was used in statistical analysis. Results：The visceral fat mass was significantly higher in 127 PD patients with MS as compared to 59 PD patients without MS （t = - 2. 135,P 〈 0. 05 ）. There were no difference in age （ t = - 0. 496,P 〉 0. 05 ）, gender （ K2 = 3. 360, P 〉 0.05） and dialysis duration （ Z=- 1. 236, P 〉 0. 05 ） between the two groups. The visceral fat mass was positively correlated with age （ r = 0. 424, P 〈 0. 01 ）, waist circumference （ r = 0. 757, P 〈 0. 01 ）, high blood glucose levels （ r = 0. 225, P 〈 0. 01 ） , and negatively correlated with serum HDL-C （ r = - 0. 376, P 〈 0. 01 ）, whereas no significantly correlations were found between visceral fat mass and dialysis duration, hypertension, serum TG and total KT/ V. Serum ultra-sensitive C reactive protein were positively related to visceral fat mass （ r = 0. 209 ,P 〈 0. 01 ）. The carotid- femoral pulse wave velocity were also positively related to visceral fat mass （r = 0. 314, P 〈 0. 01 ） in PD patients. Conclusion：The level of visceral fat mass was related to MS and arterial stiffness in PD patients. The inflammation was correlated to the visceral fat mass. The visceral fat mass was mainly associated with glucose and lipids metabolism.