正常BMI腹型肥胖者胰岛素抵抗、血脂及膳食分析

Analysis of insulin resistance,lipid metabolism and survey of dietary intake in abdominal adiposity people with normal BMI

目的探讨正常体质指数(BMI)腹型肥胖者胰岛素抵抗(IR),血脂代谢水平及其营养素摄入与正常体型人群的差异。方法以男性腰围≥85 cm,女性腰围≥80 cm为腹型肥胖判断标准,将收集到的BMI小于24 kg/m2的111例志愿者分成体型正常组和腹型肥胖组,测定其空腹状态下的血糖、胰岛素、胆固醇、甘油三酯、高密度脂蛋白、载脂蛋白B及皮褶厚度等指标,并进行连续三天24 h膳食回顾调查。结果腹型肥胖组人群的空腹胰岛素水平、稳态评估模型胰岛素抵抗指数、甘油三酯均高于体型正常组(P值分别<0.01、<0.05和<0.05),而高密度脂蛋白水平低于体型正常组(P<0.01);其中男性仅高密度脂蛋白水平差异有统计学意义(P<0.05),而女性空腹胰岛素(P<0.01),甘油三酯(P<0.05)及高密度脂蛋白(P<0.01)差异均有统计学意义。两组人群均有营养素摄入不足现象。结论正常BMI腹型肥胖人群与体型正常人群相比,空腹胰岛素、稳态评估模型胰岛素抵抗指数和甘油三酯水平较高,而高密度脂蛋白较低,胰岛素抵抗和脂代谢紊乱的危险性增加,应加强饮食指导,预防糖尿病和高脂血症的发生。

[Objective] To explore the difference of insulin resistance, lipid metabolism and dietary intake between abdominal obesity people and non-abdominal obesity ones, both are normal BMI. [Methods] 111 cases of subjects with BMI less than 24 kg/m^2 were divided into abdominal obesity group and non-abdominal obesity group by waisdine（ male： 85 era,female 80 cm）. Fasting blood glucose （Glu）, insulin （INS）, lipid profile （TG）, cholesterol （TC）, high-density lipoprotein （HDL-C） and ApoB were measured, also did waistline, skinfold thickness and other targets related. A three days 24-hours dietary reviewing survey was also studied. [ Results ] People in abdominal obesity group has a significant higher level in ins, TG and homeostasis model assessment-insulin resistance（HOMA- IR）（independent sample T-test, P is 〈0.01 、〈0.05 and 〈0.05 respectively）, and a significant lower level in HDL-C（P 〈0.01）than that in non-abdominal obesity group. The only significant difference between two groups is the level of HDL-TC（P 〈0.01） for male, but there is significant difference in fasting insulin（P 〈0.01）, TG（P 〈0.05） and HDL-TC （P 〈0.01） for female. However, both two groups have a poor nutrients intake. [ Conclusion] Compared with non- abdominal obesity group, the abdominal obesity group has a higher lever of INS, HOMA-IR and TG, and a lower lever of HDL-C. With a higher risk of insulin resistance and lipid metabolism disorders, dietary should be guided to prevent diabetes mellitus and hyperlipidaemia.