体脂分布类型和胰岛素抵抗对心血管病危险因素聚集性的影响

Influence of overweight pattern and insulin resistance on clustering of cardiovascular risk factors

目的 探讨体脂分布类型和胰岛素抵抗对心血管病危险因素聚集性的影响。方法 在自然人群中调查体重指数 (BMI)、腰围 /臀围比值 (WHR)、血压、血胆固醇 (TC)、甘油三酯 (TG)、高密度脂蛋白 胆固醇 (HDL C)、血糖 (FBS)、胰岛素 (INS)及胰岛素敏感性指数 (ISI)。结果 外周型超重组血压、TG、INS高于非超重组 ,HDL C、ISI低于非超重组 ;而中心型超重组血压、INS及危险因素聚集程度高于外周型超重组 ,ISI低于外周型超重组 ;多元分析显示ISI与血脂、血糖及危险因素聚集程度相关更密切。结论 BMI、WHR、ISI均可影响心血管病危险因素 ,但体脂分布类型是影响心血管病危险因素聚集的重要因素 ,并与胰岛素敏感性的降低密切相关。

Objective To explore the relationship between overweight pattern and insulin resistance on clustering of cardiovascular risk factors. Methods A survey was carried out in a rural population. Body mass index (BMI), waist-hip ratio (WHR), systolic and diastolic blood pressure (SBP, DBP), total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), fasting blood sugar (FBS), insulin and insulin sensitivity index (ISI) were measured in*"a*"sampled*" 1*#132 *"(496*"males*!,*"636*"femals) adults aged 35 - 59 years. Results In the overweight group with central fat distribution, mean SBP (136 0 vs 122 3, mm Hg), DBP (86 1 vs 75 7, mm Hg), TC (5 06 vs 4 68, mmol/L), TG (2 12 vs 1 22, mmol/L), FBS (6 18 vs 5 87, mmol/L), INS (7 68 vs 3 94, mU/L) were significantly higher, whereas mean HDL-C (1 56 vs 1 76, mmol/L), ISI (-6 52 vs -5 79) were significantly lower than non-overweight group with peripheral fat distribution. In the overweight group with central fat distribution, mean SBP (136 vs 128, mm Hg), DBP (86 1 vs 80 5, mm Hg), INS (7 68 vs 5 23, mU/L) were also significantly higher, whereas mean ISI (-6 52 vs -6 16) was also significantly lower than the overweight group with peripheral fat distribution. The prevalence of hypertension, diabetes mellitus, hyperlipidemia and the degree of cluster of cardiovascular risk factors were also higher for central pattern than for peripheral pattern, whether overweight or not. After controlling the effect of other variables, multivariant regression analysis revealed that the degree of cluster of cardiovascular risk factors was significantly correlated with insulin sensitivity index. Conclusion All of BMI, WHR, ISI may influence cardiovascular risk factors, but body fat distribution is an important factor influencing the cluster of cardiovascular risk factors and correlates with insulin resistance.