腹型肥胖中青年男性早期糖代谢改变与体成分的相关性分析

Relationship Between Early Change of Glucose Metabolism and Body Composition in Young and Middle-age Abdominal Obese Males

【目的】探讨糖耐量正常（NGT ）的腹型肥胖中青年男性糖耐量试验变化与体成分的关系。【方法】选择2009年在本院体检中心进行体检的67例NGT 成年男性，年龄20～50岁，根据腰围（WC）将其分为两组：WC正常成年男性组（对照组，n ＝31），腹型肥胖成年男性组（研究组，n ＝36）。两组研究对象均进行口服葡萄糖耐量试验（OGTT），并检测其空腹血糖（FPG），糖负荷后0．5 h血糖（0．5hPG）、1hPG、2hPG、3hPG。应用双能X线骨密度仪进行体成分分析。【结果】两组间FPG、2hPG、3hPG比较无统计学差异（ P ＞0．05），研究组0．5hPG ，1hPG和葡萄糖曲线下面积（AUCglu ）高于对照组（ P ＜0．05）。体质量指数（BMI），WC及各部位脂肪质量与FPG及3hPG无相关性（ P ＞0．05）；0．5hPG、2hPG与总体脂肪质量及躯干脂肪质量存在正相关（ P ＜0．05）。1hPG 及AUCglu与BMI ，WC ，总体脂肪质量，四肢脂肪质量，躯干脂肪质量均呈正相关（ P＜0．01）。【结论】糖耐量正常腹型肥胖中青年男性已存在糖负荷后血糖代谢异常，与BMI和WC相比，体脂成分分析更能有效识别肥胖男性早期糖代谢异常。

[Objective] To explore the relationship between the changes of oral glucose tolerance test and body composition in young and middle‐age abdominal obese males with normal glucose tolerance （NGT ） .[Methods] This case‐control study included 36 abdominal obese males （waist circumference ,WC≥90 cm） and 31 non‐abdominal obese males （WC〈 90 cm） aged 20～50 years with NGT .Both cases and controls were matched in age .Body fat content was measured by dual‐energy X‐ray absorptiometry .[Results]Fasting plasma glucose ,2 and 3‐hour postload plasma glucose were similar in two groups （ P 〉0 .05） .0 .5 ,1‐hour postload plasma glucose （1hPG） and glucose area under the curve （AUCglu ） were higher in abdominal obese group than those in control group （ P〈0 .05） .AUCglu was positively correlated with body mass index （ r =0 .390） ,WC （ r =0 .438） ,total body fat content （ r =0 .445） ,limbs fat content （ r =0 .372） and trunk fat content （ r =0 .475）（ P 〈0 .01） .According to multiple regression analysis ,trunk fat content was an independent predictor for AUCglu （β=3 .332 ,P=0 .000 ,R2 =0 .228） .[Conclusion] The changes of postload plasma glucose occur in young and middle‐age abdominal obese males with NGT .Body composition assessment is a valid and more ac‐curate method than BMI and WC for predicting early changes of glucose metabolism .