不同类型糖尿病患者腹部脂肪分布特点及其与胰岛素抵抗的相关性研究

Correlation Analysis between Distribution Characteristics of Abdominal Fat and Insulin Resistance in Diabetes Mellitus Patients with Different Types

目的探讨不同类型糖尿病患者腹部脂肪在不同年龄及性别的分布情况,分析其与胰岛素抵抗（IR）的相关性。方法 2010年1月—2011年1月北京大学航天临床医学院内分泌科收治的1型糖尿病（T1DM）79例和2型糖尿病（T2DM）77例,比较不同年龄和性别中腹腔内脂肪含量（VA）、腹壁脂肪含量（SA）、VA/SA、体重指数（BMI）。分析HOMA-IR与VA、SA、VA/SA、BMI、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDLC）和年龄的相关性。结果 T1DM和T2DM患者均存在IR。T1DM 10～、20～岁组女性SA高于男性,VA/SA低于男性（P〈0.01）;同性别组中,VA/SA随年龄增长而增高,男性组不同年龄VA/SA比较差异有统计学意义（P〈0.05）。T2DM患者同年龄组比较,45～、55～65岁组男性VA/SA高于女性（P〈0.01）。T1DM HOMA-IR未发现与腹部脂肪含量及其他临床指标存在相关性（P〉0.05）;T2DM HOMA-IR与VA和TG相关（r=0.259,P=0.026;r=0.378,P=0.001）。结论 T1DM和T2DM糖尿病HOMA-IR相关因素不同,评估腹部脂肪含量可对不同年龄及性别糖尿病患者的临床治疗提供参考。

Objective To investigate distribution characteristics of abdominal fat and to analyze its correlation with insulin resistance（ IR） in different types of diabetes mellitus patients in different age and gender groups. Methods A total of 79 type 1 diabetes mellitus（ T1DM） patients and 77 type 2 diabetes mellitus（ T2DM） patients in the endocrinological department of the Aerospace College of Clinical Medicine of Peking University during January 2010 and January 2011 were recruited in this study. The values of visceral adiposity（ VA）,superficial adiposity（ SA）,VA / SA and body mass index（ BMI） in different age and gender groups were compared. The correlations between IR and VA,SA,VA / SA,BMI,triglyceride（ TG）,high density lipoprotein-Cholesferol（ HDL-C）,low density lipoprotein-Cholesterol（LDL） and age factors were analyzed. Results Both T1 DM and T2 DM patients had IR. In T1 DM patients,SA values of female patients were significantly higher than those of male patients in 10-20 years old and 20-30 years old groups（ P〈0. 01）; in same gender groups,VA / SA values increased with age,and the differences of VA / SA values in male patients with different age groups were statistically significant（ P〈0. 05）. In T2 DM patients,VA / SA values of male patients were significantly higher than those of female patients in 45-55 years old and 55-65 years old groups（ P〈0. 01）. No correlation was found between IR and distribution of abdominal fat or other clinical indexes in T1 DM patients（ P〉0. 05）,but VA and TG were found to be correlated with IR in T2 DM patients（ r = 0. 259,P = 0. 026; r = 0. 378,P = 0. 001）.Conclusion T1 DM and T2 DM patients have different correlation factors with IR,therefore it can offer a guideline in treatment of diabetes mellitus patients in different age and gender groups by assessing distributions of abdominal fat.