成人生长激素缺乏症患者内脏脂肪指数与心血管疾病风险因素的相关性研究

Correlation of visceral adipose levels and cardiovascular risk factors for disease in patients with adult growth hormone deficiency

目的探讨成人生长激素缺乏症(AGHD)患者内脏脂肪指数(VAI)水平变化及其与人体测量学指标、糖脂代谢指标和炎症介质高敏C反应蛋白(hs-CRP)、白细胞介素6(IL-6)的相关性。方法收集40例AGHD患者及40例健康人群,测量两组人群人体测量学参数及糖脂生化指标,包括体重指数(BMI)、腰臀比(WHR)、VAI、腰围身高比值(WHt R)、亮氨酸氨基肽酶(LAP)、稳态模型评价的胰岛素抵抗指数(HOMA-IR)、稳态模型评价的胰岛素分泌指数(HOMA-β)、低密度脂蛋白胆固醇(LDL-C)/高密度脂蛋白胆固醇(HDL-C)比值、总胆固醇(TC)/HDL-C比值、甘油三酯(TG)/LDL-C。结果与对照组相比,AGHD组BMI、腰围(WC)、WHR、空腹胰岛素(FINS)、HOMA-β、HOMAIR、TC、TG、LDL-C/HDL-C、TC/HDL-C、hs-CPR、IL-6、VAI均明显增高,HDL-C明显降低,差异有统计学意义(P<0.05);VAI值与WC、WHR、舒张压(SBP)、FINS、HOMA-β、HOMA-IR、TG、LDL-C/HDL-C、TC/HDL-C、TG/LDL-C、hs-CPR、IL-6呈正相关(P<0.05)。多元线性回归分析显示,hs-CRP和IL-6是VAI的独立危险因素。Pearson相关指数分析显示,VAI与脂代谢和炎症因子相关性比WC、BMI、WHR、WHt R更好。结论 AGHD患者VAI值显著高于健康人群,并与罹患心血管疾病的多种危险因素显著相关。

Objective To explore the correlation of v isceral adipose index（VAI） w ith anthropometrics, glycolipid metabolism markers, high-sensitivity C-reactive protein（hs-CRP） and interleukin-6（IL-6） in patients with adult growth hormone deficiency（AGHD）. Methods A total of 40 AGHD patients from First Affiliated Hospital of Chongqing Medical University and 40 healthy adults from physical examination centre（control group）, matched with age and gender, were enrolled in present study. The general anthropometrics and blood biochemical indexes were collected and compared between the two groups. Waist circumference（WC）, body mass index（BMI）, waist-hip ratio（WHR）, waist-height ratio（WHt R）, and visceral adipose index（VAI） were examined, and homeostasis model assessment-insulin resistance（HOMA-IR）, homeostasis model assessment β-cell function（HOMA-β）, LDL-C/HDL-C, TC/HDL-C and TG/LDL-C between the two groups were calculated. Results Compared with control group, the levels of BMI, WC, WHR, fasting insulin（FINS）, HOMA-β, HOMA-IR, triglyceride（TG）, LDL-C/HDL-C, TC/HDL-C, hs-CPR, IL-6 and VAI were significantly higher, but those of HDL-C were lower in AGHD group（P〈0.05）. There was a positive correlation between VAI and all the factors including WC, WHR, FINS, HOMA-β, HOMA-IR, TC, LDL-C/HDL-C, TC/HDL-C, TG/LDL-C, hs-CRP and IL-6（P〈0.05）. Multiple linear regression analysis revealed that hs-CRP and IL-6 were the independent risk factors of VAI. Pearson correlation index analysis showed that VAI was more correlated with lipid metabolism and inflammatory cytokines than with WC, BMI, WHR and WHt R. Conclusion VAI is significantly higher in AGHD patients than in healthy people, and it shows a strong correlation with many risk factors for cardiovascular diseases.