2型糖尿病患者合并中心性肥胖对血浆B型脑钠肽影响的相关性研究

The changes of plasma B-type natriuretic peptide in patients with type 2 diabetes and central obesity

目的探讨2型糖尿病合并中心性肥胖患者血B型脑钠肽(BNP)的变化。方法 197例2型糖尿病患者作为研究对象,根据体重指数BMI分成正常及偏瘦组(BMI<24,92例)、超重组(24≤BMI<28,82例)和肥胖组(BMI≥28,23例)。以腰围身高比(WHt R)男>0.49,女>0.5为中心性肥胖标准,超重组中心性肥胖者44例,肥胖组中心性肥胖者19例。测定入院时的血浆BNP,分析BNP与BMI的相关性,并作组间比较。结果肥胖组的BNP水平[32.5(14.3~214.9)]低于超重组[82.2(45.1~377.1)]和正常及偏瘦组[187.7(89.5~534.1)],差异均具有统计学意义(Z=-2.24、-2.98,P<0.05,超重组的BNP水平亦低于正常及偏瘦组,差异具有统计学意义(Z=-2.49,P<0.05)。BNP与BMI呈负相关(r=-0.32,P<0.05)。超重组与肥胖组中的男、女中心性肥胖患者,BMI与BNP呈中度负相关(r=-0.67、-0.72,P<0.01)。结论 2型糖尿病患者随着BMI增加,血浆BNP水平下降,中心性肥胖患者,BNP水平下降更为明显。

Objective To investigate the changes of plasmal B-type natriuretic peptide （BNP） in patients with type2diabetes and central obesity. Methods 197 patients with type2 diabetes were enrolled and divided into normal-thingroup （body mass index-BMI〈24, n= 92）, overweight group （24≤BMI〈28, n=82） and obesity group （BMI≥28, n=23）based on BMI. According to waist to height ratio （Male〉0.49 and female〉0.5 as the cut off value of central obesity）, 44cases in overweight group and 19 cases in obesity group were central obesity. Plasmal BNP was measured and comparedbetween different groups. The relationship between BNP and BMI was analyzed. Results BNP was significantly lower inobesity group[32.5（14.3-214.9）] than in overweight group [82.2（45.1-377.1）]and normal-thin group[187.7（89.5-534.1）]（Z=-2.24、 -2.98, P〈0.05）, and was significantly lower in overweight group than in normal-thin group（Z=-2.49, P〈0.05）.There was negative correlation between BNP and BMI（r=-0.32, P〈0.05） in all subjects. The negative correlation betweenBNP and BMI in both male and female in overweight and obesity groups were moderate（r=-0.67、 -0.72, P〈0.01）.Conclusion With the increasing of BMI, plasma BNP level decreases in diabetic patients. BNP level decreases more indiabetic patients with central obesity.