不同性别代谢综合征患者腹内脂肪厚度与其他患病因素的关系

Correlation between Intra-abdominal Fat Thickness and Components of Metabolic Syndrome with Regard to Gender Differences

目的探讨不同性别代谢综合征(MS)患者患病情况,分析腹内脂肪厚度与MS及其患病因素的性别差异。方法 2015年5月采用横断面调查的方法调查沈阳市某居民区505例中老年人,其中男249例、女256例。根据2009年IDF AHA/NHLBI诊断标准诊断MS患者205例,其中男124例、女81例。检测MS患者各项指标,超声测量腹内脂肪厚度。结果男性MS患病率高于女性(P<0.01)。男性MS患者腰围、血糖异常发生率高于女性,而HDL-C异常发生率低于女性,差异均有统计学意义(均P<0.05)。多因素logistic回归分析结果显示,调整其他因素后,腹内脂肪厚度是男性发生MS的独立危险因素(OR=1.304,95%CI:1.014~1.676,P=0.039),而不是女性发生MS的独立危险因素(OR=1.257,95%CI:0.984~1.605,P=0.067)。逐步多元线性回归结果显示腹内脂肪厚度在男性MS患者中与年龄、腰围、2 h INS呈线性相关;而在女性MS患者中仅与腰围呈线性相关。结论男女MS患病率及MS诊断条件发生率均存在差异,腹内脂肪厚度是男性发生MS的独立危险因素。腹内脂肪在男性发生MS的作用不能简单地被腰围因素所替代。

Objective To investigate gender differences in the prevalence of metabolic syndrome （MS） and to explore the relationship between intra-abdominal fat thickness and MS and its components with respect to gender differences. Methods Based on gender and IDF AHA/NHLBI criteria used to diagnose MS, 205 middle-aged and elderly urban residents were divided into a male MS group （ 124 patients ） and a female MS group （ 81 patients）. The relative indices and the thickness of intra-abdominal fat were measured. Results The prev- alence of MS was observed to be higher in men （P 〈 0.01）. A greater number of men than women showed waist circumference and blood glucose abnormalities, but fewer men than women showed high-density lipoprotein cholesterol （HDL-C） abnormalities （ P 〈 0.05）. Multi- variate logistic regression analysis showed that after adjusting for potential confounding factors, intra-abdominal fat thickness was an inde- pendent predictor in men, but not in women （ men： OR = 1.304,95%CI： 1.014-1.676, P = 0.039, women： OR = 1.257,95%CI：0.984-1.605, P = 0.067）. Intra-abdominal fat thickness was linearly correlated with age,waist circumference,and the 2-hour insulin levels in men,but only linearly correlated with waist circumference in women. Conclusion Prevalence of MS and MS components varies between genders. Intra-abdominal fat thickness was an independent predictor of MS in men. The role of intra-abdominal fat thickness as a determinant of MS in men can not be replaced by the waistline circumference alone as determined in women.