超声测量腹腔不同部位脂肪厚度与心血管风险因素的相关性

Relationship between different regions of abdominal fat measured by ultrasonography and cardiovascular risk factors

目的:分析比较超声测量腹腔不同部位脂肪的厚度与心血管风险因子的关系。方法:随机选取本科住院体检的130例男性患者,测定人体指标和生化指标数据,超声测量其中腹腔脂肪、上腹腔脂肪、肠系膜脂肪的厚度。结果:各部位脂肪与体重指数(BMI)、腰围(WC)、臀围(HC)、腰臀比(WHR)和空腹胰岛素(FINS)、甘油三酯(TG)呈正相关,与年龄、高密度脂蛋白胆固醇(HDL-C)呈负相关,上腹腔脂肪厚度和肠系膜脂肪厚度与胰岛素抵抗指数(HOMA-RI)呈正相关,肠系膜脂肪厚度与尿酸(UA)呈正相关;校正了年龄、BMI和WC的偏相关分析显示,上腹腔脂肪与HOMA-IR及TG水平呈正相关,肠系膜脂肪与FINS及HOMA-IR呈正相关,与HDL-C呈负相关,中腹腔脂肪厚度与各临床参数未见明显相关性;逐步多元线性回归分析显示,上腹腔脂肪厚度及肠系膜脂肪厚度较中腹腔脂肪厚度对心血管风险因子的预测价值更高,且肠系膜脂肪厚度的预测价值更高。结论:上腹腔脂肪及肠系膜脂肪与各心血管风险因子的相关性优于中腹腔脂肪,且上腹腔脂肪和肠系膜脂肪分别与不同心血管风险因子有相关性。超声可分辨及测量腹腔不同部位脂肪,具有重要临床意义。

Objective：To explore and compare the relationship between the different parts of abdominal fat as determined by ultrasonic measurements and the cardiovascular risk factors. Methods：A total of 130 males from the authors＇ affiliated hospital were involved,anthropometric and metabolic parameters were measured. Each subject underwent ultrasonography to estimate the visceral fat thickness in the mid-abdominal cavity（VFT-M）,the visceral fat thickness in the upper abdominal cavity（VFT-U）and mesenteric fat thickness（MFT）. Results：All of the abdominal fat thickness were positively correlated to body mass index（BMI）,waist circumference（WC）,hip circumference（HC）,waist-hip ratio（WHR）,fasting insulin（FINS）,triglyceride（TG）,and negatively correlated to age,high-density lipoprotein（HDL-C）,the VFT-U and MFT were positively correlated to insulin resistance index（HOMA-RI）,the MFT was positively correlated to uric acid（UA）. The partial correlation analysis after adjusting for age,BMI and WC showed that：VFT-U was positively associated with HOMA-IR and TG;MFT was positively associated with FINS,HOMA-IR and was negatively associated with HDL-C;VFT-M showed no association with neither cardiovascular risk factors. The stepwise multiple linear regression showed that：VFT-U and MFT,especially the MFT,were more valuable for the prediction of cardiovascular risk factors. Conclusion：VFT-U and MFT are good correlated with cardiovascular risk factors compared with VFT-M. VFT-U and MFT are associated with different cardiovascular risk factors. Different parts of abdominal fat recognized and measured by ultrasonography show a great clinical significance.