中国中老年人群内脏脂肪指数与胰岛素抵抗和糖代谢的关系

Relationship between visceral adiposity index,insulin resistance and glucose metabolism in Chinese elderly population

目的:探讨内脏脂肪指数(visceral adiposity index,VAI)和中国内脏脂肪指数(Chinese visceral adiposity index,CVAI)对中国中老年人群胰岛素抵抗和糖代谢异常发生风险的评估作用。方法:纳入中国2型糖尿病患者恶性肿瘤发生风险的流行病学研究[risk evaluation of cancers in Chinese diabetic individuals:A iongitudinal(REACTION)study]中符合入选标准的社区40岁及以上的人群,收集人口学特征和病史资料并行体格检查,血脂、口服葡萄糖耐量试验和血胰岛素检测。结果:本研究共纳入7 523例研究对象,平均年龄54.4岁。VAI和CVAI均与稳态模型评估胰岛素抵抗指数(homeostasis model assessment of insulin resistance,HOMA-IR)呈正相关(r=0.277,P<0.001;r=0.322,P<0.001),均与Matsuda全身胰岛素敏感指数(insulin sensitivity index,ISI)呈负相关(r=-0.400,P<0.001;r=-0.432,P<0.001)。VAI最高四分位组较最低四分位组发生胰岛素抵抗和糖尿病风险分别增加3.309倍和3.669倍,CVAI则分别增加5.095倍和5.434倍。结论:VAI和CVAI可作为中国中老年人群胰岛素敏感性和糖代谢评估简单易行的临床指标。

Objective： To investigate the roles of visceral adiposity index （VAI） and Chinese visceral adiposity index （CVAI） in assessments of insulin resistance and abnormal glucose metabolism. Methods：Community-dwelling individuals aged over 40 years in the REACTION research were enrolled in our study. Demographic characteristics, disease history and physical examination information were collected by trained technicians. Blood glucose, lipid profile and insulin concentrations were examined. Results ： A total of 7 523 individuals were enrolled in our study, the average age of subjects is 54.4 years. Both VAI and CVAI had a positive relationship with homeostasis model assessment of insulin resistance （HOMA- IR）（r=0.277, P 〈 0.001; r=0.322, P 〈 0.001）and were negatively correlated with Matsuda insulin sensitivity index （ISI）（r=-0.400, P 〈 0.001 ; r=-0.432, P 〈 0.001）. Compared to those in lowest quartile, subjects in uppermost quartile of VAI had the strongest association with insulin resistance and diabetes （top vs. bottom, OR ： 3.309, 3.669） , it was the similar with CVAI （top vs. bottom, OR： 5.095,5.434）. Conclusion： VAI and CVAI may be simple and practical clinical indicators for insulin resistance and glucose metabolism evaluation in middle-aged and the elderly Chinese.