重庆地区健康体检人群超重、肥胖与血浆同型半胱氨酸、血脂、胰岛素抵抗的相关性分析

Analysis of the correlation between overweight, obesity and plasma homocysteine, serum lipid and insulin resistance in healthy physical examination population in Chongqing area

目的分析重庆地区健康体检人群超重、肥胖与血浆同型半胱氨酸、血脂、胰岛素抵抗的相关性。方法选取2015年1月至2016年10月4547例于陆军军医大学附属第三医院进行健康体检者为研究对象。分别测量体检者的身高和体重,计算其体质指数(body mass inde,BMI);采集体检者空腹静脉血,检测血浆同型半胱氨酸、血脂、血糖、血浆胰岛素水平及胰岛素抵抗指数(HOMA-IRI),分析其与超重、肥胖的相关性。结果本研究共检出高同型半胱氨酸者1812例(39.85%),其中男1485例(56.85%),女327例(16.90%),男性高同型半胱氨酸检出率和血浆同型半胱氨酸水平均显著高于女性(P<0.05)。血浆同型半胱氨酸水平随BMI的增加而升高,不同程度BMI体检者血浆同型半胱氨酸水平比较差异具有显著性(F=9.785,P<0.001)。超重、肥胖者血清总胆固醇(total cholesterol,TC)、甘油三酯(triacylglycerol,TG)及低密度脂蛋白(low density lipoprotein,LDL)水平均明显高于BMI正常者(P<0.05),血清高密度脂蛋白(high density lipoprotein,HDL)水平明显低于BMI正常者(P<0.05);BMI与血清TC、TG及LDL水平均呈正相关(r_(TC)=0.647,P<0.05;r_(TG)=0.821,P<0.01;r_(LDL)=0.436,P<0.05),与血清HDL水平呈负相关(r_(HDL)=-0.535,P<0.05)。超重、肥胖者空腹血糖(fasting plasma glucose,FPG)、空腹胰岛素(fasting insulin,FINS)水平及HOMA-IRI均明显高于BMI正常者(P<0.05);BMI与FPG、FINS水平均呈正相关(r_(FPG)=0.631,P<0.05;r_(FINS)=0.625,P<0.05)。结论重庆地区健康体检人群中,超重、肥胖者血浆同型半胱氨酸、血脂水平及HOMA-IR均明显升高,且同型半胱氨酸、高血脂及胰岛素抵抗与体检者BMI呈正相关。

Objective To explore the correlation between overweight,obesity and plasma homocysteine,serum lipid and insulin resistance in healthy physical examination population in Chongqing area.Method4547cases of health examination in the Third Affiliated Hospital of Army Medical University from January2015to October2016were selected as the subjects.The body height and weight were measured,and the body mass index(BMI)was calculated.Plasma homocysteine,blood lipid,blood sugar,plasma insulin and insulin resistance index(HOMA-IRI)were detected,and the correlation between plasma homocysteine,overweight and obesity was analyzed.Result1812cases(39.85%)of high homocysteine were detected in this study,of which1485cases(56.85%)were male,and327cases(16.90%)were female.The detection rate of high homocysteine and plasma homocysteine levels were significantly higher in male than female(P<0.05).Plasma homocysteine level increased with the increase of BMI.There was a significant difference in plasma homocysteine level among different BMI subjects(F=9.785,P<0.001).Serum total cholesterol(TC),triglyceride(TG)and low density lipoprotein(LDL)levels in overweight and obesity subjects were significantly higher than those in BMI normal subjects(P<0.05).The levels of serum high density lipoprotein(HDL)were significantly lower than those of BMI normal subjects(P<0.05).BMI was positively correlated with serum TC,TG and LDL levels(rTC=0.647,P<0.05;rTG=0.821,P<0.01;rLDL=0.436,P<0.05),and negatively correlated with the serum level of HDL(rHDL=-0.535,P<0.05).The fasting plasma glucose(FPG),fasting insulin(FINS)level and HOMA-IRI in overweight and obesity subjects were significantly higher than those in BMI normal subjects(P<0.05),and BMI was positively correlated with FPG and FINS level(rFPG=0.631,P<0.05;rFINS=0.625,P<0.05).Conclusion The plasma homocysteine,blood lipid and HOMA-IRI in overweight and obesity patients in Chongqing area are significantly increased,and homocysteine,hyperlipidemia and insulin resistance are positively correlated with BMI in physical examination people.