2型糖尿病患者腹臀脂肪与性别等因素的相关性研究

Correlation between android fat or gynoid fat percentage and multifactors including gender in patients with type 2 diabetes mellitus

目的探讨在南京某三甲医院内分泌科就诊行全身骨密度检查的2型糖尿病患者的腹部脂肪和臀部脂肪占比变化的规律和特点。方法回顾性分析从2013年3月到2016年3月江苏省中西医结合医院内分泌科门诊及病房就诊并行全身骨密度检查的内分泌代谢病患者,根据纳入标准,共纳入分析281例2型糖尿病患者的腹部内脏脂肪和臀部脂肪占比的相关数据,分别按性别、年龄、体质量指数进行分组分析。结果纳入的男性、女性患者的体质量指数无统计学差异;无论是腹部脂肪占比还是臀部脂肪占比女性患者均明显高于男性患者,且有统计学差异(P<0.001)。女性患者的腹部脂肪占比均随年龄增加而呈上升趋势,臀部脂肪占比均随年龄增加而呈下降趋势;女性患者在50～59.9岁腹部脂肪占比增加的速度最快;男性患者的腹部脂肪占比和臀部脂肪占比在70岁以下各年龄组保持相对稳定,在70岁以上均出现明显增长。男、女性腹部脂肪占比均随体质量指数增加而明显增加;在正常和超重体质量指数组,女性腹部脂肪占比和臀部脂肪占比均显著高于同体质量指数组的男性患者;在肥胖体质量指数组,男、女性患者的腹部脂肪占比无统计学差异,女性患者的臀部脂肪占比明显高于同体质量指数组的男性患者。结论 2型糖尿病女性患者腹部脂肪占比和臀部脂肪占比总体均高于男性患者。围绝经期2型糖尿病女性患者的腹部脂肪占比增加最快,臀部脂肪占比下降最快,雌激素水平的变化可能伴随脂肪的重分布。

Objective To investigate the regularity and characteristics of android and gynoid fat percentages in type 2 diabetes patients who underwent the whole body bone mineral density(BMD)examination in the Endocrinology Department of a tertiary general hospital in Nanjing.Methods Retrospective analysis of the clinic and ward patients of our department who received the whole body bone mineral density examination from Mar.2013 to Mar.2016 was performed.According to the inclusion criteria,the android fat percentage(AF%)and gynoid fat percentage(GF%)data of 281 cases was analyzed by gender groups,age groups and body mass index groups.Results BMI showed no diff erence between male and female groups.The AF%and GF%in female patients were signifi cantly higher than those in male patients(P<0.001).The AF%increased with age while the GF%decreased with age in female patients.The AF%of female patients increased fastest between 50 and 69.9 years old.The AF%and GF%in male patients remained relatively stable in all age groups until 70 years old and the AF%and GF%in male patients increased signifi cantly over 70 years old.The AF%increased signifi cantly with the increase of BMI both in male and female patient groups.In the normal-weight and overweight group,AF%and GF%were signifi cantly higher in female group than in male group.In the obesity group,there was no signifi cant diff erence of AF%between men and women,but the GF%of female patients was signifi cantly higher than that of male patients.Conclusions The AF%and GF%of female patients with type 2 diabetes mellitus was higher than those of male patients.Perimenopausal women had the fastest increase of AF%and the fastest decrease of GF%.Change of estrogen levels may be associated with the redistribution of adipose.