双生物电阻抗分析在检测2型糖尿病患者内脏脂肪面积中的应用价值

Application value of dual bioelectrical impedance analysis in detecting visceral fat area in patients with type 2 diabetes mellitus

目的探讨双生物电阻抗分析(d BIA)在检测2型糖尿病患者内脏脂肪面积(VFA)中的应用价值。方法选取2017年1月~2019年1月我院内分泌科收治的128例2型糖尿病患者,对患者进行血生化分析并记录合并高血压和(或)血脂异常病史。根据脑型钠尿肽(BNP)水平将患者分为BNP≥100 pg/ml组和BNP<100 pg/ml组。在同一天通过d BIA和计算机断层扫描(CT)测量患者的VFA。采用Pearson相关系数分析经d BIA测量的VFA(VFAd BIA)和经CT测量的VFA(VFA-CT)之间的相关性。采用多元回归分析评估VFA测量误差与多因素之间的相关性。采用受试者工作特征(ROC)曲线分析VFA对糖尿病合并高血压和(或)血脂异常的识别能力,并计算比较曲线下面积。结果BNP≥100 pg/ml组VFA-d BIA和VFA-CT之间的百分比测量误差高于BNP<100 pg/ml组[(39.2±8.1)%vs.(24.1±6.4)%,P=0.031]。排除BNP≥100 pg/ml的患者后,VFA-d BIA与VFA-CT成显著相关(r=0.917,P<0.0001)。在识别糖尿病合并高血压和(或)血脂异常的ROC曲线分析中,VFA-d BIA和VFA-CT的曲线下面积几乎相同。结论对于无潜在心力衰竭的糖尿病患者,d BIA和CT一样能准确地测量VFA。在识别糖尿病合并高血压和(或)血脂异常方面,VFA-d BIA的诊断效能和VFA-CT相当。

Objective To investigate the application value of dual bioelectrical impedance analysis(dBIA)in detecting visceral fat area(VFA)in patients with type 2 diabetes mellitus(T2DM).Methods From January 2017 to January 2019,128 patients with T2DM were selected from the department of endocrinology of our hospital.The blood biochemical analysis was performed and the history of hypertension and/or dyslipidemia was recorded.According to brain natriuretic peptide(BNP)level,the patients were divided into the BNP≥100 pg/ml group and the BNP<100 pg/ml group.VFA was measured using dBIA and computed tomography(CT)on the same day.Pearson′s correlation analysis was used to detect the relationship between VFA measured by dBIA(VFA-dBIA)and VFA measured by CT(VFA-CT).Multiple regression analysis was performed to detect multiple factors related to measurement error of VFA.The receiver operating characteristic(ROC)analysis for the VFA was used to detect the presence of comorbid hypertension and/or dyslipidemia with T2DM.The areas under the curve(AUC)were also calculated and compared.Results The percent measurement error between VFA-dBIA and VFA-CT in the BNP≥100 pg/ml group was significantly higher than that in the BNP<100 pg/ml group([39.2±8.1]%vs.[24.1±6.4]%,P=0.031).After excluding patients with BNP≥100 pg/ml,the VFA-dBIA was significantly correlated with the VFA-CT(r=0.917,P<0.0001).The AUC in the ROC analysis for the VFA-dBIA to detect the presence of comorbid hypertension and/or dyslipidemia with T2DM was almost equivalent to that for the VFA-CT.Conclusion In patients with T2DM without potential heart failure,estimation of the VFA-dBIA significantly correlates with VFA-CT,and VFA-dBIA has the same diagnostic efficacy as VFA-CT in identifying diabetes mellitus with comorbid hypertension and/or dyslipidemia.