2型糖尿病患者内脏脂肪与代谢指标及胰岛素抵抗的关系

Relationship of visceral adipose and metabolic indicators and insulin resistance in patients with type 2 diabetes mellitus

目的探讨2型糖尿病(T2DM)患者内脏脂肪与代谢指标及胰岛素抵抗的关系。方法选取T2DM患者236例,测量内脏脂肪面积(VFA)和皮下脂肪面积(SFA),检测TG、TC、HDL-C、LDL-C、尿酸(UA)、空腹胰岛素(FIns)、HbA1c、胰岛素抵抗指数(HOMA-IR)、胰岛β细胞功能指数(HOMA-β)。根据BMI和VFA对患者进行分组:BMI<24 kg/m^(2)为正常体重(A)组(92例),≥24 kg/m^(2)为超重或肥胖(B)组(144例);VFA<100 cm^(2)为非内脏脂肪型肥胖(C)组(153例),≥100 cm^(2)为内脏脂肪型肥胖(D)组(83例)。比较临床资料及代谢指标的差异,分析VFA和SFA与代谢指标及胰岛素抵抗的关系以及VFA的影响因素。结果与A组比较,B组体重较重,腰围较大,FIns、HOMA-IR、TG、UA、VFA、SFA较高,HDL-C较低(P<0.05或P<0.01)。与C组比较,D组体重较重,腰围较大,FIns、HOMA-IR、HOMA-β、TG、SFA较高,HDL-C较低(P<0.05或P<0.01)。VFA与BMI、FIns、HOMA-IR、HOMA-β、TG、TC、LDL-C、UA呈正相关(rs=0.727、0.413、0.381、0.205、0.313、0.144、0.143、0.316,P<0.05),与HDL-C呈负相关(rs=-0.32,P<0.05)。多重线性回归分析发现,BMI、腰围、HOMA-IR和TG是T2DM患者VFA的影响因素(P<0.05)。结论T2DM患者内脏脂肪与代谢指标及胰岛素抵抗相关,BMI、腰围、HOMA-IR和TG是VFA的影响因素。

Objective To investigate the relationship of visceral adipose with metabolic indicators and insulin resistance in the patients with type 2 diabetes mellitus(T2 DM).Methods The visceral fat area(VFA) and subcutaneous fat area(SFA) were detected in 236 T2 DM patients.The levels of TG,TC,HDL-C,LDL-C,uric acid(UA),fasting insulin(FIns),HbA1 c, insulin resistance index(HOMA-IR) and islet β cell function index(HOMA-β) were meassured.The patients were divided into groups of A(BMI<24 kg/m^(2)) and B(BMI≥24 kg/m^(2)) and groups of C(VFA<100 cm^(2)) and D(VFA≥100 cm^(2)).The differences of clinical data and metabolic indicators were compared.The relationship of VFA with metabolic indicators and insulin resistance was analyzed.The influencing factors for VFA were analyzed.Results Compared to group A,the weight, waistline, FIns, HOMA-IR,TG,UA,VFA and SFA were higher and HDL-C was lower in group B(P<0.05 or P<0.01).The VFA was positively correlated to BMI,FIns, HOMA-IR,HOMA-β,TG,TC,LDL-C and UA(rs=0.727,0.413,0.381,0.205,0.313,0.144,0.143 and 0.316,P<0.05),and negatively correlated to HDL-C(rs=-0.324,P<0.05).The multiple linear regression analysis showed that BMI,waistline, HOMA-IR and TG were the influencing factors for VFA(P<0.05).Conclusion The visceral adipose of T2 DM patients is related to the metabolic indicators and insulin resistance.The BMI,waistline, HOMA-IR and TG are the influencing factors for VFA.