2型糖尿病患者颈腰围与胰岛素抵抗及代谢综合征关系比较分析

Comparative analysis of the relationship between neck and waist circumference,insulin resistance and metabolic syndrome in patients with type 2 diabetes

目的探讨2型糖尿病患者颈腰围与胰岛素抵抗及代谢综合征关系。方法选取2018年4月~2019年9月在江门市人民医院门诊及住院符合WHO(1999年)糖尿病诊断标准的2型糖尿病患者200名作为研究对象,根据颈围测量值大小进行试验分组,将受试者分为颈围正常组和颈围异常组。比较两组BMI、腰围、臀围、腰臀比、空腹血糖、餐后2 h血糖、血压、CHO、TC、LDL-C、HDL-C、胱抑素C、HbA1c、骨密度、空腹、餐后60 min、120 min胰岛素及C肽。结果颈围异常组颈围、腰围、空腹血糖、餐后2 h血糖、HbA1c、TC、LDL-C与HOMA2-IR水平高于颈围正常组,HDL-C低于颈围正常组,差异有统计学意义(P<0.05);两组血压、BMI、臀围、腰臀比、CHO、胱抑素C、胰岛素、骨密度与C肽差异无统计学意义(P<0.05);颈围与2型糖尿病患者的甘油三酯表现为正相关,和高密度脂蛋白胆固醇表现为负相关(P<0.05);颈围、腰围均和HOMA2-IR呈现为正相关。结论颈围和2型糖尿病患者的胰岛素抵抗呈现出密切关联,可作为中心性肥胖的有效预测指标。

Objective To investigate the relationship between neck and waist circumference and insulin resistance and metabolic syndrome in patients with type 2 diabetes.Methods Select 200 type 2 diabetic patients who met the WHO(1999)diabetes diagnostic criteria in the outpatient and hospitalization of Jiangmen People’s Hospital from April 2018 to September 2019 as the research subjects,and grouped them according to the measured value of neck circumference.The subjects were divided into a normal neck circumference group and an abnormal neck circumference group.Comparing the two groups of BMI,waist circumference,hip circumference,waist-to-hip ratio,fasting blood glucose,2 hours postprandial blood glucose,blood pressure,CHO,TC,LDL-C,HDL-C,cystatin C,HbA1c,bone density,fasting,meal After 60 minutes,120 minutes insulin and C-peptide.Results The levels of neck circumference,waist circumference,fasting blood glucose,2-h postprandial blood glucose,HbA1c,TC,LDL-C and HOMA2-IR in the abnormal neck circumference group were higher than those in the normal neck circumference group,and HDL-C was lower than that in the normal neck circumference group(P<0.05);There was no significant difference in blood pressure,BMI,hip circumference,waist hip ratio,CHO,Cystatin C,insulin,bone mineral density and C-peptide between the two groups(P<0.05);Neck circumference was positively correlated with triglyceride in type 2 diabetic patients,and negatively correlated with high density lipoprotein cholesterol(P<0.05).Neck circumference and waist circumference were positively correlated with HOMA2-IR.Conclusion Neck circumference is closely related to insulin resistance in type 2 diabetic patients,and can be used as an effective predictor of central obesity.