脂质蓄积指数和内脏脂肪指数与直肠息肉的相关性研究

The Correlation of lipid accumulation product,visceral adopsity index with pathogenesis of rectal polyps

目的探讨脂质蓄积指数(LAP)和内脏脂肪指数(VAI)与直肠息肉发生的相关性,评估其对直肠息肉发病风险的预测能力。方法回顾性分析2018年6月~2019年6在空军杭州特勤疗养中心进行电子直乙肠镜检查人群2742例,根据检查结果分为息肉组(484例),对照组(2258例),比较两组间基本临床资料和LAP及VAI的差异。采用多因素二元logistic回归分析LAP、VAI与直肠息肉的相关性;以受试者工作特征曲线(ROC)分析评估VAI对直肠息肉发病风险的预测能力。结果肠息肉组年龄、男性比例、腰围(WC)、臀围(HC)、腰臀比(WHR)、三酰甘油(TG)、VAI、LAP均显著高于对照组,高密度脂蛋白胆固醇(HDL-C)显著低于对照组,差异均有统计学意义(P<0.01),但两组总胆固醇(TC)和低密度脂蛋白胆固醇(LDL-C)差异无统计学意义;根据息肉的不同特征进行统计分析,息肉直径≥1.0 cm的大息肉组的VAI、LAP、TG均显著高于小息肉组,差异有统计学意义,而单发性息肉组与多发性息肉组各项指标,差异无统计学意义。多因素二元logistic回归结果显示LAP、VAI每增加一个标准差,直肠息肉发病风险分别增加1.031和5.663倍。以VAI值做ROC曲线,预测直肠息肉发病的AUC为0.83,约登指数为0.51。结论新型肥胖相关指标LAP、VAI可以更好地评价肥胖与直肠息肉发病的相关性,提示可以通过对内脏脂肪蓄积的干预,预防直肠息肉的发生发展。

Objective To investigate the correlation of lipid accumulation product(LAP)and visceral adopsity index(VAI with the pathogenesis of rectal polyps,and to evaluate the effectiveness of LAP and VAI in predicting rectal polyps.Methods A retrospective analysis was performed on 2742 cases of electronic orthotopic colonoscopy personnel in our center from June 2018 to June 2019,which were divided into the polyp group(484 cases)and the control group(2258 cases).The differences of Basic clinical data、LAP and VAI were compared between the two groups.Multivariate binary logistic regression analysis was ued to the correlation between LAP,VAI and rectal polyp.The predictive ability of LAP and VAI to rectal polyp risk was evaluated by receiver operating character curve(ROC)analysis.Results Age,male ratio,waist circumference(WC),hip circumference(HC),waist-to-hip ratio(WHR),triacylglycerol(TG),VAI and LAP were significantly higher than those of the control group and high-density lipoprotein cholesterol(HDL-C)were significantly lower than those of the control group(P<0.01).There was no statistically significant difference in total cholesterol(TC)and lipoprotein cholesterol(LDL-C)between the two groups.According to the statistical analysis of different characteristics of polyps,VAI,LAP and TG of the large polyp group were significantly higher than those of the small polyp group,there was no significant difference between single polyp group and multiple polyp group.The binary logistic regression was performed as to whether or not rectal polyps as the dependent variable,and LAP,VAI,BMI,LDL-C and TG as covariates,the results showed that with the increase of LAP and VAI,the risk of rectal polyp increased by 1.031 and 5.663 times,According to the ROC curve,the AUC for the predicting the incidence of rectal polyps was 0.83 the udon index was 0.51.Conclusion The new obesity-related index LAP and VAI are more closely related to the incidence of rectal polyps,suggesting that the occurrence and development of rectal polyps can be prevented by the intervention of visceral fat accumulation.