体重指数正常的2型糖尿病患者内脏脂肪面积与心脑血管并发症的关系

Relationship between visceral fat area and cardiovascular and cerebrovascular complications in type 2 diabetes mellitus patients with normal body mass index

目的 探讨体重指数(BMI)正常的2型糖尿病患者内脏脂肪面积与心脑血管并发症的关系。方法 选取2018年1月至2021年5月在上海交通大学医学院苏州九龙医院治疗的BMI正常的2型糖尿病合并心脑血管并发症患者44例作为观察组(其中合并冠心病24例、脑梗死20例),同时选取BMI正常的单纯2型糖尿病患者132例作为对照组。比较两组内脏脂肪面积、空腹血糖(FPG)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)等差异,并绘制受试者操作特征(ROC)曲线分析内脏脂肪面积对BMI正常的2型糖尿病患者合并心脑血管疾病的诊断价值。结果 两组糖尿病病程和吸烟比例、内脏脂肪面积、FPG、FINS和HOMA-IR比较,差异有统计学意义(P<0.05)。logistic回归分析显示:糖尿病病程(OR=2.440,95%CI:1.483~4.014)、吸烟(OR=3.013,95%CI:1.730~5.247)、内脏脂肪面积(OR=2.250,95%CI:1.459~3.470)是患者合并心脑血管并发症发生的影响因素(P<0.05),该方程ROC曲线下面积为0.820(95%CI:0.746~0.894,P<0.05),灵敏度和特异度分别为75.00%和78.00%。结论 BMI正常的2型糖尿病合并心脑血管并发症患者内脏脂肪面积增加,对该病具有一定的诊断价值。

Objective To investigate the relationship between visceral fat area and cardiovascular and cerebrovascular complications in type 2 diabetes mellitus patients with normal body mass index(BMI).Methods From January 2018 to May 2021,44 patients with type 2 diabetes mellitus and cardiovascular and cerebrovascular complications (24 cases of combined coronary heart disease and 20 cases of cerebral infarction)with normal BMI who were treated in Suzhou Jiulong Hospital,School of Medicine,Shanghai Jiao Tong University were selected as the observation group,and 132 patients with simple type 2 diabetes mellitus with normal BMI were selected as the control group.The differences in visceral fat area,fasting glucose(FPG),fasting insulin(FINS),insulin resistance index(HOMA-IR),etc.between the two groups were compared,and the receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic value of visceral fat area for type 2 diabetes mellitus patients with normal BMI complicated with cardiovascular and cerebrovascular diseases.Results There were significant differences in diabetes course,smoking proportion,visceral fat area,FPG,FINS and HOMA-IR between the two groups(P<0.05).Logistic regression analysis showed that the course of diabetes(OR=2.440,95%CI:1.483-4.014),smoking[OR=3.013,95%CI:1.730-5.247],visceral fat area[OR=2.250,95%CI:1.459-3.470]were the influencing factors of patients with cardiovascular and cerebrovascular complications(P<0.05),the area under the ROC curve of this equation was 0.820(95%CI:0.746-0.894,P<0.05),sensitivity and specificity were 75.00%and 78.00%,respectively.Conclusion The visceral fat area of type 2 diabetes mellitus patients with normal BMI and cardiovascular and cerebrovascular complications increases,which has certain diagnostic value for the disease.