Analysis of the Correlation Between Visceral Fat Area and Insulin Resistance in Patients with Type 2 Diabetes and Abdominal Obesity

Objective: To analyze the correlation between visceral fat area and insulin resistance index (HOMA-IR) in patients with type 2 diabetes mellitus (T2DM) and abdominal obesity and to provide a reference for screening and related research of such patients. Methods: Two hundred patients with T2DM admitted to Guandu People’s Hospital of Kunming were included. The study was carried out from October 2022 to December 2023. The patients were divided into three groups according to different abdominal visceral fat areas (VFA): Group A (n = 65) was less than 75cm2, Group B (n = 75) was 75-100 cm2, and Group C (n = 60) was greater than 100 cm2. The subjects in the three groups were all tested for glycated hemoglobin (HbA1c), fasting insulin (FINS), and fasting blood glucose (FPG). Height and weight were measured to calculate body mass index (BMI). The HOMA-IR and TYG (fasting triglyceride and glycemic index) were also calculated. Changes in the BMI, VFA, HOMA-IR, and TYG levels were observed in the three groups. Results: The VFA, BMI, HbA1c, FPG, FINS, HOMA-IR, and TYG of the patients all increased, with a more significant increase in the BMI, FINS, HOMA-IR, and TYG levels (P < 0.01). Multiple linear stepwise regression analyses used visceral fat area (VFA) as the dependent variable. The results showed that VFA was closely related to BMI, FINS, HOMA-IR, and TYG. Conclusion: Early reduction of VFA to reduce insulin resistance may be a better treatment and effective method for T2DM, providing powerful measures and new strategies for effective blood sugar control and early prevention in the treatment of metabolic diseases.

A pilot study in relationship among changes in visceral fat area, waist circumference and body weight in Japanese freshmen students

We investigated the relationship among delta (delta represents changes in parameters) visceral fat area, waist circumference and body weight in Japanese freshmen students. Visceral fat was measured at the umbilical level using computerized tomography scanning at baseline study and 6 months later. Body weight and height, as well as waist circumference were also measured. We found that visceral fat area, waist circumference, and body weight significantly correlated with each other at baseline, and 6 months later, delta visceral fat area and changes in % visceral fat area significantly correlated with delta waist circumference and delta body weight in female and in total subjects. In addition, based on the predictive linear equations from the regression analysis, we found that 1kg of delta body weight corresponded to 0.83 cm of delta waist circumference, and 1kg of delta body weight and 1cm of delta waist circumference corresponded to 9.41% and 7.80% of changes in visceral fat area, respectively, in total subjects. The present results suggest that delta visceral fat area is closely related to delta body weight and delta waist circumference in Japanese freshmen students.

Impact of Lifestyle Intervention on the Estimated Visceral Fat Area and Skeletal Muscle Mass in Men with Obesity

Background: The lifestyle modification remains the fundamental approach for the obesity treatment. The aim of this study is to demonstrate the effect of the multimodal lifestyle intervention on the estimated visceral fat area versus changes in musculoskeletal mass in a cohort of adult men with obesity. Subjects and Methods: A retrospective cohort study in which the file of eighty-two male subjects, aged 20 - 60 years, was studied for three months. Patients had been instructed to follow a balanced-hypocaloric diet, physical activity plan and general advice for combating the unhealthy lifestyle habits through the study period. Those who succeeded to loss > 5% of their body weight were classified as weight loser (WL) group, while others as weight resistant (WR) group. The results of In Body-720 bioelectric impedance analysis were used to report the fat mass (FM), visceral fat area (VFA), skeletal muscle mass (SMM), SMM/VFA ratio, osseous mass (OM), and basal metabolic rate (BMR) before and after the study period. Anthropometric measures, glucose, and lipid profile were also analyzed. Paired t-test was used to detect the significance of change between before and after measures, independent sample t-test was used to compare WL vs. WR groups. Results: There were significant decreases in weight, FM (p 0.05) and VFA (p 0.001), in addition to a significant rise of SMM/VFA ratio (p 0.05), together with insignificant changes of osseous mass, SMM and BMR after 3 months. Additionally, total cholesterol, low-density lipoprotein, and triglycerides were significantly reduced (P 0.05). The percentages of reduction in weight, FM and VFA in WL vs. WR groups were highly significant (p 0.001), while the percentages of change in SMM, SMM/VFA ratio and BMR were significant (p 0.05). Conclusion: Lifestyle modification might be effective in production of positive changes in the body composition of patients with obesity. These changes were more significant in weight losers.

Age-dependent Changes in Skeletal Muscle Mass and Visceral Fat Area in a Chinese Population

Objective:The present study was conducted to demonstrate the age-dependent changes in skeletal muscle mass and visceral fat area in a population of Chinese adults aged 30-92 years old.Methods:A total of 6669 healthy Chinese men and 4494 healthy Chinese women aged 30-92 years old were assessed for their skeletal muscle mass and visceral fat area.Results:The results showed age-dependent decreases in the total skeletal muscle mass indexes in both men and women aged 40-92 years old as well as age-dependent increases in the visceral fat area in men aged 30-92 years old and in women aged 30-80 years old.Multivariate regression models showed that the total skeletal muscle mass index was positively associated with the body mass index and negatively associated with the age and visceral fat area in both sexes.Conclusion:The loss of skeletal muscle mass becomes obvious at approximately 50 years of age,and the visceral fat area commences to increase at approximately 40 years of age in this Chinese population.

Correlations of Body Mass Index, Japan-Defined and IDF-Defined Waist Circumference, Visceral and Subcutaneous Fat Area with Metabolic Parameters in Japanese Patients with Type 2 Diabetes

Obesity is included in the definition of metabolic syndrome. However, there are many controversies surrounding the evaluation of obesity such as body mass index (BMI) and waist circumference (WC) in the definition of metabolic syndrome among various populations. To understand precisely how various anthropometric indices of obesity influence metabolic parameters, we studied the correlations of BMI, WC (Japanese criteria), WC (IDF criteria), visceral fat area (VFA), subcutaneous fat area (SFA) and the VFA/SFA ratio with metabolic parameters in patients with type 2 diabetes. The influences of BMI and WC on diastolic blood pressure and HDL-cholesterol were larger than VFA, whereas the influences of visceral fat area on triglyceride, very low-density lipoprotein-cholesterol, C-peptide and high-sensitivity C-reactive protein were larger than BMI and WC. WC (IDF) was the strongest determinant of adiponectin among anthropometric indices. Present study showed significant different associations of BMI, Japan- and IDF-defined WC, VFA, SFA and the VFA/SFA ratio with blood pressure, glucose and lipid metabolism, and adipocytokines in Japanese patients with type 2 diabetes.

男性2型糖尿病患者AIP与IRVFA的相关性研究

目的探讨男性2型糖尿病患者血浆致动脉粥样硬化指数（AIP）与胰岛素抵抗（IR）、腹腔内脏脂肪面积（VFA）的关系。方法选择138例男性2型糖尿病患者，所有观察对象进行体格检查、血清学检查、CT测量VFA。以稳态模型评估的胰岛素抵抗指数（HOMA．IR）2．8为切点，分为胰岛素抵抗组（2-DM-IR组）和非胰岛素抵抗组（2-DM．NIR组），比较两组间的临床、生化指标、AIP、VFA。分析AIP与临床、生化指标、VFA的相关性。结果2-DM．IR组舒张压、体质指数（BMI）、腰围、糖化血红蛋白（HbAlc）、总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）、VFA、AIP较2-DM-NIR组均明显升高（p均〈0．05）。相关分析表明，AIP与BMI、腰围（WC）、腰臀比（WHR）、TC、TG、HOMA-IR、VFA正相关（P均〈0．05），与HDL．C（P〈0．01）负相关。多元逐步线性回归分析表明，TG、HDL-C、WC是AIP的独立影响因素（P均〈0．01）。结论在男性2型糖尿病患者中，AIP与BMI、WC、WHR、TC、TG、HOMA-IR、VFA关系密切。腹型肥胖是糖尿病大血管病变的独立危险因素。

内脏脂肪面积对腹膜透析病人心肺耐力的影响

目的探讨持续非卧床腹膜透析(CAPD)病人心肺耐力与内脏脂肪面积的相关性。方法共纳入2021年5月至2022年10月于徐州医科大学附属医院进行规律CAPD的52例病人,进行心肺耐力(CRF)及内脏脂肪面积(VFA)相关指标测量,以峰值耗氧量(Peak VO2)为CRF金标准,将病人分为CRF轻度受损组(Peak VO2≥20 mL·kg^(−1)·min^(−1))及CRF中重度受损组(Peak VO2<20 mL·kg^(−1)·min^(−1))。分析两组间VFA及临床指标有无差异性,探讨CRF独立危险因素。结果CRF中重度受损组VFA、脂肪组织指数、浮肿指数(ECW/TBW)、空腹血糖及三酰甘油显著高于CRF轻度受损组,CRF中重度受损组VFA为73.95(59.83,107.03)cm2,CRF轻度受损组VFA为50.75(40.68,56.85)cm2,而转铁蛋白饱和度显著低于轻度受损组(均P<0.05)。通过Pearson与Spearman相关分析发现Peak VO2分别与脂肪组织指数、内脏脂肪面积、浮肿指数、空腹血糖、CRP、糖尿病状态、服用降脂药呈负相关(均P<0.05),与转铁蛋白饱和度(r=0.32,P=0.021)呈正相关。骨骼肌指数与Peak VO2差异无统计学意义(P>0.05)。将单因素回归分析中P<0.05的指标纳入到多元线性回归分析中,发现内脏脂肪面积(β=−0.40,P=0.002)、尿素清除指数(kt/V)(β=0.31,P=0.013)及糖尿病状态(β=−0.38,P=0.026)为CRF的独立风险因素。结论内脏脂肪面积、尿素清除指数及患有糖尿病为CAPD病人低心肺耐力独立风险因素,内脏脂肪面积对心肺耐力的影响更大,加强内脏脂肪的管理可减少CAPD病人心血管疾病。

Association of ratios of visceral fat area/subcutaneous fat area and muscle area/standard body weight at T12 CT level with the prognosis of acute respiratory distress syndrome

Background:It is well-known that body composition metrics can influence the prognosis of various diseases.This study investigated how body composition metrics predict acute respiratory distress syndrome(ARDS)prognosis,focusing on the ratio of visceral fat area(VFA)to subcutaneous fat area(SFA),SFA to standard body weight(SBW),VFA to SBW,and muscle area(MA)to SBW.These metrics were assessed at the level of the twelfth thoracic vertebra(T12 computed tomography[CT]level)to determine their correlation with the outcomes of ARDS.The goal was to utilize these findings to refine and personalize treatment strategies for ARDS.Methods:Patients with ARDS admitted to the intensive care units(ICUs)of three hospitals from January 2016 to July 2023 were enrolled in this study.Within 24 hours of ARDS onset,we obtained chest CT scans to mea-sure subcutaneous fat,visceral fat,and muscle area at the T12 level.We then compared these ratios between survivors and non-survivors.Logistic regression was employed to identify prognostic risk factors.Receiver oper-ating characteristic(ROC)curve analysis was utilized to determine the optimal cutofffor predictors of in-hospital mortality.Based on this cutoff,patients with ARDS were stratified.To reduce confounding factors,1:1 propensity score matching(PSM)was applied.We conducted analyses of clinical feature and prognostic differences pre-and post-PSM between the stratified groups.Additionally,Kaplan-Meier survival curves were generated to compare the survival outcomes of these groups.Results:Of 258 patients with ARDS,150 survived and 108 did not.Non-survivors had a higher VFA/SFA ra-tio(P<0.001)and lower SFA/SBW and MA/SBW ratios(both P<0.001).Key risk factors were high VFA/SFA ratio(OR=2.081;P=0.008),age,acute physiology and chronic health evaluation(APACHE)II score,and lac-tate levels,while MA/SBW and albumin were protective.Patients with a VFA/SFA ratio≥0.73 were associated with increased mortality,while those with an MA/SBW ratio>1.55 cm^(2)/kg had lower mortality,both pre-and post-PSM(P=0.001 and P<0.001,respectively).Among 170 patients with pulmonary-origin ARDS,87 survived and 83 did not.The non-survivor group showed a higher VFA/SFA ratio(P<0.001)and lower SFA/SBW and MA/SBW(P=0.003,P<0.001,respectively).Similar risk and protective factors were observed in this cohort.For VFA/SFA,a value above the cutoffof 1.01 predicted higher mortality,while an MA/SBW value below the cutoffof 1.48 cm2/kg was associated with increased mortality(both P<0.001 pre-/post-PSM).Conclusions:Among all patients with ARDS,the VFA to SFA ratio,MA to SBW ratio at the T12 level,age,APACHE II score,and lactate levels emerged as independent risk factors for mortality.

冠心病患者BMI、VFA与其冠脉病变、hs-CRP、LDL-C水平的关系研究

目的探讨冠心病患者体质量指数(BMI)、内脏脂肪面积(VFA)与其冠脉病变、hs-CRP、LDL-C水平的关系。方法选取2017年1~12月在我院首次被确诊为冠心病并接受PCI手术治疗的患者300例为研究对象。对患者BMI和VFA进行检测,根据BMI、VFA将患者分为超重腹胖组(88例)、超重非腹胖组(75例)、非超重腹胖组(66例)、非超重非腹胖组(71例)。检测比较4组患者心力衰竭、冠状动脉内膜重度增生发生情况以及血清超敏C反应蛋白(hs-CRP)和低密度脂蛋白胆固醇(LDL-C)水平。结果4组患者的心力衰竭、冠脉内膜重度增生发生率表现为非超重腹胖组>超重腹胖组>超重非腹胖组>非超重非腹胖组,但差异无统计学意义(P>0.05)。4组患者的血清hs-CRP水平比较差异无统计学意义(P>0.05);4组患者的血清LDL-C水平表现为非超重腹胖组>超重腹胖组>超重非腹胖组>非超重非腹胖组,差异有统计学意义(P<0.05)。结论冠心病患者的BMI、VFA与其病情的严重程度均无明显相关关系,肥胖或内脏脂肪面积较大的患者其低密度脂蛋白胆固醇水平显著升高。

VFA-BIA对2型糖尿病非酒精性脂肪肝筛查效果评价

目的探讨双生物电阻抗分析内脏脂肪面积(VFA-BIA)对2型糖尿病(T2DM)非酒精性脂肪肝(NAFLD)的筛查效果,为国家标准化代谢性疾病管理中心(MMC)T2DM患者精准管理提供临床数据。方法回顾性分析2018年6月至2019年12月于南方医科大学附属南海医院内分泌科MMC入组管理的733名T2DM患者病例资料,其中确诊NAFLD患者382例(NAFLD组),非NAFLD患者351例(非NAFLD组)。分析两组间肥胖相关指标、脂代谢及胰岛素抵抗的差异。绘制受试者工作特征(ROC)曲线,分析曲线下面积(AUC),取特异性和敏感性都较高的VFA-BIA作为筛查NAFLD的最佳诊断切点,并对其预测价值与体质量指数(BMI)、腰围(WC)、臀围(HC)及腰臀比(WHR)进行比较。结果 NAFLD组的VFA-BIA、SFA-BIA、BMI、WC、HC、WHR、Ln(HOMA-IR)显著高于非NAFLD组(P<0.001)。VFA-BIA预测NAFLD的最佳诊断切点对应的ROC曲线下面积最大(AUC=0.829,P<0.001),最佳诊断切点为80 cm2,敏感度为76.2%,特异度为74.9%,优于SFA-BIA、BMI、WC、HC、WHR。结论 VFA-BIA可用于早期筛查2型糖尿病NAFLD,适合在MMC开展。

原发性醛固酮增多症患者腹部内脏脂肪与腰椎骨密度的相关性

目的探讨原发性醛固酮增多症(PA)患者腹部内脏脂肪分布与骨密度(BMD)的相关性。方法回顾性分析2017年1月至2021年2月因“高血压查因”于郑州大学第一附属医院确诊为PA的54例患者,利用定量CT(QCT)测量腰1~3椎体的BMD值,测量腰2椎体层面的腹部总脂肪面积(TFA)、腹部内脏脂肪面积(VFA)及腹部皮下脂肪面积(SFA)。按照BMD值将患者分为两组:A组(骨量减少及骨质疏松组,24例)、B组(骨量正常组,30例)。结果与B组相比,A组年龄、VFA、总胆固醇及立位的血浆醛固酮浓度(PAC)与肾素活性(PRA)的比值增高,立位的血浆肾素水平降低(P<0.05);相关分析显示BMD与年龄(r=-0.521、P<0.05)、VFA(r=-0.373,P<0.05)呈负相关;多元线性回归分析显示,校正年龄后,VFA是BMD的独立影响因素(P<0.05);进一步研究显示内脏脂肪增多较非内脏脂肪增多的PA患者BMD值降低(P<0.05)。结论内脏脂肪增多的PA患者更容易表现为低骨量,VFA增高可能是PA患者BMD降低的危险因素。

基于QCT探究腰椎骨密度、肝脏脂肪含量及血尿酸水平的相关性

目的基于QCT(quantitative computed tomography)对腰椎骨密度(bonemineral density,BMD)、腹内脂肪面积(visceral fat area,VFA)、肝脏脂肪含量以及血尿酸(serum uric acid,SUA)的相关性进行研究分析。方法选取本院2022年6月至2022年12月行中上腹部扫描的住院中老年患者233例,年龄41-80岁,其中男性119人,女性114人;对以上纳入研究人群的年龄、体重、身高、SUA等项目数据进行收集及整理,并计算出对应的体质指数(BMI);采用GE 256排Revolution CT扫描仪,并应用QCT测量软件测量腰椎骨密度、肝脏脂肪含量、VFA。结果腰椎BMD与SUA呈正相关,与肝脏脂肪含量、年龄、VFA呈负相关,P<0.05,均具有统计学意义;肝脏脂肪含量与年龄、BMI、VFA、SUA呈正相关,P<0.05,其统计学差异均具有意义;SUA与VFA、BMI呈正相关,P<0.05,均具有统计学意义。结论肝脏脂肪含量及年龄是影响腰椎BMD的危险性因素,SUA可能是影响骨代谢的保护性因素。随着SUA水平的升高,肝脏脂肪含量也随之增加,可能SUA是非酒精性脂肪性肝病(nonalcoholic fatty liver disease,NAFLD)发生的独立危险因素。

健康体检人群内脏脂肪面积与尿酸/高密度脂蛋白胆固醇比值的相关性研究

目的探讨健康体检人群内脏脂肪面积(VFA)与尿酸(UA)/高密度脂蛋白胆固醇(HDL-C)比值(UHR)的相关性。方法随机选取2020年6月至2022年6月于枣庄市立医院进行健康体检的人群360名。根据VFA值,将人群分为内脏脂肪型肥胖组(VFA≥100 cm^(2))172名和对照组(VFA<100 cm^(2))188名,比较两组一般资料及生化指标。采用Spearman相关分析评估VFA与UHR的相关性,多元线性回归分析UHR的影响因素;采用受试者工作特征(ROC)曲线评估UHR对内脏脂肪型肥胖的预测价值。结果与对照组相比,内脏脂肪型肥胖组体重指数(BMI)、VFA、皮下脂肪面积(SFA)、VFA/SFA(V/S)、甘油三酯(TG)、甘油三酯葡萄糖指数(TyG)、UA、UHR水平升高,HDL-C水平降低,差异有统计学意义(均P<0.05)。Spearman相关分析显示,UHR与BMI、VFA、SFA、V/S、TG、TyG呈正相关(P<0.01)。以UHR为因变量,BMI、VFA、SFA、V/S、TG、TyG为自变量进行多元线性回归分析,结果显示TG、VFA是UHR的影响因素。ROC曲线显示UHR预测内脏脂肪型肥胖的曲线下面积为0.741(P<0.001),最佳截断值为0.35。结论健康体检人群UHR与VFA有关,对内脏脂肪型肥胖有较好的预测价值。

中老年男性2型糖尿病患者糖化血红蛋白控制水平与性腺激素相关性的分析

目的:探讨中老年男性2型糖尿病患者糖化血红蛋白控制水平对性腺激素、体重指数、血脂、内脏脂肪面积的影响,并对影响睾酮的相关因素进行分析。方法:选择90例中老年2型糖尿病男性患者,收集30例糖化血红蛋白<7%、30例糖化血红蛋白7%~9%、30例糖化血红蛋白>9%,分别收集患者年龄、体重指数、血脂、内脏脂肪面积、性腺激素,对三组数据进行统计学分析;再根据睾酮大于中位数(>4.08 ng/mL)及小于等于中位数(≤4.08 ng/mL)分为两组,对两组之间体重指数、内脏脂肪面积、糖化血红蛋白、血脂等数据进行统计分析。结果:糖化血红蛋白水平与高密度脂蛋白、睾酮呈负相关(P<0.05),而与甘油三酯、总胆固醇、低密度脂蛋白、体重指数、内脏脂肪面积、雌二醇呈正相关(P<0.05),与促卵泡生成素、促黄体生成素、泌乳素水平无关(P>0.05)。睾酮与体重指数、内脏脂肪面积、糖化血红蛋白、甘油三酯,总胆固醇,低密度脂蛋白水平呈负相关(P<0.05),与高密度脂蛋白呈正相关(P<0.05)。Logistic回归分析显示:糖化血红蛋白水平,内脏脂肪面积、体重指数、血脂异常是睾酮减少的危险因素。结论:良好的血糖控制可有效减少男性睾酮下降,促进机体脂质代谢;较高的睾酮水平对血糖、血脂代谢亦起到积极作用;糖化血红蛋白、内脏脂肪面积、体重指数、血脂异常是睾酮减少的危险因素。

探讨定量CT及生物电阻抗测定内脏脂肪面积和骨密度的关系

目的:探讨采用定量CT(Quantitative computer tomography,QCT)及生物电阻抗(Bioelectrical impedance analysis,BIA)测定内脏脂肪面积(Visceral fat area,VFA)与骨密度(Bone density,BMD)的关系。方法:回顾性选取郑州大学第一附属医院健康管理中心1131例体检者行QCT和BIA测定的VFA及BMD,采用Pearson相关系数、多因素线性回归、单因素和多因素Logistic回归分析二者的相关性;并采用Bland-Altman评估两者测定VFA的一致性。结果:Pearson相关分析显示QCT和BIA测定的VFA与BMD呈负相关(r=-0.197和r=-0.288)。多因素Logistic回归分析显示VFA(BIA)是骨量下降的危险因素(OR=1.010,95%CI:1.005~1.015);VFA(QCT)是骨量下降的危险因素(OR=1.003,95%CI:1.001~1.005);Bland-Altman分析显示,QCT和BIA测量VFA具有较高的一致性。结论:VFA是骨量下降的危险因素,测定VFA的QCT和BIA两者具有较高的一致性,可以采用BIA测定的VFA评估骨量下降。

基于生物电阻抗方法分析血液透析患者内脏脂肪面积与腹主动脉钙化的相关性研究

目的探讨维持性血液透析(maintenance hemodialysis,MHD)患者内脏脂肪面积(visceral fat area,VFA)与腹主动脉钙化的相关性。方法采用横断面调查法,选取2019年4月至2020年5月于首都医科大学附属北京潞河医院规律血液透析且保留完整数据的患者,进行人体成分分析,排除营养不良的患者,按照腹主动脉钙化评分(Abdominal Aortic Calcification Score,AACs)将患者按照钙化程度分成4组,比较临床特点及VFA水平;采用多因素Logistic回归法分析患者腹主动脉钙化的影响因素,并通过受试者工作特征(receiver operating characteristic,ROC)曲线分析VFA水平对腹主动脉钙化的预测价值。结果本研究共纳入152例MHD患者,分为无钙化组(n=32)、轻度钙化组(n=45)、中度钙化组(n=54)以及重度钙化组(n=21);4组患者的血磷、全段甲状旁腺素(intact parathyroid hormone,iPTH)、高密度脂蛋白胆固醇(high density lipoprotein-cholesterol,HDL-C)、VFA以及是否合并糖尿病指标比较,差异有统计学意义(P<0.05)。单因素相关分析显示非营养不良的MHD患者AACs评分与是否合并糖尿病、血磷、iPTH、VFA水平等均呈显著正相关(r=0.188、0.238、0.223、0.392,P<0.05),与HDL-C水平呈显著负相关(r=-0.228,P<0.05);多因素Logistic回归分析显示,VFA以及血磷是MHD患者发生腹主动脉钙化的独立危险因素。ROC曲线显示,非营养不良的MHD患者体内VFA预测腹主动脉钙化的曲线下面积(area under the curve,AUC)为0.725(P<0.05),具有较高的预测价值。结论对于非营养不良的MHD患者,VFA升高与腹主动脉钙化的严重程度相关,是腹主动脉钙化的独立危险因素,可能成为预测患者发生腹主动脉钙化的生物学指标。

弥漫性特发性骨肥厚症的危险因素分析

目的探讨弥漫性特发性骨肥厚症(DISH)的危险因素。方法对52例DISH患者的资料进行回顾性分析,并与200例有脊柱疾病的非DISH患者资料进行比较。对DISH相关危险因素进行单因素和多因素logistic回归分析。结果年龄、性别、体重指数(BMI)、空腹血糖、糖化血红蛋白、腹腔内脏脂肪面积、代谢综合征两组比较差异均有统计学意义(P<0.05)。将临床资料中有显著性差异的因素进行单因素logistic回归分析,结果表明,年龄、性别、BMI、代谢综合征、空腹血糖、糖化血红蛋白、腹腔内脏脂肪面积与发生DISH存在显著相关性(P<0.01)。进一步进行多因素logistic回归分析,结果表明,年龄≥60岁、男性、有代谢综合征、腹腔内脏脂肪面积相对大是DISH的独立危险因素。结论年龄≥60岁、男性、有代谢综合征、腹腔内脏脂肪面积相对大是DISH的独立危险因素。

肥胖儿童青少年维生素D营养状况与身体成分的相关性研究

目的:探讨肥胖儿童青少年血清25-羟维生素D[25-(OH)D]水平与身体成分之间的相关性。方法:选取6~18岁单纯性肥胖儿童289例为研究对象,测定血清总25-(OH)D水平,采用生物电阻抗法(BIA)测定身体成分,分析血清25-(OH)D水平与BMI以及体成分指标的相关性。结果:血清维生素D缺乏和不足率分别为25.6%和43.3%。不同维生素D营养状况分组的BMI及体成分指标差异有统计学意义(P<0.05)。多重线性回归分析结果显示,经校正后,体脂率、内脏脂肪面积(VFA)、脂肪质量指数(FMI)、躯干脂肪质量指数(TFMI)均与血清25-(OH)D水平呈线性负相关关系。BMI以及体脂率、VFA、FMI、四肢脂肪质量指数(AFMI)、TFMI均与维生素D缺乏患病风险增高有关(P<0.05)。结论:肥胖儿童身体成分对血清25-(OH)D含量有影响,其中体脂肪量及脂肪分布与维生素D含量有关。

内脏脂肪面积与2型糖尿病患者亚临床性甲状腺功能减退症相关性的研究

目的 分析2型糖尿病(T2DM)患者亚临床甲状腺功能减退症(SCH)与内脏脂肪面积(VFA)的相关性。方法 选取2021年7月至2022年9月于兰州大学第一医院内分泌科住院治疗的T2DM患者559例,根据促甲状腺激素(TSH)水平将其分为T2DM合并SCH组(75例)和单纯T2DM组(484例),比较两组血清总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、血脂异常率、体重指数(BMI)、VFA、皮下脂肪面积(SFA)、VFA/SFA、Android区域脂肪比例(A)、Gynoid区域脂肪比例(G)、A/G、躯干脂肪百分比(TF%)、全身脂肪百分比(BF%)的差异,采用二元logistic回归模型分析T2DM合并SCH的影响因素。结果 T2DM合并SCH组女性占比、TC、LDL-C、VFA、A、G、TF%、BF%水平高于单纯T2DM组,差异有统计学意义(P<0.05)。二元logistic回归校正模型分析结果显示,校正混杂因素后,VFA为T2DM合并SCH的独立危险因素(OR>1,P<0.05)。结论 T2DM合并SCH患者VFA水平升高,该指标与T2DM患者SCH发生的具有一定的因果关系。

内脏脂肪面积与2型糖尿病病情进展及DPN发病风险的关联研究

目的观察内脏脂肪面积(VFA)与2型糖尿病(T2DM)病情进展及糖尿病周围神经病变(DPN)发病风险的关联。方法本研究为回顾性研究,研究对象为郑州大学附属郑州市中心医院高新区医院2022年6月至2023年6月收治的126例T2DM患者,依据胰岛素抵抗程度不同,将入组患者分别列为轻度组(日均胰岛素补充量<2.0 U,共36例)、重度组(日均胰岛素补充量为2.0~3.0 U,共45例)、极重度组(日均胰岛素补充量>3.0 U,共45例),比较三组患者VFA、血糖水平、胰岛功能指标间差异,经Spearman相关性系数检验VFA与血糖指标、胰岛功能指标间的相关性;依据是否并发DPN,将入组患者分为DPN组、非DPN组,比较两组患者VFA、血糖水平、胰岛功能指标间差异,通过绘制受试者工作特征曲线(ROC),并观察线下面积(AUC)验证VFA对T2DM并发DPN的预测效能。结果极重度组患者的VAF、空腹血糖(FBG)、餐后2 h血糖(2 hPG)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)均高于重度组、轻度组,极重度组的胰岛素敏感系数(ISI)低于重度组、轻度组,差异具有统计学意义(P<0.05)。经Spearman相关性系数检验,VFA与T2DM患者的FBG、2 hPG、HbA1c、FINS、HOMA-IR正相关,与ISI负相关(P<0.05)。DPN组的VAF、FBG、2 hPG、HbA1c、FINS、HOMA-IR均高于非DPN组,ISI低于非DPN组,差异具有统计学意义(P<0.05)。ROC曲线表明,VFA对T2DM并发DPN有较高预测效能(AUC>0.85,P<0.05),其预测灵敏度为81.44%,特异度为75.35%,截断值为121.40 cm2。结论VFA与T2DM患者的FBG、2 hPG、HbA1c、FINS、HOMA-IR正相关,与ISI负相关,通过测量VFA能实现对T2DM患者并发DPN的早期预测。