摘要
目的 探讨2型糖尿病(T2DM)患者体脂分布情况及其与胰岛素抵抗(IR)的相关性.方法 选取2019年1月至2020年12月该院内分泌科住院治疗的T2DM患者2 790例,根据是否存在IR将其分为IR组(1 915例)和非IR组(875例).以甘油三酯葡萄糖(TyG)指数评估IR情况,分析内脏脂肪组织(VAT)、皮下脂肪组织(SAT)面积与其他临床指标[体重指数(BMI)、糖化血红蛋白(HbA1c)、甘油三酯(TG)、低密度脂蛋白(LDL)和高密度脂蛋白(HDL)等]的相关性,以及体脂分布面积对IR的影响.结果 男性患者BMI、腰围、臀围、腰臀比、舒张压、TG、TyG指数、尿酸、肌酐水平及VAT面积高于女性患者,而年龄、腰高比、收缩压、胆固醇、HDL、LDL水平及SAT面积低于女性患者,差异有统计学意义(P＜0.05).VAT面积与BMI、收缩压、舒张压、腰围、腰臀比、TG、TyG指数、尿酸水平呈正相关(r＞0,P＜0.05),与HbA1c、HDL水平呈负相关(r＜0,P＜0.05).SAT面积与BMI、腰围、腰臀比、胆固醇、LDL、TyG指数、尿酸水平呈正相关(r＞0,P＜0.05),与HDL水平呈负相关(r＜0,P＜0.05).IR组舒张压、腰臀比、HbA1c、尿酸水平及VAT、SAT面积高于非IR组,而年龄、收缩压、HDL水平低于非IR组,差异有统计学意义(P＜0.05).VAT面积、舒张压、HbA1c是IR发生的独立危险因素(OR＞1,P＜0.05),而HDL是其保护因素(OR＜1,P＜0.05).结论 T2DM患者体脂分布存在性别差异,其中VAT是导致IR的危险因素.
Abstract
Objective To investigate the relationship between body fat distribution and insulin resist-ance(IR)in patients with type 2 diabetes mellitus(T2DM).Methods A total of 2 790 T2DM patients hospi-talized in the department of endocrinology of the hospital from January 2019 to December 2020 were selected and divided into the IR group(1 915 cases)and the non-IR group(875 cases)according to the presence or ab-sence of IR.IR status was assessed by TyG index,and the correlation between visceral adipose tissue(VAT),subcutaneous adipose tissue(SAT)area and other clinical indicators(body mass index(BMI),glycosylated he-moglobin(HbA1c),triglyceride(TG),low density lipoprotein(LDL)and high density lipoprotein(HDL),etc.),and the influence of body fat distribution area on IR were analyzed.Results BMI,waist circumference,hip circumference,waist-to-hip ratio,diastolic blood pressure,TG,TyG index,uric acid,creatinine level and VAT area in male patients were higher than those in female patients,while age,waist-to-height ratio,systolic blood pressure,cholesterol,HDL,LDL level and SAT area were lower than those in female patients,with sta-tistical significance(P＜0.05).VAT area were positively correlated with BMI,systolic blood pressure,dias-tolic blood pressure,waist circumference,waist-to-hip ratio,TG,TyG index,and uric acid level(r＞0,P＜0.05),and negatively correlated with HbA1c and HDL level(r＜0,P＜0.05).SAT area was positively corre-lated with BMI,waist circumference,waist-to-hip ratio,cholesterol,LDL,TyG index,and uric acid level(r＞0,P＜0.05),and negatively correlated with HDL level(r＜0,P＜0.05).Diastolic blood pressure,waist-to-hip ratio,HbA1c,uric acid level,VAT and SAT area in the IR group were higher than those in the non-IR group,while age,systolic blood pressure and HDL level were lower than those in the non-IR group,with statistical sig-nificance(P＜O.05).VAT area,diastolic blood pressure and HbA1c were independent risk factors for IR(OR＞1,P＜0.05),while HDL was protective factor(OR＜1,P＜0.05).Conclusion There is gender difference in body fat distribution in T2DM patients,and VAT is a risk factor for IR.
维普
万方数据