摘要
目的探讨老年糖尿病患者腹部内脏脂肪(visceral adipose tissue,VAT)体积和致动脉粥样硬化指数(atherogenic index of plasma,AIP)与冠状动脉狭窄和斑块的关系。方法选取老年糖尿病患者270例,根据VAT值分为VAT正常组118例、VAT增高组152例,测血压、体重指数、腰臀比和AIP。检测血生化、肝肾功能、TG、TC、HDL-C、LDL-C、空腹血糖和糖化血红蛋白等。64层螺旋CT冠状动脉造影和脐平面单层扫描测量VAT,计算Gensini积分。结果 VAT正常组钙化斑、纤维斑比例较VAT增高组明显升高,腰臀比、AIP、Gensini积分、软化斑、混合斑比例较VAT增高组明显降低(P<0.01)。多元回归分析显示,Gensini积分与年龄、腰臀比、AIP、高VAT、腹腔内脏脂肪/腹壁皮下脂肪呈正相关;AIP与VAT、TG、LDL-C和腰臀比呈正相关,与HDL-C呈负相关。结论老年糖尿病高VAT患者,64层螺旋CT冠状动脉造影和脐平面扫描显示,高VAT、冠状动脉狭窄多>75%,斑块多为软化斑和混合斑、VAT和AIP与Gensini积分密切相关,VAT可作为冠心病危险评估的有用指标。
Objective To study the relation of visceral adipose tissue （VAT） volume and athero- genic index of plasma （AIP） with coronary stenosis and plaques in elderly diabetes melittus （DM） patients. Methods Two hundred and seventy elderly DM patients were divided into normal VAT group （n：118） and high VAT group （n=152）. Their blood pressure,BMI,waist /hip ratio,and serum levels of TG, TC, HDL-C, LDL-C, fasting blood glucose, HbAlc were measured, and their liver and renal function were assayed. Their VAT,coronary artery were detected by 64-slice CT scanning at umbilical plane and coronary angiography. Their Gensini scores were calculated. Results The number of calcified and fibrous plaques were significantly higher whereas the waist/ hip ratio, AIP,Gensini score and the number of malacoplakia and mixed plaques were significantly lower in normal VAT group than in high VAT group （P〈0.01）. Multivariate regression analysis showed that the Gensini score was positively related with the age, waist /hip ratio, AIP, high VAT and VAT/abdominal wall subcutaneous adipose tissue, while AIP was positively related with VAT,serum TG and LDL-C levels and waist /hip ratio but negatively related with serum HDL-C level. Conclusion 64-slice CT coronary angiography and scanning at umbilical plane can show that coronary artery stents was over 75% of coronary stenoses, malacoplakia and mixed plaques was more than in elderly DM high VAT patients. VAT and AIP are closely related with Gensini score and can thus be used as a marker for coronary heart disease.
出处
《中华老年心脑血管病杂志》
CAS
北大核心
2013年第12期1249-1252,共4页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
关键词
糖尿病
肥胖症
脂代谢障碍
腹内脂肪
体层摄影术
X线计算机
冠状血管造影术
diabetes mellitus
obesity
lipid metabolism disorders
intra-abdominal fat
tomography, X-ray computed
coronary angiography
