摘要
目的:探究2型糖尿病(T2DM)合并肥胖患者腹部脂肪分布对其胰岛素抵抗及相关代谢指标的影响。方法:选择近年来泰安市中心医院收治的T2DM合并肥胖患者100例作为T2DM合并肥胖组,另选取同期该医院收治的单纯性肥胖患者100例作为单纯性肥胖组。对两组患者均进行腹部CT扫描,并采集其静脉血检测血糖、胰岛素及相关代谢指标的水平。比较两组患者腹部脂肪的分布情况、血糖、胰岛素及相关代谢指标的水平,分析T2DM合并肥胖患者腹部脂肪分布与胰岛素抵抗及相关代谢指标的相关性。结果:与单纯性肥胖组患者相比,T2DM合并肥胖组患者的内脏脂肪体积、内脏与皮下脂肪体积的比值均更大,皮下脂肪体积更小,空腹血糖、餐后2 h血糖的水平均更高,空腹胰岛素、餐后2 h胰岛素的水平均更低,胰岛素抵抗指数更高,尿酸、甘油三酯、低密度脂蛋白胆固醇的水平均更高,差异有统计学意义(P<0.05)。经Pearson分析显示,T2DM合并肥胖患者腹部脂肪体积与胰岛素抵抗指数、尿酸、甘油三酯均呈正相关(r=0.782、0.526、0.866,P均<0.05);其内脏脂肪体积与胰岛素抵抗指数、尿酸、甘油三酯、同型半胱氨酸、总胆固醇、低密度脂蛋白胆固醇均呈正相关(r=0.716、0.498、0.782、0.754、0.643、0.675,P均<0.05)。结论:T2DM合并肥胖患者的腹部脂肪分布与胰岛素抵抗及相关代谢指标间存在密切联系,且对胰岛素抵抗及各代谢指标均有较大的影响,特别是内脏脂肪的占比增多时,影响会进一步加剧。
Objective:To investigate the effects of abdominal fat distribution on insulin resistance and related metabolic indicators in patients with type 2 diabetes mellitus(T2DM)complicated with obesity.Methods:A total of 100 patients with T2DM and obesity admitted to Taian Central Hospital in recent years were selected as T2DM and obesity group,and another 100 patients with simple obesity admitted to Taian Central Hospital in the same period were selected as simple obesity group.Abdominal CT scan was performed in both groups,and venous blood was collected to detect the levels of blood glucose,insulin and related metabolic indicators.Abdominal fat distribution,blood glucose,insulin and related metabolic indicators were compared between the two groups,and the correlation between abdominal fat distribution and insulin resistance and related metabolic indicators in T2DM patients with obesity was analyzed.Results:Compared with patients with simple obesity group,T2DM with obese patients,visceral and subcutaneous fat,visceral fat volume occupies a larger volume,subcutaneous fat volume smaller,fasting blood sugar,2 h postprandial blood glucose levels are higher,fasting insulin,2 h postprandial insulin levels were lower,insulin resistance index is higher,The levels of uric acid,triglyceride and low density lipoprotein cholesterol were higher,and the differences were statistically significant(P<0.05).Pearson analysis showed that abdominal fat volume was positively correlated with insulin resistance index,uric acid and triglyceride in T2DM patients with obesity(R=0.782,0.526,0.866,ALL P<0.05).The visceral fat volume was positively correlated with insulin resistance index,uric acid,triglyceride,homocysteine,total cholesterol and low density lipoprotein cholesterol(R=0.716,0.498,0.782,0.754,0.643,0.675,ALL P<0.05).Conclusions:There is a close relationship between abdominal fat distribution and insulin resistance and related metabolic indexes in T2DM patients with obesity,and it has a great influence on insulin resistance and metaboli
作者
赵亮
ZHAO Liang(Tai‘an Central Hospital,Shan Dong Tai‘an 271000)
基金
山东省医药卫生科技发展计划项目,基金编号:2018ws159,课题题目:亮氨酸对营养性肥胖大鼠胰岛素抵抗及mTOR、ChREBP、TXNIP表达的影响。
关键词
2型糖尿病
肥胖
腹部脂肪分布
胰岛素抵抗
代谢指标
Type 2 diabetes mellitus
Obesity
Abdominal fat distribution
Insulin resistance
Metabolic indices
