门诊肥胖儿童代谢综合征状况分析

目的分析门诊肥胖儿童代谢综合征（MS）的发病情况。方法选择113名肥胖病营养专科门诊就诊的7～14岁肥胖儿童为病例组,以同期366名7～14岁健康学生为对照组,测量两组的身高、体质量、腰围、臀围、血压、肝脏超声,并检测空腹血糖、空腹胰岛素、血清总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白（HDL）和低密度脂蛋白（LDL）等相关生化指标,诊断MS的发病率。采用HOMA—IR的四分位数分割点来定义有无胰岛素抵抗。结果病例组与对照组的年龄和性别比无统计学差异（P〉0．05）,而体质量、体质量指数（BMI）、腰围、臀围、腰臀比（WHR）、收缩压（SBP）、舒张压（DBP）、空腹血糖、空腹胰岛素、HOMA指数和TG均明显高于对照组（P〈0．01）。对照组HOMA指数第75位百分位值为3．28,以此为切点将病例组分胰岛素抵抗组和非胰岛素抵抗组。病例组中胰岛素抵抗儿童体质量、BMI、腰围、TG均明显高于非胰岛素抵抗组儿童（P（0．05）;病例组中有51例（45．1％）儿童发生MS。胰岛素抵抗组儿童MS发病率高于非胰岛素抵抗组儿童（50．0％vs21．1％）（P〈0．05）。结论超重和肥胖儿童MS发病率较高;MS发生与胰岛素抵抗明显相关。     

Metabolic syndrome in non-obese Taiwanese: new definition of metabolically obese, normal-weight individual

Background Not only the obese, but also the non-obese adults have the high prevalence of metabolic syndrome in the upper normal weight. The aim of this study was to assess the prevalence rates of metabolic syndrome and its individual components in non-obese adult Taiwanese （body mass index （BMI） ≤ 26.9 kg/m^2）. Methods A cross-sectional study was conducted from January 2006 to December 2007. One thousand six hundred and fifty-nine subjects （aged 47.5±12.4 years）, 60.8% of which were men, were enrolled. The prevalence and odds ratios of metabolic syndrome, defined by the American Heart Association/National Heart, Lung and Blood Institute （2005）, were analyzed in the BMI category according to 2.0 unit increments, in individuals seeking a health examination. Results The higher the BMI categories, the more prevalent the metabolic syndrome was in women and in men （P 〈0.001）. Compared with those women with a BMI ≤20.9 kg/m^2, the odds ratios for metabolic syndrome in women were 1.3 （95% CI： 0.5-3.2） with BMI 21.0-22.9 kg/m^2, 3.0 （1.3-7.1） with BMI 23.0-24.9 kg/m^2, and 8.6 （3.6-20.8） for women with BMI 25.0-26.9 kg/m^2, after controlling for age, smoking status, alcohol consumption, betel nut chewing, blood routine, biochemical data, hepatitis B virus surface antigen and anti-hepatitis C virus. The corresponding odds ratios in men were 1.6 （0.6-4.2）, 3.7 （1.6-8.8）, and 9.9 （4.2-23.2）. Conclusions Individuals in the upper normal weight and slightly overweight BMI range have relatively high prevalence and increased risk of having metabolic syndrome. Therefore, physicians should screen metabolic syndrome in not only obese but also non-obese individuals for the prevention of cardiovascular disease.     

Effectiveness of Different Waist Circumference Cut-off Values in Predicting Metabolic Syndrome Prevalence and Risk Factors in Adults in China

Objective To study the effectiveness of waist circumference cut-off values in predicting the prevalence of metabolic syndrome(MetS) and risk factors in adults in China. Methods A cross-sectional survey was condcuted in 14 provinces(autonomous region, municipality) in China. A total of 47 325 adults aged ≥20 years were selected by multistage stratified sampling, and questionnaire survey and physical and clinical examination were conducted among them. MetS was defined according to the International Diabetes Federation(IDF) criteria and modified IDF criteria.Results The age-standardized prevalence of MetS was 24.2%(22.1% in men and 25.8% in women) and 19.5%(22.1% in men and 18.0% in women) according to the IDF criteria and modified IDF criteria respectively. The age-standardized prevalence of pre-MetS was 8.1%(8.6% in men and 7.8% in women) according to the modified IDF criteria. The prevalence of MetS was higher in urban residents than rural residents and in northern China residents than in southern China residents. The prevalence of central obesity was about 30% in both men and women according to the ethnicity-specific cut-off values of waist circumference for central obesity(90 cm for men and 85 cm for women). Multivariate regression analysis revealed no significant difference in risk factors between the two MetS definitions. Conclusion Using both the modified IDF criteria and ethnicity-specific cut-off values of waist circumference can provide more useful information about the prevalence of MetS in China.     

肥胖型和非肥胖型多囊卵巢综合征患者临床指标的对比研究

目的分析总结肥胖型和非肥胖型多囊卵巢综合征（PCOS）患者的内分泌和代谢特征。方法对肥胖型[体质量指数（BMI）≥25 kg/m^2]PCOS患者（A组）18例、非肥胖型（BMI〈25 kg/m^2）PCOS患者（B组）34例进行临床体征测量、内分泌激素和代谢指标测定。结果 A组和B组比较,在体质量、BMI、腰围、臀围以及腰臀比方面,差别具有统计学意义（P〈0.01）;在促卵泡生成素（FSH）、黄体生成素（LH）、LH/FSH、泌乳素、雌二醇、睾酮和硫酸脱氢表雄酮各指标,差别均无统计学意义（P〉0.05）;在血脂方面,甘油三酯及载脂蛋白B两组间差别有统计学意义（P〈0.05）,总胆固醇、高密度脂蛋白和载脂蛋白A两组间差别无统计学意义（P〉0.05）;在空腹胰岛素和服糖后15,30,60,120 min胰岛素、稳态模型指数和胰岛素曲线下面积方面,两组间差别均有统计学意义（P〈0.01）。结论肥胖型PCOS患者较非肥胖型PCOS患者存在更严重的代谢紊乱,其远期并发症的防治应受到高度重视。     

多囊卵巢综合征患者血清sICAM-1的变化与代谢之间相关性研究

摘 要：【目的】 探讨多囊卵巢综合征（PCOS）患者血清可溶性内皮细胞间粘附因子（sICAM-1）水平与血脂、血糖、肥胖、胰岛素抵抗等代谢之间的关系。【方法】选择PCOS患者63例按体重指数（BMI）分为肥胖组（A组,30例）和非肥胖组（B组,33例）,正常对照组20例（C组,）,采用ELISA方法测定受试者血清sICAM-1水平,同时测定身高、体重、腰围、臀围、血压、血糖、血脂、及血清胰岛素水平,计算BMI、腰臀比（WHR）及胰岛素抵抗指数（HOMA-IR）,将sICAM-1与临床所测指标进行多因素分析。【结果】A组、B组分别与C组相比血清sICAM-1水平明显升高（P＜0.01）;A组高于B组但差别无统计学意义。相关分析显示血清sICAM-1与体重、BMI、腰围、臀围、WHR、TG、FINS、HOMA-IR、PCOS患病呈显著正相关。【结论】PCOS患者血清sICAM-1水平明显升高,且与肥胖、向心性肥胖及胰岛素抵抗、糖脂代谢紊乱有明显相关性,由此认为sICAM-1在PCOS的发生及发展以及代谢紊乱中具有重要作用。     

Predictive Values of Body Mass Index and Waist Circumference for Rish Factors of Certain Related Diseases in Chinese Adults—Study on Optimal Cut—off Points of Body Mass Index and Waist Circumference

For prevention of obesity in Chinese population, it is necessary to define the optimal range of healthy weight and the appropriate cut-off points of BMI and waist circumference for Chinese adults. The Working Group on Obesity in China under the support of International Life Sciences Institute Focal point in China organized a meta-analysis on the relation between BMI, waist circumference and risk factors of related chronic diseases (e. g.,high diabetes, diabetes mellitus, and lipoprotein disorders). Methods 13 population studies in all met the criteria for enrollment, with data of 239 972 adults (20-70 year) surveyed in the 1990s. Data on waist circumference was available for 111411 persons and data on serum lipids and glucose were available for more than 80 000. The study populations located in 21provinces, municipalities and autonomous regions in mainland China as well as in Taiwan. Each enrolled study provided data according to a common protocol and uniform format. The Center for data management in Department of Epidemiology, Fu Wai Hospital was responsible for statistical analysis. Results and conclusion The prevalence of hypertension, diabetes, dyslipidemia and clustering of risk factors all increased with increasing levels of BMI or waist circumference. BMI at 24 with best sensitivity and specificity for identification of the risk factors, was recommended as the cut-off point for overweight, BMI at 28 which may identify the risk factors with specificity around 90 % was recommended as the cut-off point for obesity. Waist circumference beyond 85 cm for men and beyond 80 cm for women were recommended as the cut-off points for central obesity.Analysis of population attributable risk percent illustrated that reducing BMI to normal range (＜24) could prevent 45%-50% clustering of risk factors. Treatment of obese persons (BMI ≥ 28)with drugs could prevent 15%-17% clustering of risk factors. The waist circumference controlled under 85 cm for men and under 80 cm for women, could prevent 47%-58% clustering of risk factors. According to these, a classification of overweight and obesity for Chinese adults is recommended.     

Predictive Values of Body Mass Index and Waist Circumference for Risk Factors of Certain Related Diseases in Chinese Adults - Study on Optimal Cut-off Points of Body Mass Index and Waist Circumference in Chinese Adults

The body mass index of Chinese population is lower than that of the Westerncountries, however, the trends of mean body mass index and prevalence of overweight inadults have increased significantly in recent 15 years[1]. Overweight and obesity areclosely r…     

二甲双胍对氯氮平所致双相情感障碍患者代谢综合征的影响

目的观察二甲双胍对氯氮平所致的双相情感障碍（BD）患者代谢综合征（MS）的治疗效果。方法将79例伴有氯氮平所致MS的BD患者按照随机数字表法分为二甲双胍组39例和对照组40例。分别在治疗前及治疗后第8、16周末测量患者的腰围、BMI、血压、空腹血糖（FBS）、HDL、LDL、TC和TG。其中腰围、BMI、血压测量由一位经过培训的护士完成。FBS、HDL、LDL、TC、TG通过全自动生化分析仪检测。结果两组间比较,治疗第8周末两组腰围、BMI及TG指标的比较差异均有统计学意义（均P＜0.05）,治疗16周末两组腰围、BMI、HDL、TG指标比较差异均有统计学意义（均P＜0.05）。二甲双胍组与对照组比较可以改善患者的BMI、腰围、HDL和TG。结论二甲双胍可以作为一种辅助治疗,治疗氯氮平所致的双相情感障碍患者的MS。     

Overweight, obesity and metabolic syndrome in rural southeastern Australia

OBJECTIVE: To measure the prevalence of overweight, obesity and the metabolic syndrome (MetS) in rural Australia. DESIGN, SETTING AND PARTICIPANTS: Cross-sectional surveys were conducted in two rural areas in Victoria and South Australia in 2004-2005. A stratified random sample of men and women aged 25-74 years was selected from the electoral roll. Data were collected by a self-administered questionnaire, physical measurements and laboratory tests. MAIN OUTCOME MEASURES: Prevalence of overweight and obesity, as defined by body mass index (BMI) and waist circumference; prevalence of MetS and its components. RESULTS: Data on 806 participants (383 men and 423 women) were analysed. Based on BMI, the prevalence of overweight and obesity combined was 74.1% (95% CI, 69.7%-78.5%) in men and 64.1% (95% CI, 59.5%-68.7%) in women. Based on waist circumference, the prevalence of overweight and obesity was higher in women (72.4%; 95% CI, 68.1%-76.7%) than men (61.9%; 95% CI, 57.0%-66.8%). The overall prevalence of obesity was 30.0% (95% CI, 26.8%-33.2%) based on BMI (> or = 30.0 kg/m(2)) and 44.7% (95% CI, 41.2%-48.1%) based on waist circumference (> or = 102 cm [men] and > or= 88 cm [women]). The prevalence of MetS as defined by the US National Cholesterol Education Program Adult Treatment Panel III 2005 criteria was 27.1% (95% CI, 22.7%-31.6%) in men and 28.3% (95% CI, 24.0%-32.6%) in women; based on International Diabetes Federation criteria, prevalences for men and women were 33.7% (95% CI, 29.0%-38.5%) and 30.1% (95% CI, 25.7%-34.5%), respectively. Prevalences of MetS, central (abdominal) obesity, hyperglycaemia, hypertension and hypertriglyceridaemia increased with age. CONCLUSIONS: In rural Australia, prevalences of MetS, overweight and obesity are very high. Urgent population-wide action is required to tackle the problem.     

老年代谢综合征患者血清游离脂肪酸水平及其影响因素

目的 研究老年代谢综合征患者血清游离脂肪酸（FFA）水平及其与其他代谢综合征参数的相关性。方法 在1 372名体检者(≥60岁)中筛选出169例代谢综合征患者（代谢综合征组）及89名体检健康者（正常对照组）,测定和比较两组的血压、身高、体质量、腰围、臀围,检测血清生化指标,计算腰臀比、体质量指数(BMI)和胰岛素抵抗指数(HOMA-IR)。结果 代谢综合征组腰围、腰臀比（WHR）、BMI、空腹血糖(FBG)和胰岛素、HOMA-IR及血清三酰甘油(TG)、总胆固醇(TC)和FFA均较正常对照组明显升高,而高密度脂蛋白胆固醇（HDL-C）显著降低（P<0.05）。代谢综合征组血清FFA与WHR、BMI、FBG、HOMA-IR、TG及TC呈显著正相关（P<0.001）;TG和BMI为血清FFA的独立影响因素;当代谢综合征合并糖代谢异常、高脂血症和胰岛素抵抗时,血清FFA明显升高（P<0.05）。结论 血清FFA水平与代谢综合征多种组分相关,其升高可作为代谢综合征的生化标志之一。     

45~70岁中老年体检人群体脂指标变化对血尿酸与骨密度关系的影响研究

背景　血尿酸（SUA）水平与骨密度（BMD）之间的联系已被公认,但目前关于体脂指标对SUA和BMD关系的影响尚无明确定论。目的　探究45~70岁中老年人群体脂指标变化对SUA与腰椎、股骨颈BMD关系的影响,可为进一步预防中老年人群骨质疏松提供帮助。方法　选取2020年1-12月于贵州医科大学附属医院健康管理中心进行体检的中老年人群为研究对象。发放《骨质疏松健康因素调查表》进行基本资料的调查,测量体脂指标、BMD,并检测SUA。比较不同性别中老年人群基本资料、体脂分布、BMD、SUA及骨质疏松发生率,分析中老年人群SUA与BMD的相关关系,并探究体脂指标变化对SUA与BMD的影响。结果　共回收问卷750份,回收有效问卷707份,有效回收率为94.27%。707例研究对象中女314例、男393例,平均年龄（55.3±6.6）岁,平均体质指数（BMI）（24.6±6.4）kg/m2,平均腰围（84.0±9.0）cm,平均臀围（94.1±6.0）cm,平均腰臀比（WHR）（0.9±0.1）。不同性别中老年人群主动吸烟情况、被动吸烟情况、饮酒情况、喝牛奶情况、服用维生素D情况、服用钙片情况、BMI、腰围、臀围、WHR、腰椎BMD、股骨颈BMD、SUA、骨质疏松发生率比较,差异有统计学意义（P<0.05）。Pearson相关分析结果显示,SUA与腰椎BMD、股骨颈BMD均呈弱正相关（r值分别为0.202、0.164,P<0.05）。控制部分基本资料为协变量,多元线性回归分析结果显示,SUA是中老年人群腰椎、股骨颈BMD（β值分别为0.160、0.035）的影响因素（P<0.05）。控制部分基本资料及腰围为协变量,多元线性回归分析结果显示,SUA是中老年人群腰椎、股骨颈BMD（β值分别为0.103、0.095）的影响因素（P<0.05）。依据腰围四分位数将中老年人群分为Ⅰ组（腰围<77 cm）、Ⅱ组（腰围77~85 cm）、Ⅲ组（腰围86~90 cm）、Ⅳ组（腰围91~113 cm）。Ⅰ、Ⅱ组中老年人群SUA与腰椎BMD呈正相关（r值分别为0.213、0.199,P<0.05）;Ⅰ组中老年人群SUA与股骨颈BMD呈正相关（r=0.173,P<0.05）。结论　在45~70岁中老年人群中,血清SUA水平与腰椎、股骨颈BMD之间存在较强的单变量相关性,部分原因是肥胖指标的混杂作用,SUA对骨密度的有益作用更多表现在腰围≤85 cm的中老年人群。     

吸烟与代谢综合征的相关性调查与分析

目的探讨吸烟与代谢综合征的关系.方法应用整体抽样横断面调查方法,完成重庆地区3 717例自然人群问卷调查及口服75g葡萄糖耐量试验,检测空腹血糖、血脂、血浆胰岛素及糖负荷2h后血糖,测量空腹状态血压、腰围、体重、身高.结果 (1)887例正常人中,吸烟组体重指数(BMI)、腰臀比(WHR)、体重、腰围、甘油三酯(TG)及低密度脂蛋白胆固醇(LDL-C)高于非吸烟组,高密度脂蛋白胆固醇(HDL-C)低于非吸烟组.(2)3 379例资料完整自然人群按年龄分层后,40岁以下人群吸烟组糖尿病(DM)、糖耐量减低(IGT)、空腹血糖减损(IFG)、高血压、血脂紊乱、超重/肥胖及中心性肥胖的患病率高于非吸烟组.40～60岁年龄层吸烟组超重/肥胖及中心性肥胖、高TG、低HDL-C的患病率高于非吸烟组,60岁以上年龄层吸烟组代谢综合征患病率高于非吸烟组.结论吸烟与代谢综合征有关,是其发生、发展的重要环境因素之一.     

防城港市成年男性非酒精性脂肪肝患病率及其危险因素分析研究

目的 了解一般人群成年男性非酒精性脂肪肝(NAFLD)的患病率,分析其危险因素.方法 以参加防城港市第一人民医院体检的男性人群作为研究对象,内容涉及问卷、一般体格检查、血生化检测及肝脏实时超声检查,筛选出3 238例有完整调查问卷和检查资料的成年男性进行研究.结果 3 238例中检出NAFLD 832例,患病率为25....     

身体脂肪分布对血脂水平的影响

为探讨身体脂肪分布对血脂水平的影响，我们调查了江苏海门农村２５￣７４岁自然人群８６９人（男４８４，女３８５）测量身高、体重、体重指数（ＢＭＩ）、腰围、臀围及腰臀比（ＷＨＲ），同时测定血清总胆固醇（ＴＣ）、高密度脂蛋白胆固醇（ＨＤＬ－ｃ）、甘油三酯（ＴＧ）及低密度脂蛋白胆固醇（ＬＤＬ－ｃ）。结果显示男性Ｔｃ、ＬＤＬ－ｃ高于女性，男性ＷＨＲ也高于女性（０．８４对０．７８）。无论男女、随ＷＨＲ百分位升高     

Sensitivity and specificity of waist circumference as a single screening tool for identification of overweight and obesity among Malaysian adults

Generalised obesity and central obesity are risk factors for Type II diabetes mellitus and cardiovascular diseases. Waist circumference (WC) has been suggested as a single screening tool for identification of overweight or obese subjects in lieu of the body mass index (BMI) for weight management in public health program. Currently, the recommended waist circumference cut-off points of > or = 94cm for men and > or =80cm for women (waist action level 1) and > or = 102cm for men and > or = 88cm for women (waist action level 2) used for identification of overweight and obesity are based on studies in Caucasian populations. The objective of this study was to assess the sensitivity and specificity of the recommended waist action levels, and to determine optimal WC cut-off points for identification of overweight or obesity with central fat distribution based on BMI for Malaysian adults. Data from 32,773 subjects (14,982 men and 17,791 women) aged 18 and above who participated in the Third National Health Morbidity Survey in 2006 were analysed. Sensitivity and specificity of WC at waist action level 1 were 48.3% and 97.5% for men; and 84.2% and 80.6% for women when compared to the cut-off points based on BMI > or = 25kg/m2. At waist action level 2, sensitivity and specificity were 52.4% and 98.0% for men, and 79.2% and 85.4% for women when compared with the cut-off points based on BMI (> or = 30 kg/m2). Receiver operating characteristic analyses showed that the appropriatescreening cut-off points for WC to identify subjects with overweight (> or = 25kg/m2) was 86.0cm (sensitivity=83.6%, specificity=82.5%) for men, and 79.1cm (sensitivity=85.0%, specificity=79.5%) for women. Waist circumference cut-off points to identify obese subjects (BMI > or = 30 kg/m2) was 93.2cm (sensitivity=86.5%, specificity=85.7%) for men and 85.2cm (sensitivity=77.9%, specificity=78.0%) for women. Our findings demonstrated that the current recommended waist circumference cut-off points have low sensitivity for identification of overweight and obesity in men. We suggest that these newly identified cut-off points be considered.     

腹内脂肪面积切点与代谢综合征临床检出率的关系

目的探讨估测代谢综合征（MS）的腹内脂肪面积（VA）的切点,以及VA与代谢综合征检出率的关系。方法应用螺旋CT检测了564例代谢综合征、糖尿病和高血压病病人的腹内脂肪面积;分别应用ROC工作曲线和四分位法分析估测代谢综合征及其组分的VA临界点和该临界点所对应的简易体脂参数包括,体重指数（BMI）、腹围（WC）和腰臀比（WHR）,以及不同VA面积下的代谢综合征的检出率。结果（1）女性病人出现血脂紊乱、腹型肥胖和代谢综合征时VA集中在70～72cm。之间,而男性病人出现以上代谢紊乱时VA多在91～107cm^2之间,未找到高血糖和高血压相应的VA切点。（2）罹患代谢紊乱时,女性腹围在82～84cm之间,BMI在24～25kg／m^2之间;男性腹围在89cm左右,BMI在25kg／m^2左右。（3）男性VA在70cm^2、71～101cm^2、102～133cm^2、≥134cm^2时代谢综合征检出率分别为16．9％、49．4％、72．7％和87．5％,VA≥70cm^2时代谢综合征检出率显著增高（P〈0．01）;女性VA在〈55cm^2、55～84cm^2、85～104cm^2、≥105cm^2时代谢综合征检出率分别为7．7％、44．0％、67．2％和87．5％,VA≥55cm^2时代谢综合征检出率显著增高（P〈0．01）。结论代谢综合征病人腹内脂肪的堆积有性别差异;在临界超重或超重阶段,即已出现腹内脂肪堆积及各种代谢紊乱的聚集;随着腹内脂肪含量的增加,代谢综合征的临床检出率显著升高。     

2型糖尿病非酒精性脂肪肝的相关因素分析

目的探讨汉族2型糖尿病（T2DM）病人发生非酒精性脂肪肝（NAFLD）的危险因素及其预测价值。方法收集我院2009年1月至12月门诊汉族T2DM病人,进行腹部B超检查以判断有无NAFLD,同时检测体质量、腰围、血糖、血脂、胰岛素,计算体质量指数（BMI）和胰岛素抵抗指数,并进行糖尿病并发症的全面检查。结果共收集360例T2DM病人,其中52．2％（188／360）患有NAFLD。单因素对比发现,NAFLD组的BMI、腰围、胰岛素、胰岛素抵抗、甘油三酯、低密度脂蛋白水平较非NAFLD组显著升高（P〈0．05）,但多因素Logistic回归提示仅腰围和甘油三酯为独立的NAFLD危险因素（P〈0．05）。NAFLD与血糖控制指标及各种糖尿病并发症无关（P〉0．05）。受试者工作特征曲线显示腰围和甘油三酯对NAFLD的发生均有预测价值,但腰围的预测价值更大。以84cm作为腰围的预测截断值,预测敏感性和特异性分别为80％和72％。结论T2DM病人NAFLD患病率高,腰围和甘油三酯为其独立的危险因素。腰围为NAFLD发生较好的预测指标,以84cm作为预测临界值时,具有较好的预测敏感及特异性。     

脂肪因子Chemerin与肥胖及2型糖尿病的关系

目的 测定正常人群、肥胖及新诊断的2型糖尿病患者血清Chemerin水平,探讨脂肪因子Chemerin与体脂参数、糖脂代谢、胰岛素抵抗的关系.方法 收集正常糖调节(NGR)和新诊断2型糖尿病患者(T2DM)各76例,按体重指数≥25 kg/m2分为正常糖调节正常体重组(NGR-NW)、正常糖调节超重/肥胖组(NGR-OW/OB)、2型糖尿病正常体重组(T2DM-NW)、2型糖尿病超重/肥胖组(T2DM-OW/OB)4个亚组.检测所有研究对象血清Chemerin水平、空腹胰岛素(FINS)、空腹C肽和糖脂代谢参数等,并计算体重指数、腰臀比和胰岛素抵抗指数(HOMA-IR).结果 女性血清Chemerin水平高于男性[(109±28)μg/L比(98±23)μg/L,P<0.05].超重/肥胖者Chemerin水平明显高于正常体重者[(113±27)μg/L比(94±25)μg/L,P<0.01],T2DM与NGR组血清Chemerin水平差异无统计学意义[(105±29)μg/L比(102±27)μg/L,P=0.786].在校正性别和年龄后,血清Chemerin水平与体重指数(r=0.336,P=0.000),腰围(r=0.460,P=0.000),腰臀比(r=0.325,P=0.000),空腹C肽(r=0.377,P=0.000),FINS(r=0.333,P=0.000),HOMA-IR(r=0.182,P=0.027)和甘油三酯(r=0.280,P=0.001)呈正相关;与高密度脂蛋白胆固醇(r=-0.251,P<0.01)呈负相关.多元逐步回归分析显示,空腹C肽、甘油三酯是血清Chemerin水平的独立相关因素(β=0.328、0.280,均P<0.05).结论 女性血清Chemerin水平高于男性,超重/肥胖者血清Chemerin水平显著升高,与胰岛素水平、体脂分布、脂代谢相关,提示Chemerin可能参与肥胖及代谢综合征的病理生理过程.     

肥胖对多囊卵巢综合征患者非酒精性脂肪性肝病的影响

目的 研究肥胖对多囊卵巢综合征(PCOS)患者中非酒精性脂肪性肝病(NAFLD)发病的影响.方法 对306例PCOS患者及286例对照者进行基础内分泌、口服糖耐量试验及胰岛素释放试验、肝功、血脂等检查,B超诊断脂肪肝.结果 306例PCOS患者中诊断NAFLD 94例,占30.7%,明显高于对照组发病率17.5%(P＜0.05);PCOS患者中NAFLD轻度56例(59.6%),中度34例(36.2%),重度4例(4.2%).PCOS患者中NAFLD发病率随着体重指数(BMI)、腰臀比(WHR)、甘油三酯(TG)、HOMA-IR的增加而升高,脂肪肝程度随着BMI的增加而加重.腹型肥胖的PCOS患者NAFLD发病率为43.4%,明显高于腰围正常的PCOS患者NAFLD发生率为2.2%(P＜0.05).且随着BMI的增加,PCOS患者胰岛素抵抗、代谢综合征的发生率亦随之升高.结论 PCOS患者NAFLD发病率较高,腹型肥胖和Ⅱ肥胖的PCOS患者更易发生NAFLD,其发病率和脂肪肝的程度与BMI呈正相关.PCOS患者NAFLD的发生与胰岛素抵抗、肥胖、代谢异常密切相关.肥胖的PCOS患者应加强NAFLD的诊断并及时指导其改善生活方式.     

重庆地区3388个自然人群肥胖与相关疾病的关系调查

目的探讨重庆市人群肥胖及其相关疾病的发病情况,分析BMI、腰围及腰臀比与高血压、高血糖、高甘油三酯血症和胰岛素抵抗的关系.方法采取现况调查的方式,对重庆市沙坪坝区重庆大学的教职工和重庆市珞磺电厂的职工进行调查,内容包括填写问卷,测定身高、体重、血压、腰围、臀围及血脂、血糖和胰岛素水平等.结果该人群中,超重占30.93%,肥胖占3.51%,腹型肥胖占16.27%,男性超重比例高于女性,而女性腹型肥胖的患病率高于男性.随着年龄的增加,肥胖患病率亦增加.被调查人群中,高血压、血脂紊乱、高血糖和IR的患病率分别为34.06%、45.13%、27.78%和7.35%.随着BMI和腰围的增加,以上代谢紊乱的患病率持续增加.分别以BMI、腰围和腰臀比为标准,比较肥胖患者伴发其他代谢紊乱的患病率发现,在男性,腰围标准下的肥胖患者患其他代谢异常的比例显著高于腰臀比和BMI,而女性患者则更能耐受腹型肥胖.随着BMI的增高,个体具有多种代谢异常的概率增加.结论被调查人群中肥胖及其相关疾病患病率较高,随着肥胖程度的加重,伴发各种代谢紊乱的概率增加.