原发性高血压患者内脏脂肪分布与左心室肥厚的相关性

目的通过观察原发性高血压患者腹部CT内脏脂肪/皮下脂肪比值(V/S)及体质量指数(BMI)、腰臀比(WHR)、腰围/身高比值(WHtR )与原发性高血压左心室肥厚（LVH）的关系,探讨原发性高血压患者腹部CT内脏脂肪分布与LVH的相关性。方法对80例入选者行上腹CT检查及心脏超声检查,分别测量上腹CT的V/S及心脏超声左心室质量指数（LVMI）,并记录年龄、收缩压、舒张压、BMI、WHR和WHtR,应用统计学方法观察各参数与LVMI的关系。结果原发性高血压患者LVH组与非LVH组年龄、收缩压和舒张压差异均无统计学意义（P＞0.05）,而原发性高血压患者LVH组V/S、BMI、WHR和WHtR显著高于非LVH组（P＜0.05）;V/S、WHtR、WHR和BMI与LVMI之间有线性回归关系,且V/S回归系数最大。结论肥胖对原发性高血压患者LVH有促进作用,内脏脂肪聚集与LVH关系尤为密切。     

基于辛开苦降酸化法创立的运脾化浊颗粒治疗胃热脾困型代谢综合征的临床效果

目的观察基于辛开苦降酸化法创立的运脾化浊颗粒治疗胃热脾困型代谢综合征(MS)的临床效果。方法选取2018年12月至2019年12月陕西省中医医院确诊的80例胃热脾困型MS患者为研究对象,按照随机数表法将其分为观察组和对照组,各40例。对照组给予二甲双胍,观察组给予运脾化浊颗粒。比较两组治疗前、后中医症状积分、一般指标、生化指标、胰岛素抵抗指数(HOMA-IR)、安全性指标以及不良反应发生情况。结果治疗后,两组的主症、次症积分及症状总分均明显降低,且观察组低于对照组(P<0.05)。治疗后,两组的W、WC、SBP、DBP均低于治疗前,且观察组的W、WC低于对照组(P<0.05)。治疗后,两组的FPG、FINS、TG、AST、UA、HOMA-IR均降低,HDL-C均升高(P<0.05);治疗前、后,两组的ALT水平比较,差异均无统计学意义(P>0.05)。两组的不良反应总发生率比较,差异无统计学意义(P>0.05)。结论基于辛开苦降酸化法创立的运脾化浊颗粒治疗胃热脾困型MS的效果显著,值得临床推广应用。     

运脾化浊颗粒治疗胃热脾困型非酒精性脂肪性肝病的临床研究

目的观察运脾化浊颗粒治疗胃热脾困型非酒精性脂肪性肝病(NAFLD)的临床疗效。方法将92例胃热脾困型NAFLD患者采取随机数字表法分为治疗组46例和对照组46例。2组患者均给予健康教育、控制饮食、加强运动等生活方式干预,对照组在此基础上口服盐酸二甲双胍250 mg,治疗组在此基础上口服运脾化浊颗粒。观察2组患者治疗前后临床症状积分、腰围、体质量、体质量指数(BMI)、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)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)等指标。结果治疗后,2组患者临床症状积分均显著改善,TC、TG、ALT、AST、腰围、体质量、BMI显著降低,且治疗组显著优于对照组(P 0. 05)。结论对胃热脾困型非酒精性脂肪性肝病患者进行生活方式干预联合口服运脾化浊颗粒治疗,可改善患者临床症状,降低TC、TG、ALT、AST、腰围、体质量、BMI等指标水平。     

MRI及1H-MRS评估针灸治疗对肥胖儿童腹部脂肪和肝内脂质含量的影响

目的 应用MRI和¹H-MRS评估针灸治疗对肥胖儿童腹部脂肪和肝内脂质含量的影响。方法 10例肥胖儿童(男7例,女3例)接受规律针灸治疗1个月,治疗前、后分别测量体质量、体质量指数(BMI)、腰围、臀围、腰臀比值(WHR)、腹部脂肪体积(应用MRI)及肝内脂质含量(应用¹H-MRS)。结果 针灸治疗后患者的BMI较治疗前减少3.50%(P=0.005)。腹腔内脂肪(VAT)体积、腹部总脂肪(TAT)体积及腹腔内脂肪/皮下脂肪比值(V／S)均较治疗前减少(P均＜0.05)。体质量、腰围、臀围、WHR、腹部皮下脂肪(SAT)体积及肝内脂质含量(IHCL) 均较治疗前减少,但差异无统计学意义(P＞0.05)。针灸治疗前后腹部脂肪体积(SAT、VAT)与人体测量参数(体质量、BMI、腰围及臀围)显著相关,而肝内脂质含量(IHCL)与人体测量参数及腹部脂肪体积等指标之间均无相关性。结论 针灸治疗可以显著减少肥胖儿童的BMI及腹部脂肪体积,特别是腹腔内脂肪体积。     

基于磁共振成像的非酒精性脂肪肝患者上腹部脂肪体积与身体质量指数的相关性研究

目的采用磁共振成像脂肪定量技术测量上腹部(L2、L3水平)脂肪体积,探讨其与身体质量指数(body mass index,BMI)的相关性.材料与方法纳入56例非酒精性脂肪肝的患者,所有患者均计算BMI及行上腹部MRI检查.利用MRI脂肪定量技术测量L2、L3椎体水平腹腔内脏脂肪及皮下脂肪的体积,并分析其与BMI的相关性.结果56例患者的BMI为(26.90±3.18)kg/m2.L2椎体水平腹腔内脏及皮下脂肪体积分别为(556.0±165.6)cm3和(448.9±166.7)cm3;L3椎体水平分别为(513.6±163.6)cm3和(517.6±173.5)cm3.20～40岁组和>40岁组在L2、L3椎体水平的腹腔内脏脂肪及皮下脂肪体积差异均无统计学意义(P>0.05).BMI≥28 kg/cm2组的L2、L3椎体水平的腹腔内脏及皮下脂肪体积均高于BMI<24 kg/cm2组(P<0.01);在L2、L3椎体水平腹腔内脏脂肪体积方面,BMI越大,腹腔内脏脂肪体积越高.腹腔内脏脂肪体积与皮下脂肪体积正相关(r=0.347～0.410;P<0.01).BMI与L2、L3椎体水平腹腔内脏及皮下脂肪体积皆增大,呈中等偏强正相关(r=0.568～0.706;P<0.01).结论磁共振成像脂肪定量技术测量的上腹部(L2、L3椎体水平)脂肪体积与BMI具有正相关.     

内脏脂肪/皮下脂肪比值与超重/肥胖患者胰岛β细胞功能相关性

目的:探讨内脏脂肪/皮下脂肪比值与超重/肥胖患者胰岛β细胞功能的相关性。方法:选取2020年6月至2022年1月就诊于上海中医药大学附属普陀医院肥胖专病门诊的96例体重指数(body mass index,BMI)>24 kg/m^(2)的超重/肥胖患者,测量内脏脂肪面积(visceral fat area,VFA)、皮下脂肪面积(subcutaneous fat area,SFA)、身高、体重,计算BMI,测定空腹血糖(fasting blood glucose,FBG)、糖化血红蛋白(glycosylated hemoglobin,HbAl c)、空腹胰岛素(fasting insulin,FINS)、餐后胰岛素、空腹C肽、餐后C肽;测定成纤维细胞生长因子21(fibroblast growth factor 21,FGF-21)、瘦素(leptin,LEP)、脂联素(adiponectin,ADP)等脂肪因子以及胰高血糖素样肽-l(glucagon-like peptide-1,GLP-1)、YY肽重组蛋白(recombinant peptide YY,YY肽)等胃肠激素,并计算内脏脂肪/皮下脂肪比值、稳态模型胰岛素抵抗指数(homeostasis model insulin resistance index,HOMA-IR)、胰岛β细胞功能指数(isletβcell function index,HOMA-β)。根据内脏脂肪/皮下脂肪比值将患者分为低内脏脂肪/皮下脂肪比值组与高内脏脂肪/皮下脂肪比值组,分析其与胰岛β细胞功能及脂肪因子等的相关性。结果:低内脏脂肪/皮下脂肪比值组VFA、FBG、HbAlc、YY肽均低于高内脏脂肪/皮下脂肪比值组,SFA、餐后C肽、HOMA-β、FGF-21、LEP均高于高内脏脂肪/皮下脂肪比值组,差异均有统计学意义(均P<0.05)。VFA/SFA与FBG、HbAlc呈正相关(分别r=0.344、0.434,P<0.05),与餐后C肽、HOMA-β、FGF-21、LEP呈负相关(分别r=-0.406、-0.343、-0.345、-0.344,P<0.05)。结论:研究结果提示内脏脂肪/皮下脂肪比值越大,FBG、HbA1c水平越高,餐后C肽、HOMA-β、FGF-21、LEP越低。不同于传统意义上的内脏脂肪含量,内脏脂肪/皮下脂肪比值还考虑了皮下脂肪含量对胰岛β细胞功能的影响,综合分析脂肪分布情况,有助于全面评估超重、肥胖患者胰岛功能损伤的严重程度和机体的糖代谢情况。     

电针联合耳压疗法辨证分型治疗肥胖疗效观察

目的探讨电针联合耳压疗法辨证分型治疗肥胖的效果。方法选取医院收治的肥胖症患者92例作为研究对象,采用数字随机对照表将患者分为对照组和观察组,对照组行电针治疗,观察组采用电针联合耳压疗法辨证分型治疗,观察两组临床疗效,评估治疗前后体重指数(BMI)、腰臀比(WHR)、腹围、腰围(WC)、脂肪数(FAT%)的变化情况,记录治疗前后胰岛素、血清瘦素的变化情况。结果观察组治疗有效率为80.43%显著高于对照组58.70%,差异有统计学意义(P0.05);观察组治疗后BMI、WHR、腹围、WC、FAT%分别为(28.06±1.73)kg/m2、(0.85±0.05)%、(98.64±6.36)cm、(92.45±6.17)cm、(31.15±2.15)%均显著低于对照组,差异有统计学意义(P0.05);观察组治疗后瘦素、胰岛素水平分别为(14.64±6.21)μg/L、(5.13±1.28)m IU/L均显著低于对照组,差异有统计学意义(P0.05)。结论电针联合耳压疗法辨证分型治疗肥胖疗效确切。     

祛瘀化浊颗粒对非酒精性脂肪肝胰岛素抵抗的影响

目的:通过观察祛瘀化浊颗粒对非酒精性脂肪肝胰岛素抵抗(IR)的影响,探讨祛瘀化浊颗粒治疗非酒精性脂肪肝的作用机制。方法:运用祛瘀化浊颗粒治疗非酒精性脂肪肝患者40例(治疗组),并与对照组(多烯磷脂酰胆碱治疗脂肪肝)患者40例作对照,观察治疗前后肝功能、肝/脾CT值、胰岛素抵抗指数(HOMA-IR)。结果:治疗组总有效率为85.0%,对照组总有效率为82.5%,两组比较差异无统计学意义(P>0.05);两组均能明显改善患者胰岛素抵抗指数,两组比较P<0.05,治疗组疗效显著优于对照组。结论:改善胰岛素抵抗是祛瘀化浊颗粒治疗脂肪肝的可能机制。     

利拉鲁肽对新疆维吾尔族2型糖尿病肥胖患者的疗效研究

目的探讨利拉鲁肽治疗新疆维吾尔族2型糖尿病(T2DM)肥胖患者的疗效。方法纳入67例单用二甲双胍后血糖控制不理想的肥胖T2DM患者,将其随机分为二甲双胍组(单用二甲双胍)和二甲双胍+利拉鲁肽组(联合应用二甲双胍和利拉鲁肽),治疗周期为12周。分别在基线、治疗12周后检测2组患者腹部内脏脂肪面积(VA)、体脂百分比(PBF)、体脂肪量,同时测量一氧化氮(NO)、空腹血糖(FBG)、糖化血红蛋白(HbA1c)、游离脂肪酸(FFA)等相关指标,计算体质量指数(BMI)、腰臀比(WHR),采取病例对照的试验方法进行分析。结果治疗12周后,二甲双胍+利拉鲁肽组较二甲双胍组,患者体质量(W)、WHR、腰围(WC)、空腹血糖(FBG)、体脂肪量和腹内脂肪(VA)均明显下降,差异有统计学意义(P0.05)。结论接受利拉鲁肽治疗的T2DM肥胖患者在血糖、血脂得到控制的同时,能获得降低W、改善血管内皮功能、减少内脏脂肪的收益。     

运用3.0T磁共振IDEAL-IQ技术进行肝脏脂肪定量分析的可行性研究

目的探讨在3.0 T MRI上运用IDEAL-IQ序列进行肝脏脂肪定量分析的可行性。方法对31例经临床确诊的脂肪肝患者及20名健康志愿者行常规MRI扫描及IDEAL-IQ序列检查;同期空腹采静脉血检测血清甘油三酯(TG)、总胆固醇(TC)及高密度脂蛋白胆固醇(HDL-C)含量;扫描前后2 d内行上腹部CT扫描测量肝脾CT值并计算比值。比较经IDEAL-IQ直接测得肝脏脂肪分量值、肝脾CT值比值及血清学检查各项指标的一致性。结果健康对照组与脂肪肝组的TG、TC及HDL-C值差异有统计学意义(P<0.05);健康对照组与脂肪肝组的肝脾CT值比值差异有统计学意义(P<0.05);健康对照组与脂肪肝组的脂肪分量值差异有统计学意义(P<0.05);脂肪肝组的脂肪分量值与血清TG、TC值呈显著正相关(r=0.836、0.852,P<0.05),而与肝脾CT值比值、HDL-C值呈负相关(r=-0.992、-0.735,P<0.05)。结论 IDEAL-IQ成像技术定量评估肝脏的脂肪含量是可行的,并与肝脾CT值比值及临床血清学检测之间具有良好的相关性,对脂肪肝的定量诊断具有重要的临床应用价值。     

Correlation of abdominal fat accumulation and liver steatosis: importance of ultrasonographic and anthropometric measurements.

PURPOSE: This study has two objectives: (1) using ultrasound (US) as a tool for measuring subcutaneous (S) and intra-abdominal; preperitoneal (P) and visceral (V) fat thickness. (2) Assessing the relationship between selected anthropometrical variables and US-measured S, P and V fat also evaluating the contribution of abdominal fat accumulation in development of liver steatosis. METHODS AND MATERIALS: Sixty-eight obese patients (aged 43.9+/-9.3 years) and 40 non-obese subjects (aged 34.03+/-9.0 years) were recruited to this study. Height, weight (W), waist (WC) and hip circumferences were measured. Body mass index (BMI) and waist to hip ratio (WHR) were calculated. A linear-array probe (7.5 MHz) was used to measure S and P. A convex-array probe (3.5 MHz) was used for measuring V and assessing liver fatty infiltration. RESULTS: In 45 (66%) patients, there were diffuse liver fatty changes. Liver steatosis showed significant correlation with V (r=0.57), P (r=0.38) and S (r=0.37). It also correlated with W (r=0.52), BMI (r=0.6), WC (r=0.45) (P<0.0001). V positively correlated with BMI (r=0.62), W (r=0.55), WC (r=0.52) and WHR (r=0.33). P correlated with WC (r=0.29), WHR (r=0.36) and W (r=0.34), but not with BMI, height and age. A significant correlation was found between S and BMI (r=0.73), W (r=0.65), and WC (r=0.57) (P<0.0001). CONCLUSION: Obese patients showed thicker S, P, and V. Liver steatosis correlates significantly with both anthropometrical data; BMI, WHR, WC, and W, and with abdominal V, P, and S fat. V fat can be used as a good predictor for the possibility of different metabolic disorders and liver disturbances as steastosis.     

运脾化浊颗粒治疗非酒精性脂肪肝的临床效果及对患者肠道菌群的影响

目的 探究运脾化浊颗粒治疗非酒精性脂肪肝的临床效果及对患者肠道菌群的影响.方法 选取我院收治的100例非酒精性脂肪肝患者作为研究对象,采用随机数字表法将其分为对照组(50例,盐酸二甲双胍)和观察组(50例,运脾化浊颗粒+盐酸二甲双胍).比较两组的临床疗效、中医证候积分、血脂指标水平及肠道菌群计数.结果 观察组的治疗总有...     

Waist circumference,waist-to-hip ratio and body mass index as predictors of adipose tissue compartments in men

BACKGROUND: The accumulation of fat in visceral and posterior subcutaneous adipose tissue compartments is highly correlated with the metabolic abnormalities that contribute to increased risk of diabetes mellitus and cardiovascular disease. AIM: To determine which of waist circumference (WC), waist-to-hip ratio (WHR) and body mass index (BMI) was the best predictor of intraperitoneal and posterior subcutaneous abdominal adipose tissue mass in men. METHODS: We studied 59 free-living men with a wide range of BMI. WC, WHR and BMI were determined using standard methods. Intraperitoneal, retroperitoneal, anterior subcutaneous and posterior subcutaneous abdominal adipose tissue masses (IPATM, RPATM, ASAATM and PSAATM, respectively) were quantified using magnetic resonance imaging. RESULTS: In univariate regression analysis, WC, WHR and BMI were all significantly and positively correlated (all p < 0.05) with IPATM, RPATM, ASAATM and PSAATM. To assess the relative strength of these associations, we used non-nested regression models. There was no significant difference between WC and WHR in predicting IPATM and RPATM; WC was a stronger predictor of ASAATM (p < 0.001) and PSAATM (p < 0.001) than WHR; WC was also a stronger predictor of IPATM (p = 0.042) and RPATM (p = 0.045) than BMI, but the relative strengths of WC and BMI in predicting ASSATM and PSAATM did not different significantly (p > 0.05); there was no significant difference between BMI and WHR in predicting IPATM and RPATM (p>0.05), but BMI was a stronger predictor of ASAATM (p = 0.036) and PSAATM (p < 0.001) than WHR. DISCUSSION: In men WC is the anthropometric index that most uniformly predicts the distribution of adipose tissue among several fat compartments in the abdominal region, there apparently being little value in measuring WHR or BMI.     

Adiposity assessed by anthropometric measures has a similar or greater predictive ability than dual-energy X-ray absorptiometry measures for abdominal aortic calcification in community-dwelling older adults

To determine whether adiposity assessed by dual-energy X-ray absorptiometry (DXA) compared to simple anthropometric assessments, are more predictive of abdominal aortic calcification (AAC), a risk factor for atherosclerosis. A cross-sectional study of 312 participants (60.3?% female) aged 70.6?±?5.6 years was conducted in 2010–2011. AAC was assessed by radiography. Adiposity was estimated for whole body, trunk, android, gynoid and visceral regions using DXA in addition to body mass index (BMI), waist circumference (WC) and waist to hip ratio (WHR). WHR [tertile 1 as reference, OR (95?% CI) for tertile 3: 3.62 (1.35–9.72)] and android to gynoid fat ratio [tertile 3: 2.87 (1.03–8.01)] were independent predictors of AAC severity among men. Positive associations with AAC severity were observed for WC [tertile 1 as reference, OR for tertile 3: 2.46 (1.12–5.41)], % trunk fat mass [tertile 2: 3.26 (1.52–7.03)], % android fat mass [tertile 2: 2.42 (1.13–5.18), tertile 3: 2.20 (1.02–4.73)] and visceral fat area [tertile 2: 2.28 (1.06–4.87), tertile 3: 2.32 (1.01–5.34)] among women. Indices of total body composition, BMI and % body fat mass were not associated with AAC severity in either men or women. Simple anthropometric measures, WHR and WC were the best predictors of AAC severity in men and women respectively, although higher android to gynoid fat ratio and central fat, assessed by DXA, were also predictive of higher risks of AAC severity in men and women respectively. Our findings add to existing evidence that relatively inexpensive and easily obtained anthropometric measures can be clinically useful indicators of atherosclerosis risk.     

The effect of fasting month of Ramadan on the abdominal fat distribution: assessment by computed tomography

The aim of this study was to evaluate the changes in abdominal fat distribution in the fasting month of Ramadan. Thirty-eight healthy volunteers (17 women and 21 men) who fasted in the month of Ramadan in 2002 were included in this prospective study. Waist, hip and thigh circumferences, weight and height of all subjects were measured. Waist-to-hip ratio (WHR), waist-to-thigh ratio (WTR) and body mass index (BMI) were calculated for each subject. For assessing the fat distribution in the abdomen, computed tomography (CT) was performed. Both subcutaneous and visceral fat areas were calculated by the CT scanning technique. All of the calculations were done before (first measurement) and after (second measurement) Ramadan fasting and the changes were evaluated. No statistically significant differences were found in all subjects between the first and second measurements, which include total, subcutaneous and visceral fat areas, waist, hip and thigh circumferences, weight, BMI, WHR, and WTR (p > 0.05). In females and the individuals in their twenties, there was a significant decrease in visceral fat area (p < 0.05). Despite of the general opinion that supposes the change of weight during the fasting month of Ramadan, there were no significant differences in weight and abdominal fat distribution. However in female and young individuals, there was a reduction in visceral fat compartment. This could be due to fat redistribution, because they have more physical activity than males and older individuals.     

Liver fat content measured by magnetic resonance spectroscopy at 3.0 tesla independently correlates with plasminogen activator inhibitor-1 and body mass index in type 2 diabetic subjects

We measured liver fat content by 3-Tesla magnetic resonance spectroscopy (MRS) in 34 non- to mild obese Japanese subjects with type 2 diabetes, who were not complicated with any liver diseases including clinical fatty liver (liver/spleen ratio of computed tomography [CT] < 0.9) and were not being treated with oral hypoglycemic agents, insulin, or lipid-lowering agents, and analyzed the relationship between liver fat content and body composition and plasma metabolite. The liver fat content is significantly correlated with variables relating to obesity (body mass index [BMI], body weight, fat mass, waist to hip ratio, visceral fat area, subcutaneous fat area, and serum triglyceride), insulin resistance (fasting plasma insulin and homeostasis model assessment of insulin resistance [HOMA-IR]), adipocytokines (serum plasminogen activator inhibitor-1 [PAI-1] and leptin), and serum cholinesterase, but not CT liver/spleen ratio, which is correlated only with fasting plasma glucose, BMI, and HOMA-IR. Multiple regression analysis revealed that the liver fat content is independently associated with serum PAI-1 level (p < 0.001) and BMI (p < 0.05), but not visceral fat area. MRS is a more sensitive method for quantifying liver fat content than CT in type 2 diabetic subjects with non- to mild obesity and without clinical fatty liver.     

2型糖尿病合并不同程度非酒精性脂肪性肝病的危险因素分析

目的 探讨2型糖尿病(T2DM)合并不同程度非酒精性脂肪性肝病(NAFLD)与血脂异常、肥胖和胰岛素抵抗的关系及其发病的危险因素.方法 对268例2型糖尿病患者,根据肝脏B超结果分为无脂肪肝组、轻度脂肪肝组、中重度脂肪肝组.记录患者身高、体重、腰围、臀围,进行空腹血糖(FBG)、糖化血红蛋白(GHbA_1c)、血总胆醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)、丙氨酸氨基转移酶(ALT)、空腹胰岛素(FINS)测定,计算体重指数(BMI)、腰臀比(WHR)、胰岛素抵抗指数(HOMA-IR).通过非条件Logistic回归进行NAFLD的危险因素分析.结果 无脂肪肝组、轻度脂肪肝组、中重度脂肪肝组BMl分别为(24.25±5.37)、(25.98±4.63)、(27.69±4.35)kg/m~2,WC分别为(83.36 ±8.27)、(88.36±7.96)、(92.36 ±9.35)cm,WHR分另为1.01±0.32、1.12 ±0.27、1.19±0.34,FINS分别为(18.47 ±7.13)、(23.01±9.89)、(29.26±11.94)μU/L,HOMA-IR分别为4.25±2.37、7.37±3.20、9.48±4.13.TC分别为(4.92±1.25)、(5.43±1.30)、(5.60±1.04)mmol/L;LDL-C分别为(2.91 ±0.90)、(3.32±0.83)、(3.57±0.73)mmol/L,TG分别为(2.02±1.03)、(2.68±1.47)、(3.49±1.86)mmol/L,ALT分别为(26.35±14.48)、(30.68±13.54)、(37.58±16.79)U/L.与无脂肪肝组相比,轻度脂肪肝组及中重度脂肪肝组BMI、WC、WHR、HNS、HOMA-IR、TC、LDL-C、TG、ALT均较高(P均<0.05).中重度脂肪肝与轻度脂肪肝组相比,BMI、WC、WHR、HNS、HOMA-IR、TG、ALT明显升高(P均<0.05).TG、WHR、HOMA.IR是NAFLD的危险因素(彻值分别为2.394、3.273、5.256,P均<0.05).结论 T2DM合并NAFLD患者存在明显的血脂紊乱、超重、中心性肥胖及胰岛素抵抗,TG、WHR、HOMA-IR是NAFLD发病的危险因素.     

Sonographic assessment of changes in thickness of different abdominal fat layers in response to diet in obese women

PURPOSE: We evaluated the potential application of sonography to monitor alterations in abdominal fat thickness in obese women before and after dieting. METHODS: This study included 40 obese women (mean age, 42.2 +/- 9.4 years; mean body mass index [BMI], 36.0 +/- 5.9 kg/m2) who underwent a 3-month low-calorie diet. Height, weight, waist circumference (WC), and hip circumference (HC) were measured. BMI and waist-to-hip ratio (WHR) were calculated. Abdominal subcutaneous (S) and intra-abdominal preperitoneal (P) fat were measured at their maximum (max) and minimum (min) thickness sites using a 7.5-MHz linear-array probe. Intra-abdominal visceral (V) fat was measured using a 3.5-MHz convex-array probe. Measurements were taken before and after caloric restriction. RESULTS: The mean weight was reduced from 88.6 +/- 17.1 kg to 83.0 +/- 15.9 kg (p < 0.0001). The mean changes in S(min) (r = 0.376, p = 0.017), S(max) (r = 0.508, (p = 0.001), P(min) (r = 0.439, p = 0.005), and V (r = 0.365, p = 0.022) fat thicknesses were positively correlated with change in weight; the change in P(max) fat thickness showed the best and most significant correlation (r = 0.591, p < 0.0001). BMI (r = 0.969, p < 0.0001), WC (r = 0.510, p = 0.001), and HC (r = 0.422, p = 0.007) changes were also positively correlated with weight change, but the WHR change (r = 0.019, p > 0.05) was not. CONCLUSIONS: All the abdominal fat layers, particularly the intra-abdominal P fat, will decrease in response to loss of body fat by dieting. Sonography seems to be useful in monitoring small variations in the thicknesses of abdominal S and intra-abdominal P and V fat.