Prediction of Abdominal Visceral Obesity From Body Mass Index, Waist Circumference and Waist-hip Ratio in Chinese Adults： Receiver Operating Characteristic Curves Analysis

Objective To evaluate the sensitivity and specificity of body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR) measurements in diagnosing abdominal visceral obesity. Methods BMI, WC, and WHR were assessed in 690 Chinese adults (305 men and 385 women) and compared with magnetic resonance imaging (MRI) measurements of abdominal visceral adipose tissue (VA). Receiver operating characteristic (ROC) curves were generated and used to determine the threshold point for each anthropometric parameter. Results 1) MRI showed that 61.7% of overweight/obese individuals (BMI≥25 kg/m2) and 14.2% of normal weight (BMI<25 kg/m2) individuals had abdominal visceral obesity (VA≥100 cm2). 2) VA was positively correlated with each anthropometric variable, of which WC showed the highest correlation (r=0.73-0.77, P<0.001). 3) The best cut-off points for assessing abdominal visceral obesity were as followed: BMI of 26 kg/m2, WC of 90 cm, and WHR of 0.93, with WC being the most sensitive and specific fact     

中青年体质指数、腰围及腰臀比与脑卒中发生的相关性研究

目的探讨中青年人肥胖的不同指标,如体质指数(BMI)、腰围(WC)及腰臀比(WHR)与脑卒中发生的关系。方法采用以医院为基础的病例对照研究。病例组由280例脑卒中(缺血性脑卒中和出血性脑卒中)患者组成,对照组为患其他与脑卒中无关的疾病同期入住和病例组相同医院的280例患者。采用标准调查表对研究对象进行调查,收集研究对象的人口学特征、生活方式、个体疾病史、脑卒中家族遗传史以及实验室检查等资料,同时对身高、体质量、WC、臀围进行测量,并计算BMI及WHR。采用多元Logistic回归分析对研究对象的BMI、WC及WHR与脑卒中的比值比(OR)及其95%可信区间(CI)进行估计。结果 280例脑卒中患者中出血性76例,缺血性204例。与正常BMI者相比较,调整年龄、性别后的分析结果显示,超重或肥胖的病例发生缺血性脑卒中的危险性明显高于对照组〔超重者:OR=2.03,95%CI(1.26,2.91),P<0.05;肥胖者:OR=1.88,95%CI(1.32,2.39),P<0.05〕。与BMI最低四分位数相比,BMI最高四分位数的病例发生缺血性脑卒中的危险性增加了18%〔OR=1.18,95%CI(1.06,3.54),P<0.01〕。WC最高四分位数的病例发生出血性和缺血性脑卒中的危险性分别是WC最低四分位数的1.80和1.96倍〔OR=1.80,95%CI(1.03,3.16)和OR=1.96,95%CI(1.37,3.78),P<0.01〕。与WHR最低四分位数比较,WHR最高四分位数的病例发生出血性及缺血性脑卒中的危险性分别增加了98%和126%〔OR=1.98,95%CI(1.41,3.59),P<0.01和OR=2.26,95%CI(1.34,2.79),P<0.01〕。结论 BMI增高是发生脑卒中的一个重要危险因素,WC增加可使发生缺血性脑卒中的危险性显著升高,而WHR与发生出血性及缺血性脑卒中的危险性呈正相关。维持正常体质量可能是脑卒中发病的保护因素。     

肥胖及体质量变化对大肠腺瘤复发率影响的临床研究

目的 观察大肠腺瘤患者术后复发率,探讨其与肥胖及体质量变化的关系.方法 选取2010-2012年该院收治的大肠腺瘤患者1 236例,纳入其中913例完成随访者,以患者的基线体质量指数(BMI)为标准将其分为体质量正常组(BMI＜24 kg/m2),超重组(BMI:24～＜28 kg/m2),肥胖组(BMI≥28 kg/m2).以腺瘤切除术后随访两年结肠镜复查作为观察终点,并再次测量患者体质量.观察患者基础体质量及体质量变化与大肠腺瘤复发率的关系.结果 共361例(39.5％)患者复发,体质量正常组、超重组、肥胖组的复发率分别为34.5％、41.0％、41.9％,超重组、肥胖组患者复发率均高于体质量正常组,差异均有统计学意义(P＜0.05).体质量改变大于或等于2.5 kg的患者复发率与体质量变化小于2.5 kg者比较,差异均无统计学意义(P＞0.05).结论 大肠腺瘤复发与肥胖有关,但短期(两年)内的体质量改变对大肠腺瘤复发率无明显影响.     

无症状人群结直肠息肉检出情况及危险因素分析

目的 探讨不同病理类型结直肠息肉在无症状人群中的检出情况及相关危险因素.方法 收集我院2013-2016年接受结直肠镜检查但无临床症状的体检者702例的临床资料[年龄、性别、体质量指数(BMI)、吸烟情况、一级亲属结直肠癌家族史、2型糖尿病及胆囊结石病史]和肠镜结果.根据肠镜结果和息肉病理类型分组,分析不同病理类型息肉的检出情况及危险因素.结果 腺瘤、增生性息肉(hyperplasic polyp,HP)、广基锯齿状腺瘤/息肉、传统锯齿状腺瘤、炎性息肉的检出率分别为14.0％ (98/702)、8.8％ (62/702)、0.6％ (4/702)、0.1％ (1/702)、0.9％ (6/702),进展期腺瘤的检出率为2.7％(19/702).年龄≥50岁(50～ ＜60岁:OR=1.712,95％CI=1.048 ～ 2.798,P=0.032;≥60岁:OR =2.151,95％CI=1.146 ～4.036,P=0.017)、吸烟≥400支/年(OR=1.866,95％ CI=1.120 ～3.109,P=0.017)、一级亲属结直肠癌家族史(OR=1.853,95％CI=1.038 ～3.310,P=0.037)是腺瘤的独立危险因素;BMI≥24.0 kg/m2(OR=3.150,95％CI=1.069 ～9.280,P=0.037)、2型糖尿病(0R=4.430,95％CI=1.248 ～ 15.721,P=0.021)是进展期腺瘤的独立危险因素;吸烟≥400支/年(OR=2.200,95％CI=1.203 ～4.024,P=0.010)是HP唯一的独立危险因素.结论 腺瘤及HP是无症状人群结直肠息肉的主要病理类型.吸烟、50岁以上、一级亲属结直肠癌家族史是腺瘤的危险因素,若同时合并2型糖尿病或体质量超重则增加进展期腺瘤的风险.吸烟也是HP的危险因素,且对HP的促进作用可能更显著.     

Hypertension, overweight and abdominal adiposity in women. An analytical perspective

BACKGROUND: The aim of our study was to determine in a group of premenopausal (preM) and postmenopausal women with hormone replacement therapy (postM-HRT) or without HRT (postM-noHRT) whether the strength of the association of body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) with hypertension is affected by the way in which these variables are used (i.e., continuous or dichotomous) in logistic regression modeling, where weight and age are set as continuous variables only. METHODS: We studied 639 preM, 341 postM-noHRT, and 77 postM-HRT healthy women age 20-69 years. The main outcome variable was hypertension: BP > or =140 or 90 mmHg on two occasions or hypertension treatment. Risk factors were assessed as continuous variables (age, postmenopausal years, weight, stature, BMI, WC, hip circumference, and WHR); and dichotomous variables (overweight: BMI > or =25; high WC: WC > or =88 cm; and high WHR: WHR > or =0.84). Stepwise regression models for hypertension were developed for continuous (model 1) and dichotomous (model 2) variables in each group. RESULTS: In preM, model 1 included BMI (OR=1.202, CI: 1.115-1.296) and age (OR=1.154, CI: 1.081-1.296); and model 2 included weight (OR=1.070, CI: 1.040-1.100) and age (OR=1.157, CI: 1.084-1.235). In postM-noHRT, both models included age (OR=1.074, CI: 1.035-1.113) and weight (OR=1.025, CI: 1.004-1.046). Overweight and age were associated with hypertension in preM and postM-noHRT; overweight being more relevant in preM, and age in postM-noHRT. No models were found for postM-HRT. CONCLUSIONS: The strength of the association of risk factors with hypertension depends on how the variables are analyzed. Acknowledging these differential effects and assigning differential risks by age could be useful in intervention programs.     

Report on Childhood Obesity in China (10): Association of Sleep Duration with Obesity

Objective To explore the association of sleep duration with obesity among children in urban areas of China.Methods A total of 6 576 children (3 293 boys and 3 283 girls) aged 7-11 years were randomly selected from 36 primary schools in 6 metropolitan cities in China.A 7-day Physical Activity Recall was used to assess the sleep duration and physical activity level.The height,weight,waist circumference (WC)and percentage of body fat (％BF,as determined by bioelectrical impedance analysis technique) were measured by following the standardized operation procedures.The information on demography,lifestyle and eating habits was collected with a self-administered questionnaire from participants and their parents.Results The average sleep duration per night in the children was 9.7 h with the decreasing trends along with the increase of age (P＜0.05).The sleep duration was negatively associated with body mass index (BMI) and WC in both boys and girls after adjustment for confounders (β value -0.23 and -0.82 for boys,-0.24 and -0.91 for girls,respectively,P＜0.01).However,no significant association of sleep duration with ％BF was found.Children who slept less than 9.0 h per night had a higher risk for overweight and obesity (0R=1.29,95％ CI:1.01,1.64) and abdominal obesity (OR=1.38,95％ CI:1.04,1.83) as compared with those who slept for 10.0-10.9 h.Conclusions Short sleep duration is associated with obesity.It is important to ensure adequate sleep duration of children and foster their healthy lifestyle at an early stage of life.     

Gender-specific Association of Sleep Duration with Body Mass Index,Waist Circumference,and Body Fat in Chinese Adults

Objective To examine the association between habitual sleep duration and obesity among Chinese adults. Methods The association of sleep duration and obesity was investigated among 7,094 community-dwelling Chinese adults. Sleep duration was self-reported. In this study, obesity was defined as follows: body mass index(BMI) ≥ 28 kg/m~2, waist circumference(WC) ≥ 85 cm in men and ≥ 80 cm in women, and percent body fat(%BF) ≥ 25 in men and ≥ 35 in women. Logistic and quantile regressions were employed to examine relationships of interest. Results Overall, 6.42% of the participants reported short sleep durations( 6 h/d) while 14.71% reported long(≥ 9 h/d) sleep durations. Long sleepers(≥ 9 h/d) represented a greater frequency of women with obesity [odds ratio(OR): 1.30; 95% confidence interval(CI), 1.02-1.67] and high body fat(1.43, 1.04-1.96) than those who slept 7-8 h/d. An association between long sleep times and higher BMI estimations was found across the 10~(th)-75~(th) percentile of the BMI distribution. Among men, long sleepers(≥ 9 h/d) presented lower risks of developing abdominal obesity compared with individuals who slept 7-8 h/d(OR = 0.79, 95% CI: 0.44-0.99). Conclusion Our study suggests that long sleep durations are associated with general obesity in Chinese women but reduced waist circumferences in men. Confirmatory studies are needed to determine the heterogeneous association of sleep time and obesity by gender.     

有糖尿病家族史13～15岁青少年肥胖特点分析

根据父母有无糖尿病将1619名13～15岁青少年分为糖尿病家族史阳性（FHD^＋）组和糖尿病家族史阴性（FHD^-）组。FHD^＋组的腰围（WC）、腰臀比（WHR）和腰围身高比（WhtR）,均高于FHD^-组（P〈0．01）。以WC定义的腹型肥胖检出率FHD^＋组高于FHD^-组（P〈0．01）,以体重指数（BMI）定义的超重肥胖检出率差异无统计学意义。应用logistic回归分析,校正性别和年龄,FHD^＋组单纯WC升高及BMI和WC均高者分别是FHD组的2．029（1．211—3．400）和1．364（1．043—1．784）倍（P〈0．05）。2型糖尿病患者的一级亲属13～15岁青少年已存在以腹型肥胖为特点的肥胖趋势。     

评估肥胖相关指标对非酒精性脂肪肝的筛查价值

目的 探讨筛查中老年人非酒精性脂肪肝(NAFLD)的最佳肥胖相关指标。方法 本项横断面研究筛选了2019年1—3月在陕西省人民医院健康管理中心参加体检的40岁及以上受试者1 281人,进行病史采集、体格检查及实验室检查,所有受试者均接受腹部B超检查。应用logistic回归分析研究各肥胖指标与NAFLD患病风险的相关性,采用ROC曲线评估肥胖指标对NAFLD患病风险的筛查价值。结果 在1 281例受试者中,335例诊断为NAFLD,NAFLD的患病率为26.15%。NAFLD组的血压、甘油三酯、总胆固醇、低密度脂蛋白胆固醇、转氨酶、空腹血糖、空腹胰岛素、稳态模型估计的胰岛素抵抗指数、糖化血红蛋白、腰围、腰臀比、BMI、脂质蓄积指数(LAP)均明显升高,高密度脂蛋白胆固醇降低。Logistic回归分析显示,在校正了相关混杂因素后,腰围、腰臀比、BMI、LAP均与NAFLD的患病风险相关。其中LAP与NAFLD的相关性最强,与处于LAP第一分位的受试者相比,处于LAP第四分位的受试者NAFLD的患病风险显著增加(OR=18.055,95%CI:7.683～42.427,P<0.001...     

肥胖类型与2型糖尿病关系的研究

目的探讨肥胖类型与2型糖尿病之间的关系。方法从2000年参加石家庄市社区健康检查的35～55岁城市居民中筛选出无高血压、血脂异常、糖尿病或糖耐量异常及其他疾病的单纯肥胖者558例作为研究对象,2007年对上述人群进行随访,随访到520例,结合体质量指数(BMI)和腰围(WC)将研究对象分为3组:周围肥胖组185例,腹型肥胖组120例,混合肥胖组215例。分别测定血压(BP)、BMI、WC、腰臀比(WHR)、空腹血糖(FBG)、空腹胰岛素、血脂,并依据HOMA公式计算胰岛素抵抗指数(HOMA-IR)。应用Logistic回归分析WC、BMI、WHR对2型糖尿病的预测作用。结果混合肥胖组、腹型肥胖组2型糖尿病的患病率、WC、WHR、BP、总胆固醇(TC)、三酰甘油(TG)、HOMA-IR高于周围肥胖组,且混合肥胖组的BMI、WC、WHR、HOMA-IR均高于腹型肥胖组,差异均有统计学意义(P<0.05或P<0.01)。Logistic逐步回归分析显示,以是否患有2型糖尿病为因变量,以BMI、WC、WHR为自变量进行回归分析,OR值分别为2.99、3.79、3.21(P均<0.01)。结论混合肥胖与2型糖尿病的关系密切,WC可较好地预测肥胖2型糖尿病的发生。     

发展中国家中等收入人群的童年期社会经济地位与中年肥胖的关联

 目的 在中国泰州的中等收入人群中探索童年期社会经济地位(socioeconomic status,SES)与肥胖的关联。方法 本研究的数据来自泰州健康人群跟踪调查(Taizhou Longitudinal Study,TZL)第Ⅲ期基线调查中35～64岁中年人的基线数据。普通型肥胖定义为BMI≥28.0 kg/m2,中心型肥胖定义为男性腰围(waist circumference,WC)≥90 cm、女性WC≥80 cm。以20世纪中期中国家庭三大件(自行车、手表和缝纫机)数量来定义SES水平:0件、1或2件、3件分别代表SES低、中、高水平。比较不同SES组间的差异,并用Logistic回归分析童年期SES与肥胖的关联。 结果 男性中普通型肥胖的比例为13.5%,中心型肥胖的比例为30.9%;女性中普通型肥胖的比例为13.6%,中心型肥胖的比例为53.7%。男性SES水平与BMI和WC成正相关。相对于童年期家庭三大件数量为0件的人,拥有3件的人中年期普通型肥胖的风险(OR=1.79,95%CI:1.40～2.28)和中心型肥胖的风险均增加(OR=1.48,95%CI:1.12～1.80),在调节了年龄、婚姻状况、教育程度、家庭收入、吸烟饮酒状况和体力活动等混杂因素后,关联仍然显著。女性SES水平与BMI和WC成负相关。相对于童年期家庭三大件数量为0件的人,拥有3件的人中年期普通型肥胖(OR=0.72,95%CI:0.58～0.90)和中心型肥胖的风险(OR=0.45,95% CI:0.38～0.54)都降低。在调节了混杂因素后,与中心型肥胖的关联依然显著。结论 在发展中国家中等收入人群中,童年期SES与肥胖的关联存在性别差异,即高SES增加男性肥胖的风险,而降低女性肥胖的风险。在社会经济由发展中阶段向发达阶段转变的同时,童年期SES与肥胖的关联也从正相关向负相关转变,这种转变较早发生在女性身上。     

Serum Ferritin and the Risk of Metabolic Syndrome: A Systematic Review and Dose-Response Meta-Analysis of Cross-sectional Studies

Objective This study aims to assess the dose-response relationship between serum ferritin (SF) and metabolic syndrome (MetS) in the two sexes.Methods We searched for articles on PubMed, the Cochrane Library, EMBASE, and the Web of Science databases that were published from 1950 to 2020. The summary odds ratio (OR) and 95％ confidence interval (CI) of the association between SF and MetS were estimated using a random-effects model through a meta-analysis. Based on the methods described by Greenland and Longnecker, we explored the dose-response relationship between the two sexes. Results This study included 14 studies and 74,710 samples. The results of the classical meta-analysis showed that SF was positively associated with MetS (OR = 1.77, 95％ CI: 1.59–1.98). Regarding the components of MetS (8 studies included), the results showed that SF was positively associated with abdominal obesity (OR = 1.42, 95％ CI: 1.24–1.62), elevated fasting plasma glucose (OR = 1.84, 95％ CI:1.50–2.25), elevated blood pressure (OR = 1.17, 95％ CI: 1.08–1.26), elevated triglycerides (OR = 2.09, 95％ CI: 1.72–2.54), and reduced high-density lipoprotein cholesterol (OR = 1.33, 95％ CI: 1.19–1.49). In the linear dose-response meta-analysis, the ORs of males, females, and postmenopausal females were 1.14 (95％ CI: 1.13–1.16), 1.32 (95％ CI: 1.26–1.39), and 1.34 (95％ CI: 1.22–1.47), respectively.Conclusions Our study shows that SF is significantly and positively associated with MetS, and the risk in the male population is higher than that in the female population. This finding also supports the recommendation of using SF as an early warning marker of MetS.     

不同肥胖测量指标对心脏代谢性疾病预测价值的比较

目的 探索不同肥胖测量指标对高血压、糖尿病及血脂异常的预测价值.方法 2013 ～2014年期间,采用整群随机抽样的方法,对全国4个县开展了心血管病危险因素调查,实际入选5402人,有效数据4704人.利用该资料分析体重指数、腰围、臀围、腰臀比、腰围身高比、身体脂肪率及内脏脂肪指数对高血压、糖尿病和血脂异常的预测价值.结果 经单因素分析发现,内脏脂肪指数对高血压的预测价值较高,ROC曲线下面积达到0.67（95％ CI：0.65～0.69）,而腰围对糖尿病及血脂异常的预测价值较高,ROC曲线下面积分别达到0.66（95％ CI：0.63～0.69）和0.67（95％ CI：0.65～0.68）.Logistic回归调整年龄、性别、体力活动、吸烟、饮酒及教育程度因素后发现身体脂肪率对高血压（标准化OR =1.71,95％ CI：1.57～1.87）和血脂异常（标准化OR=1.88,95％ CI：1.72～2.06）的预测效果较好;而对于糖尿病来说,腰围的预测效果较好（标准化OR=1.62,95％ CI：1.45 ～1.80）.结论 本次调查发现身体脂肪率对我国35～64岁中年人群高血压和血脂异常的预测效果较好,而腰围对于糖尿病的预测效果较好.     

中老年女性腰围、腰臀比及高血压与子宫肌瘤关系

目的探讨中老年女性腰围（WC）、腰臀比（WHR）及高血压与发生子宫肌瘤（uL）危险性的关系．方法采用以医院为基础的研究方法,选择612例35。65岁女性,患者均经超声诊断或手术确诊的子宫肌瘤患者．对照组为因患其他疾病同期人住与病例相同医院的患者。采用调查表对研究对象进行调查．包括人口学特征、生活方式以及既往史等,同时对身高、体重、WE及臀围进行测量。采用多因素Logistie回归模型对患者WE、WHR及高血压与UL的比值比（OR）及其相应的95％CI进行估计。结果WC和WHR升高使发生UL的危险性增加（OR：1．504,95％CI：1．068-2．119,P=0．019;OR=1．524,95％CI：1．107—2．097,P=0．010）;罹患高血压的女性与UL呈正相关（OR=1．505,95％CI：1．046～2．165,P=0．028）。与收缩压为最低四分位数的对照相比,第3个四分位数的病例发生UL的危险性较高（OR=I．675,95％CI：1．053～2．663,P=0．029）。当调整了多种潜在性混杂因素后．WE、WHR及高血压与UL关系的结果并未发生改变。结论向心性肥胖和高血压可能是发生UL的重要危险因素．     

BMI,WC, WHtR,VFI and BFI: Which Indictor is the Most Efficient Screening Index on Type 2 Diabetes in Chinese Community Population

ObjectiveObesity is a major risk factor for type 2 diabetes, many indexes can be used to describes obesity and predict diabetes. This research attempts to identify the best indicator of obesity to screening diabetes in Chinese population.MethodsA cross-sectional data of 8121 subjects aged 35–60 years were included in this research belongs to the Diabetes Appropriate Technology Intervention Study. Anthropometric indicators including body weight, height, waist circumferences (WC), body fat index (BFI) and visceral fat index (VFI) and blood biochemical indicators after an overnight fast [fasting blood glucose, total cholesterol, high-density lipoprotein (HDL) cholesterol, and triacylglycerol] were measured. BMI (body mass index) and Weight to Height Ratio was calculated.ResultsSubjects with obesity had a higher risk of physician diagnosed diabetes (OR=2.50, 95% CI 1.83–3.43), new diagnosed diabetes (OR=4.23, 95% CI 2.91–6.15) and pre-diabetes (OR=1.75, 95% CI 1.31–2.34) compared to those with normal Body mass index (BMI). There was a significant trend of increased risk of all diabetes status with increased waist circumference (WC). The waist-to-height ratio (WHtR) yielded the most significant association with new diagnosed diabetes and physician diagnosed diabetes than other indices.ConclusionCentral obesity is significantly correlated with diabetes. VFI was most correlated with pre-diabetes while WHtR is an efficient screening index than BMI and WC in Chinese community diabetes screening.     

腹型肥胖内脏脂肪定量检测的评估及其临床意义

目的 分析临床常用体脂检测方法与内脏脂肪型肥胖(VFO)诊断切点的相关性,及其在判断腹型肥胖类型中的价值.方法 4301例研究对象,其中659例接受了CT、生物电阻抗(体脂仪)和B超3项检查.以CT检查确定的腹内脂肪面积(VA)≥100 cm2作为判断VFO的诊断标准,应用受试者工作特征(ROC)曲线分别分析简易体脂参数(腰围、体重指数、腰臀比),体脂仪参数(全身脂肪含量、全身脂肪重量),超声测值(腹壁脂肪厚度、腹内脂肪厚度)判断VFO的切点及其敏感性和特异性.结果 (1)腰围、脂肪重量、体重指数、腹内脂肪厚度、全身脂肪含量、腰臀比诊断VFO均有较高准确性(ROC曲线下面积为0.718～0.837),其中腰围判断VFO的诊断效率最好.(2)判断VFO的最佳切点及其敏感性和特异性在男性和女性分别是:腰围为89.5、85.5 cm;体重指数为25、26 kg/m2;腰臀比为0.97、0.95;全身脂肪含量为29%、38%;全身脂肪重量为18.6、20.4 kg;腹内脂肪厚度为38.5、34.7 mm.结论 简易体脂参数、体脂仪、超声可用于临床定量评估内脏脂肪变化.在确定腰围的前提下,结合超声或体脂仪参数可进一步判断腹型肥胖的类型.     

血清Asprosin、Spexin水平与2型糖尿病并内脏型肥胖的相关性研究

背景　脂肪因子与体脂分布及糖脂代谢的相关性研究已成为国内外研究热点,而脂肪因子Asprosin、Spexin在2型糖尿病（T2DM）及肥胖中的研究鲜有报道。目的　探究血清Asprosin、Spexin水平与T2DM并发内脏型肥胖（VO）的相关性。方法　选取2019年1月至2020年6月于内蒙古科技大学包头医学院第一附属医院内分泌科国家标准化代谢性疾病管理中心就诊的381例T2DM患者为研究对象。依据是否发生VO将患者分为T2DM并发VO组（T2DM-VO组,n=226）、T2DM未并发VO组（T2DM-nonVO组,n=155）。本研究中VO的诊断标准为内脏脂肪面积（VFA）≥100 cm2。比较两组患者一般资料、生化指标、体脂相关指标及血清Asprosin、Spexin水平,并分析血清Asprosin、Spexin水平与各指标间的相关性。采用二元Logistic回归分析探究T2DM并发VO的影响因素。结果　T2DM-VO组患者舒张压（DBP）、身高、空腹C肽（FCP）水平、餐后2 hC肽（2 hCP）水平、三酰甘油（TG）水平、血尿酸（UA）水平、稳态模型评估胰岛素抵抗指数（HOMA-IR）、Asprosin水平高于T2DM-nonVO组,体质量、体质指数（BMI）、腰围（WC）、臀围（HC）、腰臀比（WHR）、VFA、皮下脂肪面积（SFA）、内脏脂肪面积比皮下脂肪面积（VSR）大于T2DM-nonVO组,男性所占比例、Spexin水平低于T2DM-nonVO组（P<0.05）。Asprosin与身高、体质量、BMI、WC、HC、WHR、FCP、2 hCP、TG、HOMA-IR、VFA、SFA、VSR呈正相关,与Spexin呈负相关（P<0.05）;Spexin与体质量、BMI、WC、HC、WHR、FCP、2 hCP、Cr、UA、HOMA-IR、VFA、SFA、VSR呈负相关,与HbA1c呈正相关（P<0.05）。二元Logistic回归分析结果显示,性别〔OR=2.967,95%CI（1.830,4.810）〕、BMI〔OR=1.729,95%CI（0.801,3.732）〕、WHR〔OR=0.000,95%CI（0.000,0.105）〕、SFA〔OR=0.985,95%CI（0.977,0.992）〕、Asprosin〔OR=0.539,95%CI（0.426,0.681）〕、Spexin〔OR=1.001,95%CI（1.000,1.001）〕是T2DM并发VO的影响因素（P<0.05）。结论　血清Asprosin、Spexin水平与T2DM并发VO密切相关,为治疗T2DM、预防T2DM并发症提供了新的、可能的治疗靶点。     

TOMM7 遗传变异及基因- 环境交互作用与我国侗族人群2 型糖尿病的关联研究

目的：探讨全基因组关联研究(genome-wide association studies,GWAS)中识别的7个遗传位点与我国侗 族人群2型糖尿病(type 2 diabetes mellitus,T2DM)的相关性。方法：在我国侗族人群中采用病例对照研究方法, 利用多重PCR-SNaPshot法对PARD3B(rs849230),LOC729993(rs149228),EPHA4(rs16862811),HNT(rs3099797), PTPRD(rs17584499与rs649891),TOMM7 (rs2240727)6个基因的7个位点进行基因分型。采用非条件二分类logistic回 归方法分析每个多态位点与T2DM的相关性,利用边缘结构线性优势比模型进行基因与环境因素的交互作用分析。 结果：本研究共包括209例T2DM患者与209例健康对照。TOMM7基因的rs2240727位点多态性与T2DM相关(对于每 个拷贝的风险等位基因T,OR=1.50,P=0.004),且CT和TT基因型是T2DM的风险基因型,OR分别为2.07(95% CI： 1.14~3.76)和2.75(95% CI：1.46~5.17),经Bonferroni多重比较校正后,上述结果仍然有意义(均P<0.05)。经调整年龄、 性别、体质量指数(body mass index,BMI)后,rs2240727位点与T2DM仍有相关性(P<0.01)。交互作用分析结果表明： rs2240727位点与BMI、腰臀比(waist-hip ratio,WHR)、高血压、糖尿病家族史之间存在正交互作用,调整性别、年 龄后,交互作用超额相对危险度(relative excess risk of interaction,RERI)分别为1.5430 (95% CI：0.5797~2.5062),2.6520 (95% CI：1.7516~3.5524),2.9131 (95% CI：1.7959~4.0303),4.2062 (95% CI：1.1686~8.2439),差异有统计学意义(均 P<0.05)。结论：TOMM7基因的rs2240727位点遗传变异与我国侗族人群的T2DM相关,且与BMI、WHR、高血压和糖 尿病家族史之间存在正交互作用。     

锯齿状息肉与传统腺瘤风险因素对比及结直肠癌适宜筛查年龄

目的 对锯齿状息肉(SPs)及传统腺瘤(CA)相关风险因素进行分析、对比,探讨两类息肉风险因素间异同.方法 收集南方医院消化内镜中心2012～2015行全结肠镜及息肉病理检查的病例.随机选取健康对照103例,SPs100例,CA 115例,采集各病例性别、年龄、身高、体质量等临床数据.运用SPSS软件,先对各因素进行组间多重比较,对具有显著性的因素再纳入多因素logistic回归分析,得到风险因素及其OR值.结果 SPs平均发病年龄48.87岁(95％CI 47.22-50.52),较CA更早(P=0.038).以青年组为参照,中年组发生SPs风险增加2.31倍(95％CI 1.46-3.65)、CA风险增加4.10倍(95％CI 2.50-6.72);老年组发生SPs风险增加2.77倍(95％CI 1.52-5.04)、CA风险增加6.00倍(95％CI 3.26-11.05).其中,年龄与CA的发生较SPs关系更为密切(老年组:OR=2.14,95％CI 1.21-3.78,P=0.009).男性较女性SPs发病风险增加2.75倍(95％CI 1.50-5.07)、CA增加2.19倍(95％CI1.22-3.95).BMI每增加1个单位,SPs发病风险增加1.18倍(95％CI 1.06-1.30)、CA增加1.20倍(95％CI 1.09-1.32).结论 两类息肉风险因素类别相同,可使用同一方案进行高危人群筛查.SPs平均发病年龄早于50岁且有可能快速进展为癌,提早CRC筛查年龄值得考虑.     

MBL2基因P57位点多态性与结核易感性关系的Meta分析

目的系统评价甘露糖结合凝集素2(mannose-binding lectin 2,MBL2)基因P57位点多态性与结核易感性的相关性。方法检索Pub Med、CNKI、Wan Fang Data、CBM、EMbase、VIP等数据库,检索时限为建库至2016年6月20日。查找所有研究MBL2基因P57位点多态性与结核易感性关系的相关文献,采用Rev Man 5.3软件进行Meta分析。结果共纳入8篇英文文献,均为病例对照研究,结核组共1 375例,对照组共1 465例。经异质性检验,各研究之间不存在统计学异质性(P≥0.1),故总体分析采用固定效应模型。Meta分析结果显示:在总体人群中,MBL2基因P57位点与结核易感性关联无统计学意义(CC+AC vs AA:OR=0.84,95%CI:0.68~1.04,P0.05)。亚组分析结果显示:在亚洲人群中,MBL2基因P57位点多态性与结核易感性关联无统计学意义(CC+AC vs AA:OR=1.46,95%CI:0.82~2.60,P0.05);在高加索人群中关联也无统计学意义(CC+AC vs AA:OR=0.80,95%CI:0.33~1.92,P0.05);在非洲人群中,MBL2基因P57位点多态性可能降低结核易感性,结果有统计学意义(CC+AC vs AA:OR=0.77,95%CI:0.61~0.97,P0.05)。结论MBL2基因P57位点多态性可能降低非洲人群结核发病风险,与亚洲人群和高加索人群结核的发病风险可能不存在相关性,但该研究样本量较小,需扩大样本量进一步确认。