体质指数、腹型肥胖与心血管疾病发生风险的相关性

在心血管疾病一级预防中,肥胖是预测其风险的因素之一。本研究旨在探讨体质指数（BMI）、腹围、腰臀比与首次发生心血管事件的相关性。     

腹型肥胖对血压、血糖、血脂的影响

目的研究体重指数(BMI)、腰臀比(WHR)与血压、血糖、血脂的相关性。方法整群随机抽样后,查血压,测血糖、血脂,生化指标。结果肥胖症患病率达15.7%,而向心性肥胖达24.8%;BMI每增加2,收缩压(SBP)、舒张压(DBP)、口服葡萄糖耐量试验(OGTT)、总胆固醇(TC)、甘油三脂(TG)的均数分别增加4.11、2.54、0.44、0.09、0.10,而高密度脂蛋白胆固醇(HDL)则减少0.03;WHR每增加0.05,SBP、DBP、OGTT、TC、TG均数分别增加2.24、2.24、0.30、0.04、0.04,而HDL则减少0.03。结论以腹部脂肪聚集为特征的肥胖者其与血压、血糖、血脂的相关性,可以通过简单的测量BMI、WHR,来评估身体健康状况,可大大方便对冠心病危险因素的筛选。     

新诊断2型糖尿病患者尿酸排泄与肥胖及腹型肥胖相关性的研究

目的 探讨新诊断T2DM患者尿酸排泄(UUAE)与肥胖及腹型肥胖的相关性。方法 选取2006年1月至2012年12月于上海交通大学医学院附属第六人民医院内分泌代谢科住院治疗的新诊断T2DM患者1175例,根据UUAE四分位数分为Q1组(UUAE<2383μmol/24 h,n=295)、Q2组(2383≤UUAE<2953μmol/24 h,n=292)、Q3组(2954≤UUAE<3680μmol/24 h,n=295)、Q4组(UUAE>3680μmol/24 h,n=293)。收集各组临床资料,分析各组肥胖和腹型肥胖患病率及UUAE与肥胖和腹型肥胖的相关性。结果 肥胖总患病率为47.9%,腹型肥胖总患病率为61.9%,校正年龄后,腹型肥胖患病率女性高于男性(P<0.05)。校正年龄和性别后,Q4组肥胖患病率、MS患病率高于Q1、Q2、Q3组(P<0.05),腹型肥胖患病率高于Q1、Q2组(P<0.05)。与Q1组比较,Q4组男性比例、BMI、WC、DBP、FIns、2 hIns、胰岛素抵抗指数、TG、谷丙转氨酶、γ-谷氨酰转肽酶、血尿酸、...     

伴腹型肥胖的2型糖尿病患者的临床特点分析

目的:探讨伴腹型肥胖的2型糖尿病(T2DM)患者的临床特点。方法:选取T2DM住院患者171例,按腰围分为腹型肥胖组(AO组,男性>90 cm,女性>85 cm)和非腹型肥胖组(NAO组,男性≤90 cm,女≤85 cm),比较各组的糖代谢、脂代谢、新稳态模型(HOMA2)胰岛B细胞分泌指数(HOMA2-B)和胰岛素敏感性指数(HOMA2-S)。结果:AO组血压、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、C反应蛋白(CRP)、血糖和C肽(CP0、CP30、CP120)均较NAO组显著升高,而高密度脂蛋白胆固醇(HDL-C)、HOMA2-S则明显降低。结论:伴腹型肥胖的T2DM患者多伴TG水平升高,且血糖失控和胰岛素抵抗程度更重。     

不同肥胖测量方法与腹型肥胖男性血尿酸的相关性分析

目的 探讨腹型肥胖男性双能X线(DEXA)测量的体脂分布与血尿酸的关系,并与人体测量学指标进行比较.方法 选取20 ～ 50岁男性为研究对象,其中腰围≥90 cm 88例为腹型肥胖组,腰围＜ 90 cm 60例为对照组.以血尿酸为因变量,分别以人体测量学指标(模型1)和DEXA测量指标(模型2)为自变量构建多元线性回归方程.结果 腹型肥胖组血尿酸水平高于对照组[(389.3±78.8) μmol/L vs.(324.9±61.5) μmol/L,P＜0.01].尿酸与人体测量学指标(r=0.390 ～0.496,P＜0.01)和DEXA测量的各指标(r=0.377 ～0.459,P＜0.01)均呈正相关.模型1中,人体测量学指标腰臀比可解释24.6％血尿酸的变异;模型2中,DEXA测量的躯干脂肪质量可解释21.0％血尿酸的变异.结论成年男性体脂分布与血尿酸水平密切相关.应用人体测量学指标和DEXA两种方法评价体脂分布均与血尿酸密切相关,但DEXA测量指标并不优干人体测量学指标.     

腹型肥胖与2型糖尿病患者胰高血糖素关系的研究

T2DM组67例(分为非腹型肥胖组、腹型肥胖组、肥胖组)及正常对照组19例,测量FPG、h2PG、CP、GG。结果T2DM患者餐后C肽、GG显著升高[(4.92±4.01vs2.11±0.67)ng/mL,(201.22±46.66vs125.23±40.35)pg/mL,均P0.01];与非腹型肥胖组相比,腹型肥胖组的T2DM患者餐后C肽及其增加值显著升高[(6.65±4.62vs3.46±2.22)ng/mL,(5.07±4.19vs2.21±1.81)ng/mL,均P0.05],餐后胰高血糖素及其增加值相对升高但未达到统计学意义[(204.35±43.76vs203.06±51.27)pg/mL,(25.16±36.20vs16.04±19.14)pg/mL,均P0.05];与腹型肥胖组相比,肥胖组餐后C肽、GG及相应增加值升高,但未达到统计学意义。结论T2DM患者的胰岛α细胞存在胰岛素抵抗,腹型肥胖者胰岛α细胞的胰岛素抵抗更显著。     

社区人群腹型肥胖与高血压关系调查

目的探讨伴有腰围/身高比超标的腹型肥胖与高血压的相关性及危险程度。方法采用整群抽样方法,对542名年龄35岁以上社区居民进行问卷调查、现场体检和实验室检查。结果 (1)年龄、体重指数(BMI)、腰围(WC)与高血压患病率相关。(2)WC与高血压患病率的相关性高于BMI。(3)在腹型肥胖的高血压患者中WC与腰围/身高比(WHtR)的关系最密切。结论肥胖是高血压患病的主要危险因素之一,腹型肥胖者患高血压的比例更高,WC和WHtR均可作为评估腹型肥胖的指标,控制体重减少腹型肥胖对预防高血压具有重要的意义。     

肥胖患者血清瘦素水平性别差异的临床分析

瘦素(leptin)是体内脂肪组织分泌的一种16KDa的血浆蛋白,1994年,美国洛克菲勒大学的Zhang等利用位点克隆技术成功地克隆了小鼠的肥胖基因(ob基因),并阐明ob基因编码的蛋白质产物即瘦素的主要生理功能是抑制进食、增加代谢,从而使脂肪消耗,调节能量代谢和体重。本文探讨了瘦素分泌在肥胖患者中的性别差异。     

玉门市2型糖尿病患者肥胖与肾病的相关性

目的探讨甘肃省玉门市2型糖尿病(T2DM)人群肥胖与糖尿病肾病(DN)的关系。方法将门诊规律就诊的160例T2DM患者按体重指数(BMI)、腰围(WC)、腰臀比(WHR)分组,观察各组尿白蛋白排泄率(UEAR)的变化。对T2DM患者的如性别、年龄、病程、收缩压(SBP)、舒张压(DBP)、糖化血红蛋白(Hb A1c)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)、甘油三酯(TG)等指标进行比较,采用Logistic回归分析DN与各因素的相关性。结果 T2DM人群中超重和肥胖的患病率是45.6%和18.8%,中心性肥胖的患病率是70%;DN患病率为26.3%,DN患者中肥胖的患病率6.9%,中心性肥胖的患病率25%。DM病程和WC是DN的危险因素。结论 DN发生和发展与中心性肥胖及DM的病程独立相关;重视患者的体脂分布特点,达到预防和减轻T2DM合并肾病。     

蛋白酪氨酸磷酸酶1B基因多态性与2型糖尿病和肥胖的相关性研究

目的 研究中国人群中蛋白酪氨酸磷酸酶1B（PTP-1B）基因的单核苷酸多态性（SNP）与2型糖尿病及肥胖的相关性。方法 采用直接测序法对PTP—1B基因作SNP筛查，并在夫妻配对样本中对所检出的SNP作基因分型。结果 共检出6个SNPs位点，其中内含子区3个（15／37C→A，16／82A→G，17／301C→T），外显子区3个（E8／45C→T，E9／35G→A，E10／372G→A），其中E9／35G→A为新发现的突变类型；在病例-配偶对照研究中发现，15／37C→A，16／82A→G和17／301C→T等位基因频率在糖尿病患者和正常人配偶中差异有统计学意义（均P〈0．05），其余位点的等位基因频率在两组间的分布则无明显差异。与肥胖的相关性研究中发现15／37C→A和17／301C→T位点与男性的腰臀比（WHR）相关（P〈0．05）。结论 PTP-1B基因的SNP位点15／37C→A，16／82A→G和17／301C→T多态性可能和2型糖尿病的发病相关，其中15／37C→A和17／301C→T与男性的WHR相关。     

2型糖尿病并内脏型肥胖患者内脏脂肪面积的分析

目的探讨2型糖尿病（T2DM）并内脏型肥胖患者的临床特点及内脏脂肪面积的相关性分析。 方法本研究收集2018年5月至2018年9月在山西大同大学第一附属医院住院的共350例T2DM患者的临床资料,测量内脏脂肪面积(VFA)和皮下脂肪面积( SFA),以VFA≥100 cm²作为内脏型肥胖的诊断标准。根据VFA值分为单纯2型糖尿病对照组(VFA<100 cm²)和糖尿病合并内脏型肥胖观察组(VFA≥100 cm²),测定所有患者的身高、体重、体质量指数（BMI）、腰臀比（WHR）及血糖、血脂、肾功能等指标,比较两组间差异。 结果T2DM并内脏型肥胖组中身高、体重、BMI、头围、颈围、腰围、臀围、WHR、VFA、SFA、甘油三脂（TG）、总胆固醇（TC）、血尿酸（UA）、舒张压均高于对照组（P<0.05）,以VFA为应变量,其他各因素为自变量,进行多元线性回归分析：体重、BMI、腰围、TG、舒张压被纳入回归方程,是T2DM并内脏型肥胖的独立危险因素。 结论体重、BMI、腰围、TG、舒张压的增高是VFA的危险因素,与T2DM并腹型肥胖相关。     

Urinary tubular biomarkers in short-term type 2 diabetes mellitus patients: a cross-sectional study

The purpose of this study was to investigate the prevalence of tubular damage in short-term (less than five years) type 2 diabetes mellitus (T2DM) patients and to explore the correlation between tubular markers and their relationship with renal indices at different stages of diabetic nephropathy. A group of 101 short-term T2DM patients and 28 control subjects were recruited. Tubular markers, such as neutrophil gelatinase-associated lipocalin (NGAL), N-acetyl-β-D: -glucosaminidase (NAG), and kidney injury molecule 1 (KIM-1), as well as urinary albumin excretion were measured in voided urine. Glomerular filtration rate (GFR) was estimated via Macisaac's formula. The patients were further categorized into three groups, namely, the normoalbuminuria, microalbuminuria, and macroalbuminuria groups, according to their urine albumin/creatinine ratio (UACR). Urinary tubular markers were compared and their correlations with renal indices [UACR and estimated GFR (eGFR)] were analyzed among the different diabetic groups. Compared with the control group, Urinary NGAL [median (IQR)][83.6(41.4-138.7) μg/gcr vs. 32.9(26.1-64.5) μg/gcr], NAG [13.5(8.7-17.9) U/gcr vs. 7.6(6.5-13.0) U/gcr] and KIM-1 [120.0(98.4-139.9) ng/gcr vs. 103.1(86.8-106.2) ng/gcr] in the T2DM were all markedly increased. For all patients, urinary NGAL had stronger positive correlations with UACR than NAG (R = 0.556 vs. 0.305, both P < 0.05). In addition, only urinary NGAL showed a negative correlation with eGFR (R = -0.215, P < 0.05). Urinary KIM-1, however, showed no significant difference among the three T2DM groups and did not correlate with either UACR or eGFR. As UACR increased from the normoalbuminuria to the last macroalbuminuria group, all of the markers increased. However, only the concentrations of NGAL were statistically different among the three diabetic groups. The correlation between the tubular markers and their relationships with the renal indices differed markedly among the three T2DM groups. In conclusion, these results suggest that tubular damage is common in short-term T2DM patients. Urinary NGAL may be a promising early marker for monitoring renal impairment in short-term T2DM patients.     

Management of obesity in patients with type 2 diabetes mellitus

Type 2 Diabetes Mellitus (T2DM) is a disease of over nutrition; the onset and progression of which, is associated with excess fat accumulation in the abdomen, muscles and liver. In this review, we focus on management of obesity as the primary strategy for management of disorders of glucose metabolism. Modest weight loss (~7%) achieved by diet and exercise can prevent, or delay, the onset of T2DM. In those with established T2DM, weight loss reduces fasting and post-prandial plasma glucose levels, HbA(1c), and the need for pharmacotherapy. The beneficial effects on glucose metabolism of caloric restriction, and aerobic and resistance exercise, may occur independently of weight loss. When substantial weight loss is required, meal replacements allow a large reduction in energy consumption whilst maintaining micronutrient intake. Pharmacotherapy for obesity, as part of an integrated management plan, is useful for maintaining weight loss and optimising glycaemic control. The most effective long-term therapy for obesity remains bariatric surgery, which is associated with resolution of T2DM in over 80% of patients. The currently available pharmacotherapies for T2DM mostly result in weight gain. Pramlintide and exenatide are new therapies which hold promise, because in addition to improved glycaemic control, they also result in weight loss.     

Correlation between thyroid hormone central sensitivity and ischemic cardiovascular risk in patients with type 2 diabetes mellitus

<正>Objective To assess the relationship between thyroid hormone central sensitivity and ischemic cardiovascular disease (ICVD) risk in patients with type 2 diabetes mellitus (T2DM).Methods A total of 326 T2DM patients without thyroid dysfunction were admitted from August 2018 to January 2021.     

Increased risk of type 2 diabetes mellitus in the Maru Raika community of Rajasthan: a cross-sectional study

Type 2 diabetes mellitus (DM) is a chronic metabolic disorder affecting increasing numbers of the global population. Understanding dietary and lifestyle factors that influence the risk of DM will allow us to develop better management strategies for this disease. Here, we aimed to assess the prevalence of PDM in the Raika pastoralist community of Rajasthan, India. This indigenous group has previously shown a 0% prevalence of DM, but we aimed to assess current prevalence due to various lifestyle changes within the community. Three hundred fifteen adult Raika community members from different villages of the Jodhpur, Pali, and Sirohi districts of Rajasthan with no previous diagnosis of DM were selected for participation. Demographic and clinical profiles were obtained. Fasting glucose (FG) and glucose tolerance (GT) tests were performed to diagnose prediabetes (PDM) and DM. Data was assessed using logistic regression in Stata/IC 14. We found prevalence of PDM and DM in the Raika community to be 15.87 and 1.27%, respectively. In the Maru Raika subcaste, we found significantly increased BMI (20.39 kg/m² vs 20.26%, p = 0.002) and PDM prevalence (19.05 kg/m² vs 11.73%, p = 0.038, respectively) when compared to the Godwar Raika subcaste. PDM prevalence has significantly increased in the Raika camel-herding community, and demographic, dietary, and lifestyle changes in the traditional Raika camel herders may affect DM prevalence within this rural community.     

Association between type 2 diabetes mellitus and risk of cancers:a cohort study

<正>Objective To understand the association between type 2 diabetes and the risk of cancers.Methods Data related to type 2 diabetes mellitus(T2DM)cases and cancer cases were collected from Zhejiang Chronic Disease Surveillance Information and Management System(CDSIMS),between January 1,2007 and December 31,2013.Cumulative incidence and relative risk(RR)with