不同肥胖类型患者血清代谢指标与内脏脂肪指数的相关性分析

目的 探讨不同肥胖类型代谢指标与内脏脂肪指数(VAI)的相关性。方法 选择2017年1～12月上海市第一康复医院收治的110例肥胖患者,按照肥胖类型分为中心性肥胖(n=74)和非中心性肥胖(n=36),同时选择50例健康体检者作为对照组,采集体质量指数(BMI)、腰围(WC)、血脂、血糖和血尿酸(UA)等临床资料,计算VAI,分析不同肥胖类型患者代谢指标差异及其与VAI的相关性。结果 与对照组比较,非中心性肥胖组患者BMI(25.15±3.66 vs 21.46±2.54 kg/m²),WC(87.29±5.88 vs 79.26±4.87cm),TG(0.83±0.16 vs 0.52±0.12 mmol/L),TC(4.57±0.34 vs 4.22±0.32 mmol/L),LDL-C(2.73±0.36 vs 2.35±0.47 mmol/L)及VAI(1.59±0.38 vs 1.20±0.47)水平明显升高,HDL-C(1.24±0.35 vs 1.81±0.44 mmol/L)明显降低(t=3.69～11.50,均P<0.05); 与非中心性肥胖组比较,中心性肥胖组WC(89.80±6.13 vs 87.29±5.88cm),TG(1.14±0.35 vs 0.83±0.16mmol/L),TC(4.81±0.45 vs 4.57±0.34 mmol/L),LDL-C(3.02±0.35 vs 2.73±0.36 mmol/L),FPG(7.31±1.32 vs 6.09±1.45 mmol/L),2h PG(12.13±1.95 vs 8.34±1.49 mmol/L),UA(328.25±24.67 vs 287.19±29.23 μmol/L)及VAI(3.31±0.82 vs 1.59±0.38)水平明显升高,HDL-C(0.83±0.23 vs 1.24±0.35 mmol/L)明显降低(t=2.16～7.45,均P值均<0.05)。中心性肥胖患者VAI与BMI,WC,血糖、血脂及UA呈显著相关(r=0.38～0.45,均P<0.05); 非中心性肥胖患者VAI与BMI,WC,TC呈显著正相关,与HDL-C呈显著负相关(r=0.30～0.40,均P<0.05)。多元线性回归显示,WC,TG,肥胖类型(中心性)和UA是VAI的危险因素,HDL-C则是保护因素(t=2.026～3.413,均P<0.05)。结论 中心性肥胖较非中心性肥胖患者更容易出现代谢功能异常,VAI与代谢指标密切相关,可反映不同类型肥胖患者代谢状态。

Correlation between Serum Metabolic Indexes of Different Obesity Types and Visceral Adiposity Index

Objective To investigate the correlation between metabolic indexes of different obesity types and visceral adiposity index(VAI).Methods 110 cases of obese patients from 2017.1 to 2017.12 and 50 cases of healthy control in Shanghai First Rehabilitation Hospitalwere selected,obese patients was divided into central obesity(n=74)and non-central obesity(n=36)according to the obesity type.The body mass index(BMI),waist circumference(WC),blood lipid,blood glucose,blood uric acid(UA)and other clinical data were collected,VAI was calculated,and the difference in metabolic indexes of patients with different obesity types and their correlation with VAI were analyzed.Results Compared with control group,the levels of BMI(25.15±3.66 vs 21.46±2.54 kg/m²),WC(87.29±5.88 vs 79.26±4.87 cm),TG(0.83±0.16 vs 0.52±0.12 mmol/L),TC(4.57±0.34 vs 4.22±0.32 mmol/L),LDL-C(2.73±0.36 vs 2.35±0.47 mmol/L)and VAL(1.59±0.38 vs 1.20±0.47)in non-central obesity group were significantly increased,while HDL-C(1.24±0.35 vs 1.81±0.44mmol/L)level were significantly decreased(t=3.69～11.50,all P<0.05).Compared withnon-central obesity group,the levels of WC(89.80±6.13 vs 87.29±5.88cm),TG(1.14±0.35 vs 0.83±0.16 mmol/L),TC(4.81±0.45 vs 4.57±0.34 mmol/L),LDL-C(3.02±0.35 vs 2.73±0.36 mmol/L),FPG(7.31±1.32 vs 6.09±1.45 mmol/L),2h PG(12.13±1.95 vs 8.34±1.49 mmol/L),UA(328.25±24.67 vs 287.19±29.23 μmol/L)and VAL(3.31±0.82 vs 1.59±0.38)in central obesity group were significantly increased,while HDL-C(0.83±0.23 vs 1.24±0.35 mmol/L)level were significantly decreased(t=2.16～7.45,all P<0.05).VAI was significantly correlated with BMI,WC,blood glucose,blood lipid and UA in patients with central obesity(r=0.38～0.45,all P<0.05).In patients with non-central obesity,VAI was positivelycorrelated with BMI,WC and TC,and negatively correlated with HDL-C(r=0.30～0.40,all P<0.05).Multiple linear regression showed that WC,TG,obesity type(centrality)and UA were risk factors for VAI,while HDL-C was a protective factor(t=2.026～3.413,all P<0.05).Conclusion Compared with patients with non-central obesity,patients with centralobesity were more likely to have abnormal metabolic functions.VAI was closelyrelated to metabolic indicators and can reflect the metabolic status of patientswith different types of obesity.