围绝经期及绝经后女性基于腰椎定量电子计算机断层扫描测定的内脏脂肪与糖脂代谢的相关性

目的 研究围绝经期及绝经后女性内脏脂肪与糖脂代谢的相关性。方法 回顾性分析2018年9月至2020年2月期间在首都医科大学附属北京妇产医院内分泌科就诊并接受腰椎定量电子计算机断层扫描（quantitative computed tomography，QCT）检查的患者185例，依据内脏脂肪面积分为内脏型肥胖组和正常组，记录患者一般信息，对人体测量学指标及糖脂代谢指标进行测定。结果 在围绝经期及绝经后患者中，内脏型肥胖组的空腹血糖，空腹胰岛素及稳态胰岛素指数均高于正常组，VAT与三者呈明显正相关。围绝经期三酰甘油浓度高于正常组，高密度脂蛋白胆固醇低于正常组（P<0.05）；总胆固醇、低密度脂蛋白胆固醇、载脂蛋白A和B的浓度差异无统计学意义（P>0.05）。VAT与三酰甘油及载脂蛋白B呈正相关（P<0.05），与高密度脂蛋白胆固醇及载脂蛋白A呈负相关（P<0.05），尚未发现VAT与总胆固醇及低密度脂蛋白胆固醇具有明显相关性（P>0.05）。绝经后低密度脂蛋白胆固醇、载脂蛋白B浓度明显高于正常组，高密度脂蛋白胆固醇及载脂蛋白A浓度明显低于正常组（P<0.05）；总胆固醇及三酰甘油浓度差异无统计学意义（P>0.05）。VAT与载脂蛋白B呈正相关，与高密度脂蛋白胆固醇及载脂蛋白A呈负相关，尚未发现VAT与总胆固醇、三酰甘油及低密度脂蛋白胆固醇具有明显相关性（P>0.05）。结论 围绝经期及绝经后女性内脏脂肪与糖脂代谢密切相关，应该关注局部脂肪分布与健康的关系。

Visceral adipose tissue measured with the quantitative computed tomography:relationship between visceral adipose tissue and glycolipid metabolism in different menopausal period women

Objective To study the relationship between visceral adipose tissue and glycolipid metabolism in perimenopause and postmenopausal women. Methods From Sep 2018 to Feb 2020, a total of 185 women with menopausal symptoms who underwent quantitative computed tomography (QCT) testing were included in our study Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. According to the intra-abdominal fat area, the patients were divided into visceral obesity group with visceral adipose tissue (VAT) ≥ 100 cm² and normal group. The human body index and glycolipid indexes were measured in two groups. Results In peri- and postmenopausal women, fasting blood glucose, fasting insulin, and homeostasis model assessment insulin resistance (HOMA-IR) in visceral obesity group were significantly higher than those in normal group, and VAT was positive correlation with them. In perimenopausal women, compared with the normal group, the level of triglyceride (TG) was significantly increased, and the level of high density lipoprotein-cholesterol (HDL-C) significantly decreased in visceral obesity group (P<0.05). There was no significant difference in the levels of total cholesterol, low-density lipoprotein-cholesterol (LDL-C), apolipoprotein (Apo) A and Apo B (P>0.05). The linear correlation analysis indicated that VAT was positively correlated with TG and Apo B (P<0.05). VAT was negatively correlated with HDL-C and Apo A (P<0.05). There was no significant correlation between VAT, total cholesterol (TC) and LDL-C (P>0.05). In postmenopausal women, compared with the normal group, the level of LDL-C and Apo B were significantly increased, and the level of HDL-C and Apo A were significantly decreased in visceral obesity group (P<0.05). There were no significant differences in the level of TC and TG (P>0.05). The linear correlation analysis indicated that VAT was positively correlated with Apo B. VAT was negatively correlated with HDL-C and Apo A. There was no significant correlation with TC, TG, and LDL-C (P>0.05). Conclusion Visceral adipose tissue is closely correlated with glycolipid metabolism disorder in peri- and postmenopausal women. More attention should be paid to the relationship between local adipose tissue distribution and health.