血清脂质代谢指标水平、内脏脂肪面积与糖代谢异常合并肥胖的相关性研究

目的探讨血清脂质代谢指标总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]水平、内脏脂肪面积(VFA)与糖代谢异常合并肥胖的相关性。方法选取2019年2-10月就诊于该院内分泌科的1243例2型糖尿病患者纳入研究,根据是否合并肥胖分为糖代谢异常合并肥胖组(725例)和糖代谢异常不合并肥胖组(518例),以性别、年龄、烟酒史为配对因素选取相匹配的同期于该院体检中心体检的66例糖代谢正常的肥胖成人作为糖代谢正常合并肥胖组,66例体检健康的成人作为糖代谢正常不合并肥胖组。比较4组人群的临床特征及生化指标,分析糖代谢异常合并肥胖患者各指标的相关性,不同脂质代谢指标水平和VFA发生糖代谢异常合并肥胖的趋势,以曲线下面积(AUC)评估脂质代谢指标和VFA对糖代谢异常合并肥胖的预测价值。结果4组人群间收缩压(SBP)、舒张压(DBP)、体质量指数(BMI)、VFA、空腹血糖(FBG)、糖化血红蛋白(HbA1c)、TC、TG、LDL-C、HDL-C和尿酸比较,差异有统计学意义(P<0.05);TC、TG和LDL-C水平与BMI、FBG、HbA1c、VFA呈正相关,HDL-C水平与BMI、FBG、HbA1c、VFA呈负相关(P<0.05);VFA水平与BMI、FBG、HbA1c呈正相关(P<0.05);随着TC、TG、LDL-C水平和VFA的增加,糖代谢异常合并肥胖的相对危险度(RR)值呈升高的线性趋势,随着HDL-C降低,糖代谢异常合并肥胖的RR呈升高的线性趋势(P<0.05);TC、TG、LDL-C、HDL-C和VFA预测糖代谢异常合并肥胖的AUC分别为0.736、0.778、0.752、0.754、0.773。结论血清脂质代谢指标水平、VFA与糖代谢异常合并肥胖有关,可作为糖代谢异常患者肥胖预测和代谢状态监控的指标。

Correlation of serum lipid metabolism indicators and visceral fat area with abnormal glucose metabolism c obesity

Objective To investigate the correlation of serum lipid metabolism indicatorstotal cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C)]and visceral fat area(VFA)with abnormal glucose metabolism complecated with obesity.Methods A total of 1243 patients with Type 2 diabetes mellitus in the hospital from February 2019 to October 2019 were enrolled in the study and divided into two groups,obesity study group(n=725)and non-obesity study group(n=518),meanwhile another 66 obesity individuals with normal glucose metabolism(normal glucose metabolism with obesity group)and 66 healthy individuals(normal glucose metabolism without obesity group)were also enrolled.The correlation of various indicators in patients with abnormal glucose metabolism and obesity was analyzed.The incidence rate of abnormal glucose metabolism and obesity of individuals with different lipid metabolic levels and VFA was observed;then the AUC was used to evaluate the predictive value of lipid metabolism indicators and VFA for abnormal glucose metabolism complecated with obesity.Results The systolic blood pressure(SBP),diastolic blood pressure(DBP),body mass index(BMI),VFA,fasting blood glucose(FBG),glycosylated hemoglobin(HbA1c),TC,TG,LDL-C,HDL-C and uric acid(UA)were significant different among four groups(P<0.05).TC,TG and LDL-C levels were significantly positively correlated with BMI,FBG,HbA1c,VFA,while HDL-C level was significantly negatively correlated with BMI,FBG,HbA1c,VFA(P<0.05).VFA level was positively correlated with BMI,FBG,HbA1c(P<0.05).With the increase of TC,TG,LDL-C and VFA,the relative risk(RR)of abnormal glucose metabolism complecated with obesity increased linearly;with the decrease of HDL-C,the RR of abnormal glucose metabolism complecated with obesity increased linearly(P<0.05).The AUC of TC,TG,LDL-C,HDL-C and VFA were 0.736,0.778,0.752,0.754 and 0.773 respectively.Conclusion Serum lipid metabolism indicators and VFA are associated with abnormal glucose metabolism complicated with obesity,and can be used as indicators for predicting obesity and monitoring metabolic status in patients with abnormal glucose metabolism.