2型糖尿病患者尿酸/高密度脂蛋白胆固醇比值与内脏脂肪面积的相关性研究
目的:探讨2型糖尿病（T2DM）患者尿酸/高密度脂蛋白胆固醇比值（UHR）与内脏脂肪面积（VFA）的相关性。方法:选取2018年5月至2020年7月在江苏大学附属医院标准化代谢性疾病管理中心就诊的909例T2DM患者作为研究对象。收集研究对象的一般临床资料，测定身体测量指标［身高、体重、收缩压（SBP）、舒张压（DBP）、颈围、腰围、臀围、VFA及皮下脂肪面积（SFA）］，计算体重指数（BMI）、腰臀比值（WHR）及内脏脂肪/皮下脂肪面积比值（V/S）。测定糖代谢指标［空腹血糖（FPG）、空腹胰岛素（FINS）、餐后2 h血糖（2hPG）、餐后2 h胰岛素（2hINS）及糖化血红蛋白（HbA...
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| Published in | 中华糖尿病杂志 Vol. 14; no. 9; pp. 954 - 960 |
|---|---|
| Main Authors | , , , , , , , , , |
| Format | Journal Article |
| Language | Chinese |
| Published |
江苏大学附属医院内分泌代谢科，镇江 212001
01.09.2022
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| Subjects | |
| Online Access | Get full text |
| ISSN | 1674-5809 |
| DOI | 10.3760/cma.j.cn115791-20211217-00670 |
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| Abstract | 目的:探讨2型糖尿病（T2DM）患者尿酸/高密度脂蛋白胆固醇比值（UHR）与内脏脂肪面积（VFA）的相关性。方法:选取2018年5月至2020年7月在江苏大学附属医院标准化代谢性疾病管理中心就诊的909例T2DM患者作为研究对象。收集研究对象的一般临床资料，测定身体测量指标［身高、体重、收缩压（SBP）、舒张压（DBP）、颈围、腰围、臀围、VFA及皮下脂肪面积（SFA）］，计算体重指数（BMI）、腰臀比值（WHR）及内脏脂肪/皮下脂肪面积比值（V/S）。测定糖代谢指标［空腹血糖（FPG）、空腹胰岛素（FINS）、餐后2 h血糖（2hPG）、餐后2 h胰岛素（2hINS）及糖化血红蛋白（HbA
1c）］、生化指标［总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）、γ-谷氨酰转肽酶（GGT）、尿酸（UA）、血尿素氮（BUN）及血肌酐（Scr）］及甲状腺激素水平［游离三碘甲腺原氨酸（FT3）、游离甲状腺素（FT4）、高敏促甲状腺激素（sTSH）］，计算稳态模型评估胰岛素抵抗指数（HOMA-IR）、稳态模型评估胰岛β细胞功能指数（HOMA-β）和UHR。根据UHR三分位水平，将患者分为
Q1组（UHR≤21.10%，303例）、
Q2组（21.10%<UHR≤31.06%，303例）和
Q3组（UHR>31.06%，303例）。根据VFA值，将患者分为对照组（VFA<100 cm
2，597例）和内脏型肥胖（VO）组（VFA≥100 cm
2，312例）。组间差异的比较采用单因素方差分析、Kruskal-Wallis非参数检验和
χ2检验。采用Spearman相关分析法分析UHR与各指标的相关性，并采用多元线性回归分析法分析T2DM患者VFA的影响因素。
结果:与
Q1组比较，
Q2、
Q3两组的男性比例、吸烟及饮酒比例、合并高血脂比例、FINS、HOMA-β、TG、GGT、Scr、BMI、颈围、腰围、臀围、WHR、VFA、SFA及V/S均升高，而SBP、DBP、2hINS、HOMA-IR、ALT、AST、FT3仅在
Q3组升高；年龄、TC、LDL-C在
Q3组降低（
P<0.05）。与
Q2组比较，
Q3组的男性比例、合并高血脂比例、DBP、HOMA-IR、TG、ALT、GGT、BMI、腰围及VFA升高，而年龄、LD |
|---|---|
| AbstractList | 目的:探讨2型糖尿病（T2DM）患者尿酸/高密度脂蛋白胆固醇比值（UHR）与内脏脂肪面积（VFA）的相关性。方法:选取2018年5月至2020年7月在江苏大学附属医院标准化代谢性疾病管理中心就诊的909例T2DM患者作为研究对象。收集研究对象的一般临床资料，测定身体测量指标［身高、体重、收缩压（SBP）、舒张压（DBP）、颈围、腰围、臀围、VFA及皮下脂肪面积（SFA）］，计算体重指数（BMI）、腰臀比值（WHR）及内脏脂肪/皮下脂肪面积比值（V/S）。测定糖代谢指标［空腹血糖（FPG）、空腹胰岛素（FINS）、餐后2 h血糖（2hPG）、餐后2 h胰岛素（2hINS）及糖化血红蛋白（HbA
1c）］、生化指标［总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）、γ-谷氨酰转肽酶（GGT）、尿酸（UA）、血尿素氮（BUN）及血肌酐（Scr）］及甲状腺激素水平［游离三碘甲腺原氨酸（FT3）、游离甲状腺素（FT4）、高敏促甲状腺激素（sTSH）］，计算稳态模型评估胰岛素抵抗指数（HOMA-IR）、稳态模型评估胰岛β细胞功能指数（HOMA-β）和UHR。根据UHR三分位水平，将患者分为
Q1组（UHR≤21.10%，303例）、
Q2组（21.10%<UHR≤31.06%，303例）和
Q3组（UHR>31.06%，303例）。根据VFA值，将患者分为对照组（VFA<100 cm
2，597例）和内脏型肥胖（VO）组（VFA≥100 cm
2，312例）。组间差异的比较采用单因素方差分析、Kruskal-Wallis非参数检验和
χ2检验。采用Spearman相关分析法分析UHR与各指标的相关性，并采用多元线性回归分析法分析T2DM患者VFA的影响因素。
结果:与
Q1组比较，
Q2、
Q3两组的男性比例、吸烟及饮酒比例、合并高血脂比例、FINS、HOMA-β、TG、GGT、Scr、BMI、颈围、腰围、臀围、WHR、VFA、SFA及V/S均升高，而SBP、DBP、2hINS、HOMA-IR、ALT、AST、FT3仅在
Q3组升高；年龄、TC、LDL-C在
Q3组降低（
P<0.05）。与
Q2组比较，
Q3组的男性比例、合并高血脂比例、DBP、HOMA-IR、TG、ALT、GGT、BMI、腰围及VFA升高，而年龄、LD |
| Abstract_FL | Objective:To explore the correlation between uric acid/high-density lipoprotein cholesterol ratio (UHR) and visceral fat area (VFA) in patients with type 2 diabetes mellitus (T2DM).Methods:A total of 909 patients with T2DM treated in National Metabolic Management Center (MMC) of the Affiliated Hospital of Jiangsu University from May 2018 to July 2020 were enrolled in this study. The general clinical information and physical examination [including height, weight, systolic blood pressure (SBP), diastolic blood pressure (DBP), neck circumference, waist circumference, hip circumference, VFA and subcutaneous fat area (SFA)] were collected. Body mass index (BMI), waist hip ratio (WHR) and VFA/SFA ratio (V/S) were calculated. And glucose metabolism indexes [fasting plasma glucose (FPG), fasting insulin (FINS), 2 hour postprandial plasma glucose (2hPG), 2 hour postprandial insulin (2hINS) and glycated hemoglobin A
1c (HbA
lc)], biochemical indexes [total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), alanine aminotransferase (ALT), aspartate aminotransferase (AST), γ-glutamyl transpeptidase (GGT), blood urea nitrogen (BUN) and serum creatinine (Scr)] and thyroid hormone [free triiodothyronine (FT3), free thyroxine (FT4), sensitivity thyrotropin stimulating hormone (sTSH)] were conducted on all subjects. Homeostasis model assessment of insulin resistance (HOMA-IR), homeostasis model assessment of β-cell function (HOMA-β) and UHR were calculated. Meanwhile, according to UHR, all patients were divided into tertiles, which included group
Q1 (UHR≤21.10%, 303 cases), group
Q2 (21.10%<UHR≤31.06%, 303 cases) and group
Q2 (UHR>31.06%, 303 cases). Based on VFA, patients were divided into control group (VFA<100, 597 cases) and visceral obesity (VO) group (VFA≥100, 312 cases). The differences between groups were compared by one-way analysis of variance (ANOVA), Kruskal-Wallis nonparametric test and
χ2 test. Spearman correlation analysis was used to analyze the correlation between UHR and various indicators, and multiple linear regression analysis was used to analyze the influencing factors of VFA in T2DM patients.
Results:Compared with group
Q1, the proportions of males, smoking, drinking, the proportion of hyperlipidemia, FINS, HOMA-β, TG, GGT, Scr, BMI, neck circumference, waist circumference, hip circumference, WHR, VFA, SFA and V/S in groups
Q2 and
Q3 were all increased, while SBP, DBP, 2hINS, HOMA-IR, ALT, AST, FT3 only increased in group
Q3. Age, TC, LDL-C only decreased in group
Q3. Compared with group
Q2, the proportion of males, hyperlipidemia, DBP, HOMA-IR, TG, ALT, γ-GT, BMI, waist circumference and VFA in group
Q3 were increased, while age and LDL-C decreased (
P<0.05). Spearman correlation analysis indicated that UHR was positively correlated with VFA and V/S(
r=0.328, 0.205,both
P<0.001）. Multiple linear regression analysis indicated that UHR was independently correlated with VFA (β=0.241, 95%CI 0.097-0.384,
P<0.01). Compared with control group, UHR in VO group was statistically significantly higher (
P<0.01).
Conclusion:There is a positive correlation between UHR and VFA as well as V/S in patients with T2DM, and it has clinical value for early warning of VO in the T2DM. |
| Author | 贾珏 沈怡蓉 喻夏雯 杨玲 刘若双 石康茹 袁国跃 夏玥 程彩芹 王东 |
| AuthorAffiliation | 江苏大学附属医院内分泌代谢科，镇江 212001 |
| AuthorAffiliation_xml | – name: 江苏大学附属医院内分泌代谢科，镇江 212001 |
| Author_FL | Xia Yue Yang Ling Liu Ruoshuang Wang Dong Cheng Caiqin Shen Yirong Yuan Guoyue Shi Kangru Jia Jue Yu Xiawen |
| Author_FL_xml | – sequence: 1 fullname: Shen Yirong – sequence: 2 fullname: Liu Ruoshuang – sequence: 3 fullname: Yu Xiawen – sequence: 4 fullname: Xia Yue – sequence: 5 fullname: Cheng Caiqin – sequence: 6 fullname: Shi Kangru – sequence: 7 fullname: Wang Dong – sequence: 8 fullname: Yang Ling – sequence: 9 fullname: Yuan Guoyue – sequence: 10 fullname: Jia Jue |
| Author_xml | – sequence: 1 fullname: 沈怡蓉 – sequence: 2 fullname: 刘若双 – sequence: 3 fullname: 喻夏雯 – sequence: 4 fullname: 夏玥 – sequence: 5 fullname: 程彩芹 – sequence: 6 fullname: 石康茹 – sequence: 7 fullname: 王东 – sequence: 8 fullname: 杨玲 – sequence: 9 fullname: 袁国跃 – sequence: 10 fullname: 贾珏 |
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| Keywords | 糖尿病，2型 Uric acid and high-density lipoprotein cholesterol ratio Diabetes mellitus, type 2 内脏型肥胖 尿酸/高密度脂蛋白胆固醇比值 Visceral fat area 内脏脂肪面积 Visceral obesity |
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| PublicationTitle | 中华糖尿病杂志 |
| PublicationTitle_FL | Chinese Journal of Diabetes Mellitus |
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| Publisher | 江苏大学附属医院内分泌代谢科，镇江 212001 |
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