超重和肥胖成人心外膜脂肪组织和胰岛素抵抗关系研究.docVIP

超重和肥胖成人心外膜脂肪组织和胰岛素抵抗的关系研究 超重和肥胖成人心外膜脂肪组织和胰岛素抵抗的关系研究 作者：李浙成，杨德业，徐永远，胡智星，童跃锋，赖长春 作者单位：1.温州医学院附属第一医院，浙江温州； 2.永康市第一人民医院，浙江永康 【摘要】 目的 研究超重和肥胖成人胰岛素敏感性、胰岛素抵抗及心外膜脂肪组织和胰岛素抵抗的关系。方法 收集2005年3月至2005年12月在我院体检中心符合入选标准的资料210份，均具人体指标测量、空腹血生化检查和经超声测量心外膜脂肪组织厚度、腹壁脂肪厚度（SFT）等数据，根据中国肥胖工作组推荐的判定标准，分为超重肥胖组和体重正常组。采用稳态模式胰岛素抵抗指数（HOMA_IR）评价胰岛素抵抗。用SPSS 13.0软件进行统计分析。结果 超重肥胖组SI显著低于体重正常组（P＜0.01)，FINS、HOMA_IR显著高于体重正常组（P＜0.01)，心外膜脂肪组织厚度明显厚于体重正常组（P＜0.01)；控制年龄、性别、腰围影响因素进行偏相关分析，显示心外膜脂肪组织厚度和FINS、HOMA_IR成正相关，相关系数分别为0.239、0.249，P＜0.05；和SI成负相关，相关系数为0.249，P＜0.05，SFT则与各个因素无相关性；逐步法多元线性回归分析显示，心外膜脂肪组织厚度和HOMA_IR呈正相关，标准化偏回归系数0.309，P＜0.01，而SFT仅和BMI呈正相关。结论 超重肥胖成人存在胰岛素敏感性降低、胰岛素抵抗，心外膜脂肪组织厚度和胰岛素抵抗成正相关,可能是新的心血管和代谢疾病的危险因素。 【关键词】 超重和肥胖；心外膜脂肪组织；超声测量；胰岛素抵抗 The Relationship between Epicardial Adipose Tissue and Insulin Resistance in Overweight and Obesity Adults. LI Zhe_cheng, YANG De_ye, XU Yong_yuan, et al. The First Affiliated Hospital of Wenzhou Medical College，Zhejiang 325000, China ［Abstract］ Objective To explore the relationship between epicardial adipose tissue and insulin resistance in overweight and obesity population. Methods The data of 210 adults were surveyed and divided into normal weight, overweight and obese groups according to body mass index (BMI). Each subject underwent ultrasonography to measure epicardial adipose tissue thickness. Anthropometric, metabolic, and cardiac parameters were also evaluated. HOMA_IR and insulin sensitivity index(ISI) were valuated. SPSS（13.0）software was used to process the data. Results SI was significantly lower in overweight and obese groups than that in normal group (P＜0.01）. FINS、insulin index(IR) and epicardial adipose tissue thickness were significantly higher in overweight and obese groups than those in normal group（P＜0.01). Adjusted by age、sex、WC，partial correlation analysis showed that epicardial adipose tissue thickness was positively correlated to FINS、IR(r=0.239，P=0.031；r=0.249，P=0.024，respectively)，and it was negatively corr