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目的探讨男性2型糖尿病患者体脂分布特点及其与心血管危险因素的关系。方法横断面研究,用CT测量91例男性T2DM患者腹壁皮下脂肪面积(SA)及腹腔脏器脂肪面积(VA),计算VA/SA(VSR)以及腹部总体脂量(TAF),同时检测代谢参数,计算BMI;对体脂参数与代谢危险因素行peanson相关分析、偏相关分析及多元逐步回归分析。结果 (1)相关分析结果显示,体脂分布与年龄无相关关系;无论BMI高低,其VSR均明显高于欧美肥胖人群和我国肥胖人群;内脏型肥胖的HbA_1c、TG、FFA水平高于皮下型肥胖组,FIns、FPG水平低于皮下型肥胖组,差异有统计学意义(P<0.05);(2)在校正年龄、糖尿病病程和BMI后,VA、SA和TAF均与FFA呈正相关,VSR与HbA_1c呈正相关;(3)BMI为影响DBP、UA、FIns的独立危险因素,影响SBP、TG、HDL-C的重要因素;TAF是影响2hFFA的独立危险因素;VA为影响FFA的独立危险因素;SA是影响FPG的独立危险因素;VSR是影响HbA_1c的独立危险因素。结论男性T2DM患者体脂分布以中心性肥胖、尤其是腹部内脏脂肪增加为特点;其心血管危险因素不仅与总体脂有关,更与体脂分布(腹型肥胖)有关。
Objective To investigate the characteristics of body fat distribution and its relationship with cardiovascular risk factors in male patients with type 2 diabetes mellitus. Methods The transverse subcutaneous fat area (SA) and abdominal visceral fat area (VA) of 91 male T2DM patients were measured by CT. The VA / SA (VSR) and total abdominal fat mass (TAF) were calculated and the metabolic parameters , Calculated BMI; body fat parameters and metabolic risk factors peanson correlation analysis, partial correlation analysis and multiple stepwise regression analysis. Results (1) The results of correlation analysis showed that there was no correlation between body fat distribution and age. The VSR of BMI was significantly higher than that of European and American obese people and Chinese obese people. The levels of HbA 1c, TG and FFA in visceral obesity were higher than those in subcutaneous The levels of FIns and FPG in obese group were lower than those in subcutaneous obesity group (P <0.05). (2) VA, SA and TAF were positively correlated with FFA after adjusting for age, duration of diabetes and BMI. (3) BMI is an independent risk factor affecting DBP, UA, FIns, an important factor affecting SBP, TG, HDL-C; TAF is an independent risk factor affecting 2hFFA; VA is an independent risk factor affecting FFA ; SA is an independent risk factor affecting FPG; VSR is an independent risk factor affecting HbA_1c. Conclusions Body fat distribution in T2DM patients is characterized by central obesity, especially abdominal visceral fat. Cardiovascular risk factors are not only related to total fat, but also body fat distribution (abdominal obesity).