2型糖尿病患者血糖控制与内脏脂肪指数的关系

doi:10.3969/j.issn.1671-167X.2017.03.012

北京大学学报(医学版) ›› 2017, Vol. 49 ›› Issue (3): 446-450. doi: 10.3969/j.issn.1671-167X.2017.03.012

2型糖尿病患者血糖控制与内脏脂肪指数的关系

曹亚英1，唐迅1，孙可欣1，刘志科1，项骁1，隽娟1，宋菁1，殷琼洲1，扎西德吉1，胡亚楠1，#br# 杨燕芬1，史末也1，田耀华1，黄少平2，刘晓芬2，李娜3，李劲1，吴涛1，陈大方1，胡永华1△

(1. 北京大学公共卫生学院流行病与卫生统计学系，北京 100191; 2. 北京市房山区疾病预防控制中心，北京 102401; 3. 北京市房山区科学技术委员会，北京 102488)

出版日期:2017-06-18 发布日期:2017-06-18
通讯作者: 胡永华 E-mail: yhhu@bjmu.edu.cn

Relationship between glycemic control and visceral adiposity index among the patients with type 2 diabetes mellitus

CAO Ya-ying1, TANG Xun1, SUN Ke-xin1, LIU Zhi-ke1, XIANG Xiao1, JUAN Juan1, SONG Jing1, YIN Qiong-zhou1, ZHAXI De-ji1, HU Ya-nan1, YANG Yanfen1, SHI Mo-ye1, TIAN Yao-hua1, HUANG Shao-ping2, LIU Xiao-fen2, LI Na3, LI Jin1, WU Tao1, CHEN Da-fang1, HU Yong-hua1△

(1. Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China; 2. Fangshan District Center for Disease Control and Prevention, Beijing 102401, China; 3. Fangshan District Science and Technology Commission, Beijing 102488, China)

Online:2017-06-18 Published:2017-06-18
Contact: HU Yong-hua E-mail: yhhu@bjmu.edu.cn

摘要/Abstract

摘要： 目的：探讨2型糖尿病(type 2 diabetes mellitus, T2DM)患者血糖控制情况与内脏脂肪指数(visceral adiposity index, VAI)的关系。方法：采用流行病学现场调查的方法，对社区40岁及以上T2DM患者人口学特征、生活习惯、疾病史、家族史、服药史等资料进行收集，并进行体格检查及空腹血糖、糖化血红蛋白(glycosylated hemoglobin, HbA1c)、血脂等指标的血生化检测。以HbA1c ≥7.0%作为血糖控制不良的标准，分析其与不同水平VAI的关系。结果：共纳入1 607例研究对象，平均年龄为(59.4±8.1)岁，平均糖尿病病程为(7.0±6.4)年，其中78.3%在接受降糖治疗。按VAI四分位数升高的次序将研究对象分为Q1、Q2、Q3和Q4组，其血糖控制不良率依次为60.6%、65.7%、70.1%和71.0% (趋势χ2=12.20, P<0.001)。Logistic回归模型调整年龄、性别、收缩压、舒张压、低密度脂蛋白胆固醇、吸烟情况、心脑血管疾病史、降糖治疗情况、糖尿病病程及家族史后显示，T2DM患者血糖控制情况与VAI水平关联显著。与Q1组研究对象相比，Q2、Q3和Q4组血糖控制不良的OR值分别为1.239 (95% CI 0.918~1.672)、1.513 (95% CI 1.117~2.050)和1.535 (95% CI 1.128~2.088, 趋势P=0.003)；VAI每升高一个四分位数，血糖控制不良OR值为1.162 (95% CI 1.054~1.282)。结论：T2DM患者血糖控制情况与VAI显著相关，VAI水平高预示血糖控制不佳。

关键词: 内脏脂肪, 糖尿病, 2型, 血红蛋白A, 糖基化

Abstract: Objective： To explore the relationship between glycemic control and visceral adiposity index (VAI) among type 2 diabetes mellitus (T2DM) patients. Methods: A community-based epidemiological field study for patients with T2DM aged ≥ 40 years was conducted in China.Every participant underwent physical examinations, biochemical tests of fasting glucose, glycosylated hemoglobin (HbA1c), total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) and so on, and a questionnaire, including anthropometric characteristics, lifestyle, disease history, family history, and medication use. Those participants with HbA1c ≥7.0% were classified as the poorly controlled in our analysis of relationship between glycemic control and VAI. Anthropometric characteristics, lifestyle, and biochemical indexes of the participants were compared among the groups of different VAI levels. Logistic models were applied in multiple analysis adjusting for possible confounders. Results: A total of 1 607 patients with T2DM were recruited in our analysis with a mean age of (59.4±8.1) years and an average T2DM duration of (7.0±6.4) years. Among them, 78.3% were on hypoglycemic therapy. The cutoff points of quartiles of VAI were calculated for the males and females, respectively. According to the ascending order of the quartiles of VAI, the participants were divided into four groups, i.e. Q1, Q2, Q3, and Q4. The poor glycemic control rate for these groups were 60.6%, 65.7%, 70.1%, and 71.0%, respectively (Trendχ2=12.20, P<0.001). After adjustment for age, gender, systolic blood pressure (SBP), diastolic blood pressure (DBP), LDL-C, smoking, cardio-cerebral vascular disease (CVD) history, hypoglycemic therapy, T2DM duration, and family history of diabetes, the Logistic regression models showed that the glycemic control rate was significantly associated with VAI levels among the patients with T2DM. Compared with the participants in group Q1, the ORs of poor glycemic control for those in groups Q2, Q3, and Q4 were 1.239 (95%CI 0.918 to 1.672), 1.513 (95%CI 1.117 to 2.050), and 1.535 (95%CI 1.128to 2.088), respectively (trend P=0.003). With each quartile increase in VAI, the OR of poor glycemic control was 1.162 (95%CI 1.054 to 1.282). Conclusion: The glycemic control among the patients with T2DM is significantly associated with VAI. High level of VAI is an indicator of poor glycemic control.

Key words: Visceral adipose, Diabetes mellitus, type 2, Hemoglobin A, glycosylated

中图分类号:

曹亚英，唐迅，孙可欣，刘志科，项骁，隽娟，宋菁，殷琼洲，扎西德吉，胡亚楠，. 2型糖尿病患者血糖控制与内脏脂肪指数的关系[J]. 北京大学学报(医学版), 2017, 49(3): 446-450.

CAO Ya-ying, TANG Xun, SUN Ke-xin, LIU Zhi-ke, XIANG Xiao, JUAN Juan, SONG Jing, YIN Qiong-zhou, ZHAXI De-ji, HU Ya-nan, YANG Yan-fen, SHI Mo-ye， TIAN Yao-hua, HUANG Shao-ping, . Relationship between glycemic control and visceral adiposity index among the patients with type 2 diabetes mellitus[J]. Journal of Peking University(Health Sciences), 2017, 49(3): 446-450.

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2型糖尿病患者血糖控制与内脏脂肪指数的关系

Relationship between glycemic control and visceral adiposity index among the patients with type 2 diabetes mellitus

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