Tayama K, Inukai T, Shimomura Y
Department of Medicine, Koshigaya Hospital, Dokkyo University School of Medicine, Japan.
Diabetes Res Clin Pract. 1999 Jan;43(1):49-58. doi: 10.1016/s0168-8227(98)00118-1.
Preperitoneal fat is an indicator of visceral fat deposition, which is closely related to atherosclerosis and coronary heart disease in obese patients. We assessed the relationship of preperitoneal fat deposition and various clinical characteristics in 90 patients with non-insulin-dependent diabetes mellitus (NIDDM). Preperitoneal and subcutaneous fat deposition were measured by ultrasonography. In both the male and female diabetics, preperitoneal fat levels were significantly higher than in age-matched healthy subjects. We also determined blood pressures, fasting plasma glucose, glycosylated hemoglobin A1c, serum lipids, fasting immunoreactive insulin (FIRI), daily urinary C-peptide (CPR), serum leptin, urinary albumin excretion and body mass index (BMI). Of these parameters, BMI, FIRI, leptin and daily urinary CPR were positively correlated with preperitoneal fat deposition. Patients with diet therapy alone showed significantly higher preperitoneal fat levels than those receiving insulin therapy. In female, patients with increased preperitoneal fat showed higher prevalence of hypertension than those with decreased fat. Macroalbuminuric patients had a lower preperitoneal fat than microalbuminuric and normoalbuminuric patients. Patients with proliferative retinopathy exhibited lower preperitoneal fat than did those without retinopathy. Preperitoneal fat levels were positively correlated with motor or sensory nerve conduction velocity.
The present findings suggest that in NIDDM patients, increased preperitoneal fat deposition is closely associated with obesity, hypertension and hyperinsulinemia, and negatively modulates diabetic microangiopathy including nephropathy, retinopathy and neuropathy.
腹膜前脂肪是内脏脂肪沉积的一个指标，在肥胖患者中它与动脉粥样硬化和冠心病密切相关。我们评估了90例非胰岛素依赖型糖尿病（NIDDM）患者腹膜前脂肪沉积与各种临床特征之间的关系。通过超声检查测量腹膜前和皮下脂肪沉积。在男性和女性糖尿病患者中，腹膜前脂肪水平均显著高于年龄匹配的健康受试者。我们还测定了血压、空腹血糖、糖化血红蛋白A1c、血脂、空腹免疫反应性胰岛素（FIRI）、每日尿C肽（CPR）、血清瘦素、尿白蛋白排泄量和体重指数（BMI）。在这些参数中，BMI、FIRI、瘦素和每日尿CPR与腹膜前脂肪沉积呈正相关。仅接受饮食治疗的患者腹膜前脂肪水平显著高于接受胰岛素治疗的患者。在女性中，腹膜前脂肪增加的患者高血压患病率高于脂肪减少的患者。大量白蛋白尿患者的腹膜前脂肪低于微量白蛋白尿和正常白蛋白尿患者。增殖性视网膜病变患者的腹膜前脂肪低于无视网膜病变的患者。腹膜前脂肪水平与运动或感觉神经传导速度呈正相关。
目前的研究结果表明，在NIDDM患者中，腹膜前脂肪沉积增加与肥胖、高血压和高胰岛素血症密切相关，并对包括肾病、视网膜病变和神经病变在内的糖尿病微血管病变产生负面影响。
