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肌少症性肥胖与胰岛素抵抗、炎症和维生素 D 状态的关系:韩国肌少症性肥胖研究。

Relationships between sarcopenic obesity and insulin resistance, inflammation, and vitamin D status: the Korean Sarcopenic Obesity Study.

机构信息

Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea.

出版信息

Clin Endocrinol (Oxf). 2013 Apr;78(4):525-32. doi: 10.1111/j.1365-2265.2012.04433.x.

DOI:10.1111/j.1365-2265.2012.04433.x
PMID:22563924
Abstract

OBJECTIVE

It has been suggested that insulin resistance, low-grade inflammation and vitamin D deficiency are associated with obesity and sarcopenia. However, their relationships with sarcopenic obesity (SO) are unclear. We evaluated the impact of homoeostasis model assessment of insulin resistance (HOMA-IR), high-sensitivity C-reactive protein (hsCRP) and 25-hydroxyvitamin D (25[OH]D) levels on SO in Korean adults. STUDY SUBJECT/MEASUREMENTS: This study included 493 apparently healthy adults (180 men and 313 women) enrolled in the Korean Sarcopenic Obesity Study. Sarcopenia was defined as a skeletal muscle mass index (SMI) of 1 SD below the sex-specific mean value for a young reference group. Obesity was defined as a visceral fat area (VFA) ≥100 cm(2) . We classified the participants into four sarcopenia/obesity groups based on both SMI and VFA.

RESULTS

The prevalence of SO was 17·8% in men and 24·9% in women. In women, the SO group had higher HOMA-IR and hsCRP levels compared with the non-SO group. In men, the 25[OH]D levels were significantly lower in the SO group than the non-SO group. Both hsCRP and HOMA-IR levels were negatively correlated with SMI and positively correlated with VFA in both men and women, whereas 25[OH]D levels were positively correlated with SMI in both men and women. Multiple binary logistic regression analysis showed that HOMA-IR and 25[OH]D levels were independently associated with SO in men, while HOMA-IR and hsCRP were significant factors predicting SO in women.

CONCLUSION

Insulin resistance, inflammation and vitamin D deficiency were associated with SO in a Korean adult population.

摘要

目的

有研究表明,胰岛素抵抗、低度炎症和维生素 D 缺乏与肥胖和肌肉减少症有关。然而,它们与肌肉减少性肥胖(SO)的关系尚不清楚。我们评估了稳态模型评估的胰岛素抵抗(HOMA-IR)、高敏 C 反应蛋白(hsCRP)和 25-羟维生素 D(25[OH]D)水平对韩国成年人 SO 的影响。

研究对象/测量:本研究纳入了韩国肌肉减少性肥胖研究中的 493 名健康成年人(男性 180 名,女性 313 名)。肌肉减少症定义为骨骼肌质量指数(SMI)低于年轻参考组性别特异性平均值 1 个标准差。肥胖定义为内脏脂肪面积(VFA)≥100 cm²。我们根据 SMI 和 VFA 将参与者分为四个肌肉减少症/肥胖组。

结果

男性 SO 的患病率为 17.8%,女性为 24.9%。在女性中,SO 组的 HOMA-IR 和 hsCRP 水平高于非 SO 组。在男性中,SO 组的 25[OH]D 水平明显低于非 SO 组。在男性和女性中,hsCRP 和 HOMA-IR 水平与 SMI 呈负相关,与 VFA 呈正相关,而 25[OH]D 水平与 SMI 在男性和女性中均呈正相关。多因素二分类逻辑回归分析显示,HOMA-IR 和 25[OH]D 水平与男性 SO 独立相关,而 HOMA-IR 和 hsCRP 是女性 SO 的重要预测因素。

结论

在韩国成年人中,胰岛素抵抗、炎症和维生素 D 缺乏与 SO 相关。

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