预测 2 型糖尿病患者的心外膜脂肪组织。
Predictors of epicardial adipose tissue in patients with type 2 diabetes mellitus.
机构信息
Department of Endocrinology, Erzincan University Mengucek Gazi Training and Research Hospital, Erzincan, Turkey.
Department of Cardiology, Erzincan University Mengucek Gazi Training and Research Hospital, Erzincan, Turkey.
出版信息
Diabetol Metab Syndr. 2014 May 9;6:55. doi: 10.1186/1758-5996-6-55. eCollection 2014.
BACKGROUND
Epicardial adipose tissue (EAT), visceral fat depot of the heart, was found to be associated with coronary artery disease in cardiac and non-cardiac patients. Platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) were introduced as potential markers to determine inflammation in various disorders. Recently, atherogenic index of plasma (AIP) was found to be closely associated with atherosclerosis in general population. Waist circumference is commonly used to assess the risk factors in various metabolic disorders. There has been a well known relation between inflammation and peripheral adipose tissue in diabetes mellitus. However, the data regarding EAT and inflammation is scant in this population. Hence, we aimed to determine the relationship between PLR, NLR, AIP, waist circumference and EAT in diabetic patients.
METHODS
This was a cross-sectional study involving 156 patients with type 2 diabetes mellitus (87 females, 69 males; mean age, 53.62 ± 9.33 years) and 50 control subjects (35 females, 15 males; mean age, 51.06 ± 8.74 years). EAT was measured by using a trans-thoracic echocardiogram. Atherogenic index of plasma was calculated as the logarithmically transformed ratio of the serum triglyceride to high density lipoprotein (HDL)cholesterol. NLR and PLR were calculated as the ratio of the neutrophils and platelets to lymphocytes, respectively.
RESULTS
Waist circumference, PLR, NLR, AIP and EAT measurements were significantly higher in diabetic patients when compared to control subjects. When diabetic patients were separated into two groups according to their median value of EAT (Group 1, EAT < 4.53 (n = 78) and group 2, EAT ≥4.53 (n = 78)), group 2 patients had significantly higher Body mass index (BMI), waist circumference, AIP, NLR and PLR levels. In the bivariate correlation analysis, EAT was positively correlated with PLR, NLR, AIP, BMI and waist circumference (r = 0.197, p = 0.014; r = 0.229, p = 0.004; r = 0.161, p = 0.044; r = 0.248, p = 0.002; r = 0.306, p < 0.001, respectively). Waist circumference was found to be independent variables of EAT.
CONCLUSIONS
Simple calculation of PLR and measurement of waist circumference were found to be associated with increased EAT in diabetic patients.
背景
心外膜脂肪组织（EAT）是心脏的内脏脂肪库，已被发现与心脏和非心脏患者的冠状动脉疾病有关。血小板与淋巴细胞比值（PLR）和中性粒细胞与淋巴细胞比值（NLR）被引入作为确定各种疾病炎症的潜在标志物。最近，血浆致动脉粥样硬化指数（AIP）被发现与一般人群的动脉粥样硬化密切相关。腰围通常用于评估各种代谢紊乱的危险因素。在糖尿病中，炎症与外周脂肪组织之间存在众所周知的关系。然而，在该人群中，关于 EAT 和炎症的数据很少。因此，我们旨在确定 2 型糖尿病患者中 PLR、NLR、AIP、腰围和 EAT 之间的关系。
方法
这是一项横断面研究，共纳入 156 例 2 型糖尿病患者（女性 87 例，男性 69 例；平均年龄 53.62±9.33 岁）和 50 例对照组（女性 35 例，男性 15 例；平均年龄 51.06±8.74 岁）。使用经胸超声心动图测量 EAT。血浆致动脉粥样硬化指数按血清甘油三酯与高密度脂蛋白（HDL）胆固醇的对数比计算。NLR 和 PLR 分别计算为中性粒细胞与血小板和淋巴细胞的比值。
结果
与对照组相比，糖尿病患者的腰围、PLR、NLR、AIP 和 EAT 测量值明显更高。当根据 EAT 的中位数将糖尿病患者分为两组（组 1，EAT<4.53（n=78）和组 2，EAT≥4.53（n=78））时，组 2 患者的 BMI、腰围、AIP、NLR 和 PLR 水平明显更高。在双变量相关分析中，EAT 与 PLR、NLR、AIP、BMI 和腰围呈正相关（r=0.197，p=0.014；r=0.229，p=0.004；r=0.161，p=0.044；r=0.248，p=0.002；r=0.306，p<0.001）。腰围是 EAT 的独立变量。
结论
PLR 的简单计算和腰围的测量与糖尿病患者 EAT 的增加有关。
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