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中国葡萄糖调节受损和糖尿病患者的心外膜和腹盆腔内脏脂肪组织的贡献。

Contribution of epicardial and abdominopelvic visceral adipose tissues in Chinese adults with impaired glucose regulation and diabetes.

机构信息

Department of Radiology, Ruijin Hospital Affiliated with Shanghai Jiaotong University School of Medicine, No. 197 Ruijin 2nd Rd, Shanghai, 200025, People's Republic of China.

Division of Biostatistics, School of Public Health, The University of Minnesota, 420 Delaware St SE, Minneapolis, MN, 55455, USA.

出版信息

Acta Diabetol. 2019 Sep;56(9):1061-1071. doi: 10.1007/s00592-019-01348-z. Epub 2019 Apr 26.

Abstract

AIMS

To quantify epicardial adipose tissue (EAT) and visceral adipose tissue (VAT) in Chinese adults with impaired glucose regulation (IGR) or diabetes and compare the contributions of EAT and VAT to the occurrence of IGR and diabetes with those of traditional obesity indices.

METHODS

Cardiac and abdominopelvic noncontrast computed tomographic images of 668 individuals were used to measure EAT and VAT volume. Multivariable logistic regression and area under the receiver operating characteristic (ROC) curve were used to illustrate the contributions of these tissues.

RESULTS

Patients with IGR or diabetes had larger EAT and VAT volumes than did the controls, and the VAT volume was significantly different between the IGR and diabetic groups. In multivariable models, higher EAT or VAT volume was positively associated with the presence of IGR and diabetes. After adjusting further for body mass index (BMI) and waist-to-hip ratio (WHR), a higher EAT volume was still positively associated with IGR (odds ratio (OR) = 1.46; 95% confidence interval (CI), 1.04-2.03), and a higher VAT volume was positively associated with IGR (OR = 1.86; 95% CI, 1.15-3.02) and diabetes (OR = 1.86; 95% CI, 1.16-2.99). The areas under the curve (AUCs) of the association of EAT (AUC = 0.751; 95% CI, 0.712-0.789) and VAT (AUC = 0.752; 95% CI, 0.713-0.792) with dysglycemia (IGR + diabetes) were significantly larger than those of the traditional obesity indices (all P < 0.05).

CONCLUSIONS

High EAT or VAT volume is positively associated with IGR and diabetes in Chinese adults. With a given WHR and BMI, such an association still exists to some extent. The correlation may be stronger than those of the traditional obesity indices.

摘要

目的

定量检测糖调节受损(IGR)或糖尿病中国成年人的心脏外膜脂肪组织(EAT)和内脏脂肪组织(VAT),并将 EAT 和 VAT 对 IGR 和糖尿病的发生的贡献与传统肥胖指数进行比较。

方法

使用 668 例个体的心脏和腹部非对比计算机断层扫描图像来测量 EAT 和 VAT 体积。多变量逻辑回归和接受者操作特征(ROC)曲线下面积用于说明这些组织的贡献。

结果

IGR 或糖尿病患者的 EAT 和 VAT 体积大于对照组,IGR 和糖尿病组之间的 VAT 体积有显著差异。在多变量模型中,较高的 EAT 或 VAT 体积与 IGR 和糖尿病的存在呈正相关。进一步调整体重指数(BMI)和腰臀比(WHR)后,较高的 EAT 体积仍与 IGR 呈正相关(比值比(OR)=1.46;95%置信区间(CI),1.04-2.03),较高的 VAT 体积与 IGR(OR=1.86;95%CI,1.15-3.02)和糖尿病(OR=1.86;95%CI,1.16-2.99)呈正相关。EAT(AUC=0.751;95%CI,0.712-0.789)和 VAT(AUC=0.752;95%CI,0.713-0.792)与糖代谢异常(IGR+糖尿病)的关联曲线下面积(AUC)明显大于传统肥胖指数(均 P<0.05)。

结论

高 EAT 或 VAT 体积与中国成年人的 IGR 和糖尿病呈正相关。在给定的 WHR 和 BMI 下,这种相关性在一定程度上仍然存在。这种相关性可能比传统肥胖指数更强。

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