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中国非胰岛素依赖型糖尿病患者的内脏脂肪与心血管危险因素

Visceral fat and cardiovascular risk factors in Chinese NIDDM patients.

作者信息

Anderson P J, Chan J C, Chan Y L, Tomlinson B, Young R P, Lee Z S, Lee K K, Metreweli C, Cockram C S, Critchley J A

机构信息

Department of Clinical Pharmacology, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, New Territories, Hong Kong.

出版信息

Diabetes Care. 1997 Dec;20(12):1854-8. doi: 10.2337/diacare.20.12.1854.

Abstract

OBJECTIVE

The interrelations between obesity, glucose intolerance, hypertension, dyslipidemia, and insulin resistance are well recognized. These relationships are of particular interest in Hong Kong's Chinese population, in whom increasing affluence has coincided with a marked increase in the prevalence of NIDDM. We designed a pilot study to examine the relationships between visceral fat and cardiovascular risk factors in Chinese NIDDM patients.

RESEARCH DESIGN AND METHODS

We studied 21 Chinese NIDDM patients whose visceral fat was quantified by magnetic resonance imaging. Cardiovascular risk factors including plasma lipids and 24-h ambulatory blood pressure (BP) were measured. In addition, insulin resistance was determined by a short insulin tolerance test (SITT).

RESULTS

Increased visceral adiposity was significantly correlated with plasma triglycerides (r = 0.63, P = 0.004), the total cholesterol/HDL cholesterol ratio (r = 0.61, P = 0.008), the urinary albumin/creatinine ratio (r = 0.49, P = 0.04), and decreased insulin sensitivity as measured by the SITT (r = 0.47, P = 0.03). When the data were analyzed by tertiles, increasing visceral fat area was associated with higher plasma triglycerides, lower HDL cholesterol, and a smaller plasma glucose decrement during the SITT. In addition, the diurnal rhythm in BP and heart rate tended to be best preserved in those with the least visceral obesity.

CONCLUSIONS

This pilot study demonstrates that visceral fat accumulation is associated with dyslipidemia, hypertension, insulin resistance, and albuminuria in Chinese patients with NIDDM.

摘要

目的

肥胖、糖耐量异常、高血压、血脂异常和胰岛素抵抗之间的相互关系已得到充分认识。这些关系在香港的中国人群中尤为令人关注,在该人群中,财富的增加与非胰岛素依赖型糖尿病(NIDDM)患病率的显著上升同时出现。我们设计了一项初步研究,以探讨中国NIDDM患者内脏脂肪与心血管危险因素之间的关系。

研究设计与方法

我们研究了21例中国NIDDM患者,通过磁共振成像对其内脏脂肪进行定量。测量了包括血脂和24小时动态血压(BP)在内的心血管危险因素。此外,通过短胰岛素耐量试验(SITT)测定胰岛素抵抗。

结果

内脏脂肪增多与血浆甘油三酯(r = 0.63,P = 0.004)、总胆固醇/高密度脂蛋白胆固醇比值(r = 0.61,P = 0.008)、尿白蛋白/肌酐比值(r = 0.49,P = 0.04)显著相关,并且通过SITT测量的胰岛素敏感性降低(r = 0.47,P = 0.03)。当按三分位数分析数据时,内脏脂肪面积增加与较高的血浆甘油三酯、较低的高密度脂蛋白胆固醇以及SITT期间较小的血浆葡萄糖下降相关。此外,血压和心率的昼夜节律在内脏肥胖最少的患者中往往保存得最好。

结论

这项初步研究表明,中国NIDDM患者内脏脂肪堆积与血脂异常、高血压、胰岛素抵抗和蛋白尿有关。

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