| 2型糖尿病患者颈腰围与胰岛素抵抗及代谢综合征关系比较分析 |
| 投稿时间：2018-01-19 修订日期：2018-03-02 点此下载全文 |
| 引用本文：许忆峰,郭庆军,王超群,黄勤.2型糖尿病患者颈腰围与胰岛素抵抗及代谢综合征关系比较分析[J].医学研究杂志,2018,47(10):36-40 |
| DOI：
10.11969/j.issn.1673-548X.2018.10.011 |
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| 基金项目:国家自然科学基金资助项目（81471038，80272665）；国家卫生和计划生育委员会公益性行业科研基金资助项目（201502011） |
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| 中文摘要:目的 比较分析2型糖尿病患者中颈围、腰围与胰岛素抵抗及代谢综合征的相关关系。方法 选取2016年1月~2017年12月上海长海医院内分泌科住院的412例2型糖尿病患者为观察组，其中男性228例，女性184例。采用Pearson线性相关性检验分析颈围与年龄、病程、血脂、血尿酸、糖化白蛋白、糖化血红蛋白、空腹血糖、空腹胰岛素之间的相关关系；Z检验比较颈围、腰围与改良的胰岛素抵抗指数之间相关性；Z检验比较颈围、腰围预测代谢综合征的ROC曲线下面积。结果 颈围与2型糖尿病患者的血尿酸、甘油三酯呈正相关（r分别为0.396、0.312，P<0.05），与高密度脂蛋白胆固醇呈负相关（r=-0.432，P<0.05）；颈围、腰围均与HOMA2-IR指标呈正相关（r分别为0.462、0.497，P<0.01），两相关系数r之间比较差异无统计学意义（Z=-0.650，P>0.05）。预测代谢综合征（MS1） ROC曲线下的面积颈围组与腰围组比较差异无统计学意义（男性组0.788±0.037 vs 0.806±0.036，女性组0.711±0.045 vs 0.757±0.043，P>0.05）。结论 颈围与2型糖尿病患者的胰岛素抵抗密切相关，其相关性作用并不低于腰围，可作为中心性肥胖的有效测量指标之一，在预测2型糖尿病代谢综合征中的效能亦不低于腰围，适合在临床推广应用。 |
| 中文关键词:2型糖尿病 颈围 腰围 胰岛素抵抗 代谢综合征 |
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| Comparision of the Relationship between Neck Circumference and Waist Circumference in Insulin Resistance and Metabolic Syndrome in Type 2 Diabetic Patients |
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| Abstract:Objective To compare the relationship between neck circumference and waist circumference in insulin resistance and metabolic syndrome in type 2 diabetic patients. Methods A total of 412 patients diagnosed with type 2 diabetes (228 males and 184 females)who were admitted to the endocrinology department of Shanghai Changhai hospital from January 2016 to December 2017 were selected as the observation group. The correlation between neck circumference and age, course of disease, blood lipid, serum uric acid, glycosylated albumin, glycosylated hemoglobin, fasting plasma glucose and fasting insulin was analysed by pearson linear correlation test. The correlation between neck circumference, waist circumference and HOMA2-IR was compared by Z test;The AUC of ROC of metabolic syndrome predicted by neck circumference and waist circumference was compared by Z test. Results Neck circumference was moderately positively correlated with serum uric acid and triglyceride in type 2 diabetic patients(r=0.396, 0.312, P<0.05). Neck circumference was moderately negative correlation with HDL cholesterol(r=-0.432, P<0.05). Neck circumference and waist circumference were both moderately positively correlated with the index of HOMA2-IR(r=0.462, 0.497, P<0.01). There was no significant difference between the two correlation coefficients(Z=-0.650,P>0.05). There were no significant differences between the neck circumference group and the waist circumference group compared with the AUC of the ROC predicting metabolic syndrome (MS1)(males group 0.788±0.037 vs 0.806±0.036,females group 0.711±0.045 vs 0.757±0.043,P>0.05). Conclusion Neck circumference was closely related to insulin resistance in type 2 diabetic patients, and its correlation was not lower than waist circumference, which can be used as one of the effective measures for central obesity. In the prediction of MS in type 2 diabetic patients, the efficacy was not lower than that of waist circumference, so neck circumference was suitable for clinical application. |
| keywords:Type 2 diabetes Neck circumference Waist circumference Insulin resistance Metabolic syndrome |
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