Intra-abdominal fat is a major determinant of the national cholesterol education program adult treatment panel III criteria for the metabolic syndrome
Intra-abdominal fat is a major determinant of the national cholesterol education program adult treatment panel III criteria for the metabolic syndrome
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DOI：
10.2337/diabetes.53.8.2087
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发表时间：
2004-08-01
期刊：
影响因子：
7.7
通讯作者：
Kahn, SE
中科院分区：
文献类型：
--
作者：
Carr, DB;Utzschneider, KM;Kahn, SE
代谢综合征的潜在病理生理学是争论的主题，胰岛素抵抗和肥胖都被认为是重要的因素。我们评估了胰岛素抵抗和中心体脂分布在确定国家胆固醇教育计划(NCEP)成人治疗小组III定义的代谢综合征中的不同作用。此外，我们还确定了哪些NCEP标准与胰岛素抵抗和中心性肥胖有关。对年龄26~75岁、体重指数18.4~46.8 kg/m(2)的健康男性(n=89)和女性(n=129)进行了胰岛素敏感指数(S-I)、腹内脂肪(IAF)和皮下脂肪(SCF)面积的测量。与无代谢综合征的受试者相比，有较低的S-I[中位数：3.13vs.6.09×10(-5)min(-1)/(pmoL/L)]、较高的IAF(166.3对79.1 cm(2))和SCF(285.1对179.8 cm(2))的受试者中有34例(15.6%)出现代谢综合征(P<；0.001)。包括S-I、IAF和SCF在内的多变量模型显示，每个参数都与证候有关。然而，LAX与所有五种代谢综合征标准独立相关。在以标准为协变量的多变量模型中，腰围和甘油三酯水平与S-I、IAF和SCF面积独立相关(P<；0.001)。虽然胰岛素抵抗和中心体脂都与代谢综合征相关，但IAF与所有标准都独立相关，这表明它可能具有病理生理作用。在NCEP标准中，腰围和甘油三酯可能最好地识别空腹血糖为6.4 mmol/L的个体的胰岛素抵抗和内脏肥胖症。
The underlying pathophysiology of the metabolic syndrome is the subject of debate, with both insulin resistance and obesity considered as important factors. We evaluated the differential effects of insulin resistance and central body fat distribution in determining the metabolic syndrome as defined by the National Cholesterol Education Program (NCEP) Adult Treatment Panel III. In addition, we determined which NCEP criteria were associated with insulin resistance and central adiposity. The subjects, 218 healthy men (n = 89) and women (n = 129) with a broad range of age (26-75 years) and BMI (18.4-46.8 kg/m(2)), underwent quantification of the insulin sensitivity index (S-i) and intraabdominal fat (IAF) and subcutaneous fat (SCF) areas. The metabolic syndrome was present in 34 (15.6%) of subjects who had a lower S-i [median:3.13 vs. 6.09 x 10(-5) min(-1)/(pmol/l)] and higher IAF (166.3 vs. 79.1 cm(2)) and SCF (285.1 vs. 179.8 cm(2)) areas compared with subjects without the syndrome (P < 0.001). Multivariate models including S-i, IAF, and SCF demonstrated that each parameter was associated with the syndrome. However, LAX was independently associated with all five of the metabolic syndrome criteria. In multivariable models containing the criteria as covariates, waist circumference and triglyceride levels were independently associated with S-i and IAF and SCF areas (P < 0.001). Although insulin resistance and central body fat are both associated with the metabolic syndrome, IAF is independently associated with all of the criteria, suggesting that it may have a pathophysiological role. Of the NCEP criteria, waist circumference and triglycerides may best identify insulin resistance and visceral adiposity in individuals with a fasting plasma glucose < 6.4 mmol/l.