Two-hour insulin determination improves the ability of abdominal fat measurement to identify risk for the metabolic syndrome.
Two-hour insulin determination improves the ability of abdominal fat measurement to identify risk for the metabolic syndrome.
复制标题
两小时胰岛素测定提高了腹部脂肪测量的能力，以识别代谢综合征的风险。
作者：
F. Ribeiro;A. N. Faria;N. Kohlmann;M. Zanella;S. R. Ferreira
目的
内脏性肥胖被证明是发病率和死亡率的预测因子。我们评估了全身性肥胖和内脏脂肪面积（VFA）的测量与代谢综合征（MS）异常的关系。
研究设计和方法
76名BMI为38.7 +/- 5.4 kg/m2的女性（47.9 +/- 9.2岁）接受了人体测量、实验室检查、生物电阻抗和腹部计算机断层扫描（CT）。MS的诊断基于腹部肥胖和以下组分中的至少两种的存在：高血压、血脂异常和葡萄糖耐受不良和/或高胰岛素血症。
结果
BMI与皮下脂肪（r = 0.66，P < 0.01）和VFA（r = 0.33，P < 0.02）以及瘦素水平（r = 0.38，P < 0.01）均相关。与此相反，VFA与2小时血糖和胰岛素水平（r分别为0.32和0.35，P < 0.05）、甘油三酯、高密度脂蛋白胆固醇和尿酸（r分别为0.33、-0.34和0.24，P < 0.05）相关。与BMI匹配的高VFA受试者显示出更大的血糖曲线下面积（621 +/- 127 vs. 558 +/- 129 mg x h（-1）x dl（-1），P < 0.05），2小时胰岛素（804 +/- 599 vs. 579 +/- 347 pmol/l，P < 0.05）和尿酸水平（0.33 +/- 0.07 vs. 0.26 +/- 0.06 mmol/l，P < 0.05）。Logistic回归分析显示，腰围、VFA和2小时胰岛素是MS的独立预测因子。受试者工作特征曲线分析指出，腰围104 cm是MS的独立预测因子（特异性58.1%，灵敏度84.1%），VFA为158.5 cm（2）（特异性78.1%，灵敏度52.3%），2小时胰岛素为559.8 pmol/l（71.9%的特异性，69.8%的敏感性）;三个变量中至少有两个的存在导致76%的一致性。
结论
虽然BMI无法区分肥胖人群和MS风险较高的人群，但腹部脂肪与代谢异常有关。当结合2小时胰岛素测定时，腹部脂肪在识别高危受试者中的有用性可能会得到改善。
OBJECTIVE
Visceral obesity is shown to be a predictor of morbidity and mortality. We evaluated the association of measurements of generalized adiposity and visceral fat area (VFA), with abnormalities of metabolic syndrome (MS).
RESEARCH DESIGN AND METHODS
Seventy-six women (47.9 +/- 9.2 years) with BMI of 38.7 +/- 5.4 kg/m(2) underwent anthropometric measurements, laboratory procedures, bioeletrical impedance, and abdominal computed tomography (CT) scan. Diagnosis of MS was based on the presence of abdominal obesity and at least two of the following components: hypertension, dyslipidemia, and glucose intolerance and/or hyperinsulinemia.
RESULTS
BMI was correlated with both components of adipose tissue--subcutaneous (r = 0.66, P < 0.01) and VFA (r = 0.33, P < 0.02)--and leptin levels (r = 0.38, P < 0.01). In contrast, VFA was correlated with 2-h glucose and insulin levels (r = 0.32 and 0.35, P < 0.05, respectively), triglyceride, HDL cholesterol, and uric acid (r = 0.33, -0.34 and 0.24, P < 0.05, respectively). Subjects with high VFA, matched for BMI, showed greater plasma glucose area under the curve (621 +/- 127 vs. 558 +/- 129 mg x h(-1) x dl(-1), P < 0.05), 2-h insulin (804 +/- 599 vs. 579 +/- 347 pmol/l, P < 0.05), and uric acid levels (0.33 +/- 0.07 vs. 0.26 +/- 0.06 mmol/l, P < 0.05) than subjects with low VFA. In logistic regression analysis, waist circumference, VFA, and 2-h insulin were identified as independent predictors of MS. Receiver operating characteristic curve analysis pointed out the values of 104 cm for waist circumference (58.1% specificity, 84.1% sensitivity), 158.5 cm(2) for VFA (78.1% specificity, 52.3% sensitivity), and 559.8 pmol/l for 2-h insulin (71.9% specificity, 69.8% sensitivity); the presence of at least two of the three variables resulted in a degree of concordance of 76%.
CONCLUSIONS
While BMI was unable to differentiate between obese people and those at higher risk for MS, abdominal fat was shown to be associated with its metabolic abnormalities. The usefulness of abdominal fat in the identification of high-risk subjects may be improved when combined with 2-h insulin determination.
腹内脂肪组织切点与女性心血管风险升高相关。
DOI：
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发表时间：
1996
期刊：
International journal of obesity and related metabolic disorders : journal of the International Association for the Study of Obesity
影响因子：
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作者：
Williams,MJ;Hunter,GR;Kekes-Szabo,T;Trueth,MS;Snyder,S;Berland,L;Blaudeau,T
通讯作者：
Blaudeau,T