【摘要】：目的探討內(nèi)臟脂肪指數(shù)(VAI)對(duì)成人生長(zhǎng)激素缺乏癥(AGHD)患者代謝綜合征(MS)的評(píng)估作用。方法選取2015年1月—2016年1月在重慶醫(yī)科大學(xué)附屬第一醫(yī)院確診2年及以上的AGHD患者66例為AGHD組;選取同期在本院體檢中心進(jìn)行體檢的健康人群66例為對(duì)照組。并根據(jù)VAI三分位數(shù)將AGHD患者分為3組:低VAI組(n=22)、中VAI組(n=22)、高VAI組(n=22)。測(cè)量所有受試者身高、體質(zhì)量、腰圍(WC)、臀圍(HC)、血壓〔收縮壓(SBP)、舒張壓(DBP)〕等;測(cè)定空腹血糖(FPG)、空腹胰島素(FINS)、血脂〔包括總膽固醇(TC)、三酰甘油(TG)、低密度脂蛋白膽固醇(LDL-C)、高密度脂蛋白膽固醇(HDL-C)〕水平;計(jì)算BMI、腰臀比(WHR)、穩(wěn)態(tài)模型評(píng)價(jià)的胰島素抵抗指數(shù)(HOMA-IR)及VAI。通過(guò)繪制受試者工作特征(ROC)曲線,計(jì)算ROC曲線下面積(AUC),分析VAI的評(píng)估作用。結(jié)果 AGHD組中男21例,女45例;對(duì)照組中,男21例,女45例。兩組受試者年齡、身高、SBP、DBP、FPG、TC、LDL-C間差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),而體質(zhì)量、BMI、WC、HC、WHR、FINS、TG、LDL-C、HDL-C、VAI、HOMA-IR間差異有統(tǒng)計(jì)學(xué)意義(P0.05)。不同VAI患者性別、年齡、身高、WHR、FINS、TC、LDL-C間差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);而體質(zhì)量、BMI、WC、HC、SBP、DBP、FPG、TG、HDL-C、HOMA-IR及MS發(fā)生率間差異有統(tǒng)計(jì)學(xué)意義(P0.05)。年齡調(diào)整前后,VAI與WC、DBP、FPG、TG均呈正相關(guān)(P0.05),與HDL-C呈負(fù)相關(guān)(P0.05),與SBP無(wú)相關(guān)性(P0.05)。VAI評(píng)估AGHD患者M(jìn)S的AUC為0.871〔95%CI(0.788,0.954),P0.001〕,最佳臨界值為1.9,靈敏度為0.960,特異度為0.610。結(jié)論 VAI可作為AGHD患者M(jìn)S的篩查與評(píng)估手段。
[Abstract]:Objective to evaluate the effect of visceral fat index (VAI) on metabolic syndrome (MS) in adult growth hormone deficiency (AGHD) patients. Methods from January 2015 to January 2016, 66 patients with AGHD diagnosed for 2 years or more in the first affiliated Hospital of Chongqing Medical University were selected as AGHD group, and 66 healthy people who underwent physical examination in the same period were selected as control group. The patients with AGHD were divided into three groups according to the number of three digits of VAI: low VAI group (n = 22), middle VAI group (n = 22) and high VAI group (n = 22). Height, body mass, waist circumference, (WC), hip circumference, (HC), blood pressure (systolic (SBP), diastolic pressure (DBP), etc.) were measured in all subjects. Fasting blood glucose, (FPG), fasting insulin, (FINS), serum lipids (including total cholesterol, (TC), triacylglycerol, (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) were measured. Evaluation of Insulin Resistance Index (HOMA-IR) and VAI. by (WHR), Steady-state Model for calculating BMI, WHR The area (AUC), under the ROC curve was calculated by drawing the operating characteristic (ROC) curve of the subjects to evaluate the evaluation of VAI. Results there were 21 males and 45 females in AGHD group and 45 males and 45 females in control group. There was no significant difference in age, height and SBP,DBP,FPG,TC,LDL-C between the two groups (P0.05), but the body mass, BMI,WC,HC,WHR,FINS,TG,LDL-C,HDL-C,VAI, were not significantly different between the two groups (P0.05). The difference of HOMA-IR was statistically significant (P0.05). There was no significant difference in sex, age, height and WHR,FINS,TC,LDL-C among different VAI patients (P0.05). The body mass, BMI,WC,HC,SBP,DBP,FPG,TG,HDL-C,HOMA-IR and MS incidence were significantly different (P0.05). Before and after age adjustment, VAI was positively correlated with WC,DBP,FPG,TG (P0.05), and negatively correlated with HDL-C (P0.05). There was no correlation between AUC and SBP (P0.05). VAI, AUC was 0.871 (95%CI (0.7880.94), P0.001), the best critical value was 1.9, the sensitivity was 0.960and the specificity was 0.610. Conclusion VAI can be used as a screening and evaluation method for MS in AGHD patients.
【作者單位】： 重慶醫(yī)科大學(xué)附屬第一醫(yī)院內(nèi)分泌科;
【基金】：教育部基金項(xiàng)目(20135503120001) 國(guó)家臨床重點(diǎn)專科建設(shè)項(xiàng)目(2011) 重慶市科委自然科學(xué)基金面上項(xiàng)目(cstc2012jj A10035)
【分類號(hào)】：R589

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