围绝经期及绝经后女性基于腰椎定量电子计算机断层扫描测定的内脏脂肪与糖脂代谢的相关性

doi:10.3969/j.issn.1006-7795.2020.04.002

首都医科大学学报 ›› 2020, Vol. 41 ›› Issue (4): 508-513.doi: 10.3969/j.issn.1006-7795.2020.04.002

围绝经期及绝经后女性基于腰椎定量电子计算机断层扫描测定的内脏脂肪与糖脂代谢的相关性

张露平¹, 阮祥燕^1,2, 鞠蕊¹, 秦爽¹, 王宾红¹, 许新¹, 杨瑜¹, Alfred O. Mueck^1,2

1. 首都医科大学附属北京妇产医院内分泌科, 北京 100026;
2. 德国图宾根大学妇产医院妇女健康部与妇女健康研究中心, 图宾根 D-72076, 德国

收稿日期:2020-05-08 出版日期:2020-08-21 发布日期:2020-07-22
通讯作者: 阮祥燕 E-mail:ruanxiangyan@163.com
基金资助:
中国健康促进基金会项目（CHPF-2018-OP-11），北京市医院管理中心"登峰"计划专项（DFL20181401），首批北京市级妇幼保健专科示范单位"更年期保健专科"，中国国际人才交流促进会医疗健康技术创新与人才培养专项基金（2017041900004），北京市卫生系统高层次卫生技术人才（2014-2-016）。

Visceral adipose tissue measured with the quantitative computed tomography:relationship between visceral adipose tissue and glycolipid metabolism in different menopausal period women

Zhang Luping¹, Ruan Xiangyan^1,2, Ju Rui¹, Qin Shuang¹, Wang Binhong¹, Xu Xin¹, Yang Yu¹, Alfred O. Mueck^1,2

1. Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China;
2. Department of Women's Health, University Women's Hospital and Research Center for Women's Health, University of Tubingen, Tubingen D-72076, Germany

Received:2020-05-08 Online:2020-08-21 Published:2020-07-22
Supported by:
This study was supported by China Health Promotion Foundation (CHPF-2018-OP-11),Beijing Municipal Administration of Hospitals 'Ascent Plan' (DFL20181401), Beijing Municipal Health Commission, China International Talent Exchange Association Medical Health Technology Innovation and Talent Training Special Fund (2017041900004), Beijing Municipality Health Technology High-level Talent (2014-2-016).

摘要/Abstract

摘要： 目的研究围绝经期及绝经后女性内脏脂肪与糖脂代谢的相关性。方法回顾性分析2018年9月至2020年2月期间在首都医科大学附属北京妇产医院内分泌科就诊并接受腰椎定量电子计算机断层扫描（quantitative computed tomography，QCT）检查的患者185例，依据内脏脂肪面积分为内脏型肥胖组和正常组，记录患者一般信息，对人体测量学指标及糖脂代谢指标进行测定。结果在围绝经期及绝经后患者中，内脏型肥胖组的空腹血糖，空腹胰岛素及稳态胰岛素指数均高于正常组，VAT与三者呈明显正相关。围绝经期三酰甘油浓度高于正常组，高密度脂蛋白胆固醇低于正常组（P<0.05）；总胆固醇、低密度脂蛋白胆固醇、载脂蛋白A和B的浓度差异无统计学意义（P>0.05）。VAT与三酰甘油及载脂蛋白B呈正相关（P<0.05），与高密度脂蛋白胆固醇及载脂蛋白A呈负相关（P<0.05），尚未发现VAT与总胆固醇及低密度脂蛋白胆固醇具有明显相关性（P>0.05）。绝经后低密度脂蛋白胆固醇、载脂蛋白B浓度明显高于正常组，高密度脂蛋白胆固醇及载脂蛋白A浓度明显低于正常组（P<0.05）；总胆固醇及三酰甘油浓度差异无统计学意义（P>0.05）。VAT与载脂蛋白B呈正相关，与高密度脂蛋白胆固醇及载脂蛋白A呈负相关，尚未发现VAT与总胆固醇、三酰甘油及低密度脂蛋白胆固醇具有明显相关性（P>0.05）。结论围绝经期及绝经后女性内脏脂肪与糖脂代谢密切相关，应该关注局部脂肪分布与健康的关系。

关键词: 内脏脂肪, 糖脂代谢, 定量电子计算机断层扫描, 内脏型肥胖

Abstract: Objective To study the relationship between visceral adipose tissue and glycolipid metabolism in perimenopause and postmenopausal women. Methods From Sep 2018 to Feb 2020, a total of 185 women with menopausal symptoms who underwent quantitative computed tomography (QCT) testing were included in our study Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. According to the intra-abdominal fat area, the patients were divided into visceral obesity group with visceral adipose tissue (VAT) ≥ 100 cm² and normal group. The human body index and glycolipid indexes were measured in two groups. Results In peri- and postmenopausal women, fasting blood glucose, fasting insulin, and homeostasis model assessment insulin resistance (HOMA-IR) in visceral obesity group were significantly higher than those in normal group, and VAT was positive correlation with them. In perimenopausal women, compared with the normal group, the level of triglyceride (TG) was significantly increased, and the level of high density lipoprotein-cholesterol (HDL-C) significantly decreased in visceral obesity group (P<0.05). There was no significant difference in the levels of total cholesterol, low-density lipoprotein-cholesterol (LDL-C), apolipoprotein (Apo) A and Apo B (P>0.05). The linear correlation analysis indicated that VAT was positively correlated with TG and Apo B (P<0.05). VAT was negatively correlated with HDL-C and Apo A (P<0.05). There was no significant correlation between VAT, total cholesterol (TC) and LDL-C (P>0.05). In postmenopausal women, compared with the normal group, the level of LDL-C and Apo B were significantly increased, and the level of HDL-C and Apo A were significantly decreased in visceral obesity group (P<0.05). There were no significant differences in the level of TC and TG (P>0.05). The linear correlation analysis indicated that VAT was positively correlated with Apo B. VAT was negatively correlated with HDL-C and Apo A. There was no significant correlation with TC, TG, and LDL-C (P>0.05). Conclusion Visceral adipose tissue is closely correlated with glycolipid metabolism disorder in peri- and postmenopausal women. More attention should be paid to the relationship between local adipose tissue distribution and health.

Key words: visceral adipose tissue, glycolipid metabolism, quantitative computed tomography (QCT), visceral obesity

中图分类号:

R711

张露平, 阮祥燕, 鞠蕊, 秦爽, 王宾红, 许新, 杨瑜, Alfred O. Mueck. 围绝经期及绝经后女性基于腰椎定量电子计算机断层扫描测定的内脏脂肪与糖脂代谢的相关性[J]. 首都医科大学学报, 2020, 41(4): 508-513.

Zhang Luping, Ruan Xiangyan, Ju Rui, Qin Shuang, Wang Binhong, Xu Xin, Yang Yu, Alfred O. Mueck. Visceral adipose tissue measured with the quantitative computed tomography:relationship between visceral adipose tissue and glycolipid metabolism in different menopausal period women[J]. Journal of Capital Medical University, 2020, 41(4): 508-513.

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围绝经期及绝经后女性基于腰椎定量电子计算机断层扫描测定的内脏脂肪与糖脂代谢的相关性

Visceral adipose tissue measured with the quantitative computed tomography:relationship between visceral adipose tissue and glycolipid metabolism in different menopausal period women

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