腹部脂肪分布与2 型糖尿病合并肥胖患者胰岛素抵抗 和骨密度的关系研究.

Objective: To investigate the correlation between abdominal fat distribution and insulin resistance and bone mineral density in type 2 diabetic patients with obesity. Methods: 159 obese patients with type 2 diabetes (observation group) who were admitted to the department of endocrinology and metabolism, affiliated hospital of Qingdao university from February 2017 to July 2019 and 100 cases of simple obesity with normal oral glucose tolerance test (OGTT) (control group) at the same time were selected as study subjects. The visceral fat area (VFA), itra-abdominal fat volume (IAFV) and total abdominal fat volume (TAV) were obtained by multi-slice spiral CT (MSCT), the ratio of IAFV to TAV was calculated. Blood lipid, fasting plasma glucose (FPG) and fasting insulin (FINS) were measured by automatic biochemical analyzer, the insulin resistance index (HOMA-IR) was calculated. The lumbar bone mineral density, femoral bone mineral density, hip bone mineral density were measured by bone mineral density instrument, The correlation between VFA, IAFV, TAV, IAFV/TAV and insulin resistance and bone mineral density was analyzed. Results: VFA, IAFV, IAFV/TAV, FPG, HOMA-IR, FINS, total cholesterol (TC), triglycerides (TG) and low density lipoprotein cholesterol (LDL-C) in the observation group were higher than those in the control group (P<0.05), while High density lipoprotein cholesterol(HDL-C), lumbar vertebral bone mineral density, femoral bone mineral density and hip bone mineral density in the observation group were lower than those in the control group (P<0.05). There was no significant difference between TAV and control group (P>0.05). Pearson analysis showed that VFA, IAFV, IAFV/TAV were positively correlated with FPG, homa-ir, FINS, TC, TG and LDL-C (P<0.05), and they were negatively correlated with lumbar spine bone density, femu bone density, hip bone density and HDL-C (P<0.05). Partial correlation analysis showed that VFA, IAFV, IAFV/TAV were positively correlated with HOMA-IR (P<0.05), and they were negatively correlated with bone mineral density of lumbar spine, femur and hip (P<0.05). Conclusion: The abnormal accumulation of abdominal fat has a significant correlation with insulin resistance and bone mineral density in type 2 diabetic patients with obesity. The risk of insulin resistance and osteoporosis in type 2 diabetic patients with obesity can be estimated by detecting the distribution of abdominal fat. [ABSTRACT FROM AUTHOR]