肠道主要产丁酸细菌与内脏脂肪和胰岛素抵抗的相关性CSCD

目的 探讨4种肠道主要产丁酸细菌与内脏脂肪和和胰岛素抵抗的关系,为后续研究提供参考。方法 应用实时荧光定量PCR检测胰岛素抵抗组(76例,HOMA-IR≥2.68)和健康对照组(273例,HOMAIR<2.68)对象4种肠道主要产丁酸细菌的丰度变化。采用生物电阻抗法测量所有研究对象的内脏脂肪面积(visceral fat area,VFA)和体脂肪百分比(body fat percentage,BFP)。运用ROC曲线比较VFA和BFP对胰岛素抵抗的诊断价值。结果 VFA的ROC曲线下面积(0.751)显著高于BFP(0.647)。胰岛素抵抗组和健康对照组对象肠道4种产丁酸细菌的丰度差异均无统计学意义(均P>0.05)。Spearman相关分析显示普拉梭菌(R=-0.106,P<0.05)和柔嫩梭菌(R=-0.115,P<0.05)与HOMA-IR呈负相关。VFA与普拉梭菌呈负相关(R=-0.105,P<0.05),BFP与普拉梭菌和柔嫩梭菌均无显著相关性。调整BMI和年龄因素后,回归分析显示普拉梭菌与甘油三酯和空腹血糖独立相关,柔嫩梭菌与尿酸独立相关。结论 VFA对胰岛素抵抗的诊断价值比BFP高。普拉梭菌和柔嫩梭菌与胰岛素抵抗存在相关性,且普拉梭菌与内脏脂肪相关。     

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

目的:探讨腹部脂肪分布与2型糖尿病合并肥胖患者胰岛素抵抗和骨密度的相关性。方法:选择2017年2月至2019年7月青岛大学附属医院内分泌与代谢病科收治的159例肥胖合并2型糖尿病患者(观察组)和同期100例单纯性肥胖且口服葡萄糖糖耐量试验(OGTT)正常者(对照组)。采用多层螺旋CT(MSCT)测量腹腔内脂肪面积(VFA)、腹内脂肪体积(IAFV)、全腹脂肪体积(TAV),并计算IAFV/TAV;采用全自动生化分析仪检测受试者血脂、空腹血糖(FPG)、空腹胰岛素(FINS)水平,并计算胰岛素抵抗指数(HOMA-IR);采用骨密度仪测量腰椎骨密度、股骨骨密度、髋骨骨密度。分析VFA、IAFV、TAV、IAFV/TAV与胰岛素抵抗和骨密度之间相关性。结果:观察组VFA、IAFV、IAFV/TAV、FPG、HOMA-IR、FINS、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)高于对照组(P0.05),高密度脂蛋白胆固醇(HDL-C)、腰椎骨密度、股骨骨密度、髋骨骨密度低于对照组(P0.05),TAV与对照组比较差异无统计学意义(P0.05)。Pearson相关分析结果示VFA、IAFV、IAFV/TAV与FPG、HOMA-IR、FINS、TC、TG、LDL-C呈正相关(P0.05),与腰椎、股骨、髋骨骨密度、HDL-C呈负相关(P0.05),偏相关分析结果显示,VFA、IAFV、IAFV/TAV与HOMA-IR呈正相关(P0.05),与腰椎、股骨、髋骨骨密度呈负相关(P0.05)。结论:腹内脂肪异常堆积与2型糖尿病合并肥胖患者胰岛素抵抗和骨密度具有显著相关性,临床可通过检测腹内脂肪分布情况预估2型糖尿病合并肥胖患者发生胰岛素抵抗和骨质疏松的风险。     

2型糖尿病内脏脂肪含量与胰岛β细胞功能及胰岛素抵抗的关系研究

目的:研究2型糖尿病患者内脏脂肪含量与胰岛β细胞功能及胰岛素抵抗的关系。方法:对65例初诊2型糖尿病患者采用256 CT平脐经L4、5水平进行扫描并测量皮下及内脏脂肪含量,并以BMI不同进行分组,即体重正常组、超重组、肥胖组。采用稳态模式评估法(HOMA)计算胰岛素抵抗指数、胰岛B细胞分泌功能,测量入组患者的相关人体指标、空腹血生化检查指标。结果:超体重组、肥胖组患者腰围、体重指数(body mass index, BMI)、甘油三酯(triglyceride, TG)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol, LDL-C)、空腹血糖,(fasting blood-glucose, FBG)、空腹胰岛素(fasting insulin, FINS)INS、稳态模型胰岛素抵抗指数(Homeostatic Model Assessment for Insulin Resistance, HOMA-IR)、胰岛β细胞功能指数(Homeostasis model assessment-β,HOMA-β)指标肥胖组、超重组均明显高于正常体重组(P0.05),超体重组、肥胖组内脏脂肪含量、内脏脂肪面积、皮下脂肪含量、脂肪总含量、脂肪百分比,超重组、肥胖组均明显高于正常体重组(P0.05),且肥胖组各项指标明显高于超重组(P0.05)。多元回归分析显示腹部脂肪总含量、内脏脂肪含量、皮下脂肪含量、内脏脂肪面积、BMI与胰岛素抵抗呈正相关,而其中内脏脂肪含量及面积关系最密切。结论:内脏脂肪含量是2型糖尿病胰岛素抵抗及B细胞功能变化的独立影响因素。     

用18F-FDG观察脂肪肝患者肝脏葡萄糖摄取变化

目的:通过PET/CT检查观察脂肪肝患者肝脏及其他组织对18F脱氧葡萄糖(18F-FDG)摄入变化,探讨脂肪肝与糖脂代谢的相关性.方法:36例做PET/CT的健康和2型糖尿病男性患者,分为对照组(n=18例);脂肪肝组(n=9例):糖尿病脂肪肝组(n=9例).常规测血糖、血脂及肝肾功能.PET/CT测肝脏CT值和肝脏、肾皮质,骨骼肌组织18F-FDG的最大标准摄入值(SUVmax)及平均标准摄入值(SUVmean).结果:1.糖尿病脂肪肝组的TG显著高于单纯脂肪肝组和正常对照组,P=0.0003,0.0000.单纯脂肪肝组的TG亦显著高于正常对照组,P=0.028.2.糖尿病脂肪肝组的肝脏18F-FDG的SUVmean和SUVmax显著高于正常对照组的SUVmean和SUVmax,P=0.0054,0.0133.单纯脂肪肝组的肝脏SUVmean和SUVmax亦高于正常对照组,但比较无统计学差异.脑皮质、肾皮质和骨骼肌组织的18FDG的SUVmean和SUVmax三组间比较无显著性差异.3.Spearman相关性分析发现FBG与TG显著正相关(r=0.59919,P=0.0004);FBG和TG与肝脏的CT值显著负相关(r=-0.55625,P=0.0004;r=-0.45739,P=0.0097).结论:脂肪肝与空腹血糖和甘油三酯升高显著相关.脂肪肝及2型糖尿病脂肪肝患者肝脏对葡萄糖摄取增高.     

维吾尔族新发2型糖尿病患者肠道 乳杆菌属和多形拟杆菌的定量研究

目的定量研究维吾尔族新发2型糖尿病(T2DM)患者和糖耐量正常(NGT)人群肠道中乳杆菌属(Lactobacillus genus)和多形拟杆菌(Bacteroides thetaiotaomicron)的相对水平。方法严格按照纳入标准、排除标准收集维吾尔族新发T2DM患者96例,NGT 98例。提取所有研究对象的粪便细菌总DNA后,采用16SrDNA基因实时荧光定量PCR(Real-time PCR)对乳杆菌属和多形拟杆菌的水平进行定量检测;运用Pearson相关性分析乳杆菌属与研究对象的BMI、腰围、臀围、收缩压(SBP)、舒张压(DBP)、空腹血糖(FBG)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白(HDL-C)和低密度脂蛋白(LDL-C)的相关性。结果 16SrDNA基因Real-time PCR结果显示:(1)与新疆维吾尔族NGT组相比,乳杆菌属水平在新发T2DM中较低,差异有统计学意义(t=8.557,P=0.000)。但是多形拟杆菌在两组差异无统计学意义(t=0.524,P=0.601);(2)新疆维吾尔族上述人群肠道中乳杆菌属水平与FBG呈负相关(r=-0.334,P=0.000),腰围呈负相关(r=-0.170,P=0.018),TC呈负相关(r=-0.178,P=0.013),TG呈负相关(r=-0.157,P=0.030),收缩压呈负相关(r=-0.255,P=0.000)。结论 Lactobacillus genus水平在肠道中降低可能与2型糖尿病的发病,血糖和血脂代谢有关,其机制需进一步研究探讨。     

用~（18）F-FDG观察脂肪肝患者肝脏葡萄糖摄取变化

目的：通过PET/CT检查观察脂肪肝患者肝脏及其他组织对18F脱氧葡萄糖（18F-FDG）摄入变化,探讨脂肪肝与糖脂代谢的相关性。方法：36例做PET/CT的健康和2型糖尿病男性患者,分为对照组（n=18例）;脂肪肝组（n=9例）;糖尿病脂肪肝组（n=9例）。常规测血糖、血脂及肝肾功能。PET/CT测肝脏CT值和肝脏、肾皮质,骨骼肌组织18F-FDG的最大标准摄入值（SUVmax）及平均标准摄入值（SUVmean）。结果：1.糖尿病脂肪肝组的TG显著高于单纯脂肪肝组和正常对照组,P=0.0003,0.0000。单纯脂肪肝组的TG亦显著高于正常对照组,P=0.028。2.糖尿病脂肪肝组的肝脏18F-FDG的SUVmean和SUVmax显著高于正常对照组的SUVmean和SUVmax,P=0.0054,0.0133。单纯脂肪肝组的肝脏SUVmean和SUVmax亦高于正常对照组,但比较无统计学差异。脑皮质、肾皮质和骨骼肌组织的18F-FDG的SUVmean和SUVmax三组间比较无显著性差异。3.Spearman相关性分析发现FBG与TG显著正相关（r=0.59919,P=0.0004）;FBG和TG与肝脏的CT值显著负相关（r=-0．55625,P=0．0004;r=-0．45739,P=0．0097）。结论：脂肪肝与空腹血糖和甘油三酯升高显著相关。脂肪肝及2型糖尿病脂肪肝患者肝脏对葡萄糖摄取增高。     

血清γ-谷氨酰转移酶与冠心病影响因素及血管病变严重程度的相关性研究

目的:探究血清γ-谷氨酰转移酶(GGT)水平与冠心病影响因素及患者血管病变严重程度之间的相关性。方法:选取2013年7月至2017年10月于我院经冠状动脉造影确诊为冠心病的61例患者为实验组,将其按照临床症状分为稳定性心绞痛组(下简称A组,20例)、不稳定性心绞痛组(下简称B组,21例)和急性心肌梗死组(下简称C组,20例),另选取同期于我院进行冠脉造影检查确诊为非冠心病的30例患者为对照组,检测和比较四组患者的空腹血糖(FBG)、总胆固醇(TC)、甘油三酯(TG)、收缩压(SBP)、舒张压(DBP)、尿酸等水平,而分析GGT与危险因素、冠脉Gensini评分的相关性。结果:(1)实验组患者血清FBG、TC、TG、SBP、DBP、尿酸水平均高于对照组患者,差异具有统计学意义(P0.05);(2)GGT水平与冠心病上述危险因素呈正相关性(r=0.236、0.351、0.316、0.239、0.301、0.395,P=0.035、0.000、0.000、0.034、0.001、0.000);(3)四组患者GGT及Gensini评分均按照C组B组A组对照组的趋势变化,且各组间对比差异具有统计学意义(P0.05);(4)冠心病患者血清GGT水平与Gensini评分呈正相关性(r=0.681,P=0.000)。结论:冠心病患者血清GGT水平与血清FBG、TC、TG、SBP、DBP、尿酸水平及血管病变的严重程度均呈显著正相关,其可能作为预测冠心病患者病变程度的参考指标。     

预防性小剂量葡甘聚糖对SD大鼠摄食量及体脂和血脂血糖影响的研究

目的：研究预防性应用小剂量葡甘聚糖对摄食量、体脂、血脂、血糖的影响。方法：将雄性SD大鼠按体重分层随机分为2组（正常对照组和葡甘聚糖组），每组13只，均喂饲普通饲料。实验阶段记录各组进食量并监测体重，连续喂养12周后空腹处死，测定空腹血糖（FBG）、甘油三酯（TG）、血清总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）。对腹部脂肪（腹后壁脂肪、肠系膜脂肪、肾周脂肪及精索部脂肪）进行称重。截取食管下端至肛门的肠段，摘除肠系膜脂肪后称重肠道重量，并计算SD大鼠去除肠道后体重和净体重。结果：葡甘聚糖组每日平均摄食量［（20.97±1.92）g］大于正常对照组［（20.24±2.38）g］，差异具有统计学意义（P=0.029＜0.05）。两组实验大鼠的每日平均体重、空腹体重、肠道重量、腹内脂肪、去除肠道后体重以及净体重差异均无统计学意义（P＞0.05）。两组血液指标（FBG、TG、TC、LDL-C、HDL-C）差异均无统计学意义（P＞0.05）。结论：喂饲普通饲料过程中，预防性应用小剂量葡甘聚糖，可提高正常SD大鼠摄食量，但对其体重、腹部脂肪、血脂、血糖均无明显影响。     

新疆维、哈两民族粪样中奇异菌簇和产气柯林斯菌属水平与2型糖尿病的相关性研究

目的检测新疆维吾尔族、哈萨克族糖耐量正常人群及2型糖尿病患者粪便中奇异菌簇和产气柯林斯菌属的水平,分析奇异菌簇和产气柯林斯菌属与2型糖尿病的相关性。方法收集新疆维吾尔族、哈萨克族糖耐量正常人群及2型糖尿病患者血样和粪便样本,采用16S r DNA实时荧光定量PCR技术检测粪便样本中奇异菌簇和产气柯林斯菌属的水平;运用Pearson分析目标菌属水平与4组人群的空腹血糖(FBG)、年龄、身高、体重、体重指数(BMI)、腰围、胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDLC)、低密度脂蛋白胆固醇(LDL-C)的相关性。结果 (1)与哈萨克族糖耐量正常组比较,该民族T2DM组中奇异菌簇、产气柯林斯菌属水平均降低(P=0.012,P=0.024),两民族糖耐量正常组之间奇异菌簇、产气柯林斯菌属水平差异有统计学意义(P=0.025,P=0.007);(2)奇异菌簇水平与HDL-C(r=0.281,P=0.031)呈正相关,与体重(r=-0.514,P=0.000)、BMI(r=-0.400,P=0.002)、TC(r=-0.503,P=0.000)、LDL-C(r=-0.581,P=0.000)水平呈负相关;产气柯林斯菌属水平与HDL-C(r=0.550,P=0.000)水平呈正相关,与体重(r=-0.449,P=0.000)、BMI(r=-0.432,P=0.001)水平呈负相关。结论肠道中奇异菌簇和产气柯林斯菌属,可能与与新疆维吾尔族、哈萨克族2型糖尿病患者的脂代谢紊乱密切相关。     

老年糖尿病患者空腹血糖、糖化血红蛋白和血脂检测的临床研究

目的探讨老年糖尿病患者空腹血糖、糖化血红蛋白和血脂检测的意义和相关性。方法选择2013年1月至2013年12月我院慢病诊疗中心收治的老年糖尿病患者120例为观察组,同期100例健康体检老年人为对照组,比较两组人群空腹血糖、糖化血红蛋白和血脂等指标检测结果,对指标间相关性进行分析。结果观察组患者空腹血糖、糖化血红蛋白和血脂与对照组相比差异均有统计学意义(P0.001,P0.01)。观察组患者的FBG与TC、TG、LDL呈显著正相关(P0.01),与HDL呈负相关(P0.05);HbA1C与TC、TG、LDL呈显著正相关(P0.01),与HDL呈负相关(P0.05)。HbA1C与TC、TG、LDL和HDL的相关性优于FBG。结论老年糖尿病患者血糖和血脂密切相关,患者在监测血糖的同时也要注意监测血脂,积极降脂治疗,对预防和控制糖尿病及并发症有重要的临床意义。     

Subcutaneous fat accumulation shows a beneficial correlation with serum cholesterol in postmenopausal Japanese women

This study aimed to investigate whether accumulation of subcutaneous abdominal fat has a beneficial correlation with lipid metabolism in premenopausal and/or postmenopausal Japanese women. The study enrolled 146 premenopausal women, ranging in age from 19 to 54 years, and 82 postmeno-pausal women, ranging in age from 47 to 66 years. Fat distribution, including abdominal visceral fat area (VFA) and abdominal subcutaneous fat area (SFA), were measured in an outpatient clinic by magnetic resonance imaging. Homogeneity of the regression slopes for SFA to total cholesterol (P = 0.030), low-density lipoprotein cholesterol (P = 0.020), apolipoprotein B (apoB) (P = 0.001), and the ratio of apoB to apolipoprotein A-I (apoA-I) (P = 0.003) were not found between premenopausal and postmenopausal women, even after adjustment for both VFA and age. However, the regression slopes for VFA to all measured lipid parameters, as well as apolipoproteins, were homogeneous between the premenopausal and postmeno-pausal groups. Abdominal SFA in postmenopausal women correlated negatively with total cholesterol (P = 0.007), low-density lipoprotein cholesterol (P = 0.002), apoB (P < 0.001), and the ratio of apoB to apoA-I (P = 0.001), after adjustment for age and VFA, but this was not the case in premenopausal women. The mechanisms involved in the beneficial effects of subcutaneous fat accumulation in postmenopausal women remain obscure, but upregulated aromatase expression, derived from adipose tissue, may possibly improve lipid and apolipoprotein metabolism.     

Associations of smoking cessation with visceral fat area and prevalence of metabolic syndrome in men: the Hitachi health study

Weight gain after smoking cessation may deteriorate metabolic risk profiles, including that for metabolic syndrome. How risk profiles change according to the duration of smoking cessation and whether the visceral fat area (VFA) or the subcutaneous fat area (SFA) contributes to these changes remains uncertain. The subjects comprised 5,697 Japanese men who underwent an abdominal computed-tomography examination during a health check-up. Using never smokers as a reference group, the odds ratios of having metabolic syndrome and its components, defined using the National Cholesterol Education Program Adult Treatment Panel IIIcriteria, were calculated for each smoking category with adjustments for age, alcohol drinking, and physical activity (model 1) using a logistic regression analysis. Additional adjustments were also made for either VFA (model 2) or SFA (model 3). Current smokers had the lowest VFA (120.4 cm2) whereas ex-smokers (124.0-132.0 cm2) had a higher VFA than nonsmokers (123.1 cm2). Among the ex-smokers, VFA tended to decrease with increasing years of smoking cessation. In model 1, the odds ratios of having metabolic syndrome for current smokers and ex-smokers with smoking cessation for ≤ 4, 5-9, 10-14, and ≥ 15 years were 1.02, 1.33, 1.36, 1.40, and 1.09, respectively. The elevated odds ratios among ex-smokers (≤ 14 years) were reduced by 35-55.6% after further adjustment for VFA but not for SFA. Smoking cessation is associated with a deterioration of the metabolic risk profile, which can be ascribed, at least in part, to an increase in VFA not SFA.     

Visceral fat accumulation determines postprandial lipemic response,lipid peroxidation,DNA damage,and endothelial dysfunction in nonobese Korean men

Visceral fat has been associated with multiple cardiovascular disease (CVD) risk factors. The aim of this study was to identify anthropometrical measures most closely associated with some well-known CVD risk factors. Because most Asians at risk have normal body mass index (BMI) according to Western standards, we studied healthy nonobese Korean males (n = 102; age: 36.5 +/- 0.8 years, BMI: 23.8 +/- 0.2 kg/m2). Visceral fat area (VFA) at the fourth lumbar vertebra was associated with increased postprandial triglyceride (TG) response (r = 0.53, P < 0.001) and with plasma malondialdehyde (MDA) (r = 0.36, P < 0.01) and PGF2alpha (r = 0.24, P < 0.05). When matched for BMI and age, men with high VFA (HVFA) (>/=100 cm2; n = 27) had higher blood pressure (P < 0.01), increased consumption of cigarettes (P < 0.01), and lower ratio of energy expenditure to calorie intake (P < 0.01) as compared with low VFA men (<100 cm2; n = 27). Men with HVFA showed higher TG, glucose, and insulin responses following fat and oral glucose tolerance tests respectively higher plasma concentrations of MDA (P < 0.001), urinary PGF2alpha (P < 0.05), and lymphocytes deoxyribonucleic acid tail moments (P < 0.01). Conversely, HVFA was associated with lower testosterone, insulin-like growth factor-1, and brachial artery flow-mediated dilation (P < 0.001). In conclusion, our data indicate that visceral fat accumulation, even in nonobese men, is a major factor contributing to increased CVD risk.     

Visceral fat area cutoff for the detection of multiple risk factors of metabolic syndrome in Japanese: the Hitachi Health Study

The relationships between metabolic risk factors and abdominal fat distribution determined using computed tomography (CT) are poorly defined in large populations. We investigated the cutoff values of the visceral fat area (VFA) to detect subjects with multiple risk factors of metabolic syndrome (MS) by sex and age groups, and attempted to examine whether sex- and age-specific cutoff values are needed. The subjects of this study were 11,561 Japanese men and women who participated in the Hitachi Health Study, received CT examination, and answered questionnaires on lifestyles between 2004 and 2009. VFA and waist circumference were measured using CT. The VFA cutoff values yielding an 80% sensitivity for the detection of multiple risk factors of MS were typically smaller among men under the age of 40 years (<40 years vs. ≥40 years; 86.4 cm(2) vs. 103.9 cm(2)). The area under the receiver operator characteristic curve of VFA for the detection tended to decrease according to age (P = 0.056 and P = 0.020 for trends in men and women). Age- and sex-specific cutoff values are needed. The sensitivity of the subjects under the age of 40 years is relatively smaller (70.0% for men and 60.0% for women) compare to other age groups when the same cutoff value is used regardless of age (e.g., cutoff value calculated to correspond to 80% sensitivity for subjects of all ages). Therefore, a smaller VFA cutoff point should be used among men under the age of 40 years.     

Implications of Pericardial,Visceral and Subcutaneous Adipose Tissue on Vascular Inflammation Measured Using 18FDG-PET/CT

Objective

Pericardial adipose tissue (PAT) is associated with adverse cardiometabolic risk factors and cardiovascular disease (CVD). However, the relative implications of PAT, abdominal visceral and subcutaneous adipose tissue on vascular inflammation have not been explored.

Method and Results

We compared the association of PAT, abdominal visceral fat area (VFA), and subcutaneous fat area (SFA) with vascular inflammation, represented as the target-to-background ratio (TBR), the blood-normalized standardized uptake value measured using ¹⁸F-Fluorodeoxyglucose Positron Emission Tomography (¹⁸FDG-PET) in 93 men and women without diabetes or CVD. Age- and sex-adjusted correlation analysis showed that PAT, VFA, and SFA were positively associated with most cardiometabolic risk factors, including systolic blood pressure, LDL-cholesterol, triglycerides, glucose, insulin resistance and high sensitive C-reactive proteins (hsCRP), whereas they were negatively associated with HDL-cholesterol. In particular, the maximum TBR (maxTBR) values were positively correlated with PAT and VFA (r = 0.48 and r = 0.45, respectively; both P <0.001), whereas SFA showed a relatively weak positive relationship with maxTBR level (r = 0.31, P = 0.003).

Conclusion

This study demonstrated that both PAT and VFA are significantly and similarly associated with vascular inflammation and various cardiometabolic risk profiles.     

Intraperitoneal Fat and Insulin Resistance in Obese Adolescents

Obesity is epidemic among adolescents in the United States. We sought to analyze the anthropometric measures of adiposity and fasting indices of insulin resistance, including insulin‐like growth factor–binding protein‐1 (IGFBP‐1), and to provide a clinical estimate of intraperitoneal (IP) fat in obese adolescents (BMI ≥95th percentile), between ages 13 and 17 years. Subjects had baseline testing to determine eligibility for a subsequent randomized, placebo‐controlled trial of metformin XR therapy. Anthropometry and dual‐energy X‐ray absorptiometry (DXA) were used to quantify total body fat while abdominal computed tomography (CT) was used to measure IP (CT‐IP) and subcutaneous (CT‐SQ) fat. Using anthropometry and fasting laboratory data, we constructed regression models for both CT‐IP and CT‐SQ. A total of 92 subjects, 33 males, were evaluated. Of the 92 subjects, 19 were black. Fasting insulin concentrations were highly associated with other measures of insulin resistance. Median percent body fat across all subjects, as measured by DXA, was 41%. Using CT measures, 67% of abdominal cross‐sectional area was fat, 14% of which was IP fat. In multiple regression analysis, waist circumference (WC) and BMI, jointly and independently, were strongly associated with both CT‐IP and CT‐SQ fat. BMI and WC explained 62% of variance of CT‐SQ fat, but only 26% of variance of CT‐IP fat. Adding triglyceride:high‐density lipoprotein (TG:HDL) ratio and IGFBP‐1 (among nonblacks) to the regression model increased the explained variance for estimating CT‐IP fat to 45%. When evaluating the metabolic morbidity of an obese adolescent, a model using fasting IGFBP‐1, TG:HDL, BMI, and WC may be worthwhile as an estimate of IP fat.     

住院老年人骨骼肌质量指数与TG/HDL-C的相关性研究

摘要 目的：分析住院老年人骨骼肌质量指数（ASMI）与甘油三酯与高密度脂蛋白胆固醇比值（TG/HDL-C）的相关性,评估TG/HDL-C对老年住院患者发生低ASMI的预测价值。方法：选取2022年7月至2023年8月兰州大学第一医院收治的299例住院老年患者,根据2019年亚洲肌少症工作组发布的关于肌少症的诊疗共识,分为低ASMI组（105例）和正常ASMI组（194例）。比较2组的临床资料,通过Spearman相关分析研究ASMI与相关变量之间的相关性,通过多因素Logistic回归分析ASMI的影响因素,采用受试者工作特征（ROC）曲线评估TG/HDL-C对老年住院患者发生低ASMI的预测价值。结果：随着ASMI的增加,TG/HDL-C比值增加（P＜0.001）。Spearman相关分析显示,ASMI与腰臀比、基础代谢、肌肉、握力、体脂率、BMI、ALT、TG、TG/HDL-C均成正相关（P＜0.05）,与HDL-C成负相关（P＜0.05）。 多因素分析显示：体脂率、尿酸、TG/HDL-C是ASMI的独立影响因素。ROC曲线显示,TG/HDL-C曲线下面积为0.67（95%CI：0.607~0.722）。结论：高TG/HDL-C是低ASMI的保护因素。TG/HDL-C对低ASMI的发生有一定的预测价值,通过简单易得的血脂指标来估计骨骼肌质量易于实现,对可疑早期肌少症患者进行监测与干预。     

Inverse Relationship between Serum Lipoxin A4 Level and the Risk of Metabolic Syndrome in a Middle-Aged Chinese Population

Metabolic syndrome (MetS) has been identified to be associated with a state of chronic, low-grade inflammation in adipose tissue. Lipoxins are endogenously generated from arachidonic acid, and exhibit anti-inflammatory actions. Currently, there is no available cohort study identifying the association between serum lipoxins level and MetS. Here we investigate the relationship between serum lipoxin A4 (LXA4) level and the risk of incident MetS in a middle-aged Chinese population. A total 624 participants aged 40–65 years were enrolled at baseline, with 417 (including 333 MetS absence) of them were followed up at 2.5 years. Abdominal visceral fat area (VFA) and abdominal subcutaneous fat area (SFA) were determined using MRI. Serum lipoxin A4 levels were measured by ELISA. At baseline, serum LXA4 levels were significantly correlated with a cluster of traditional MetS risk factors related to obesity (P≤0.05). A higher incidence of new Mets was found in the participants of the lowest tertile of LXA4 levels as compared with that in participants of the highest tertile (P = 0.025). Low serum LXA4 levels [OR 2.607(1.151–5.909), P = 0.022] and high VFA [OR 2.571(1.176–5.620), P = 0.018] were associated with an increased incident Mets, respectively, which remained statistically significant after adjustment for age, gender, current smoking, and alcohol drinking status. Logistic regression analysis suggested a combination of low serum LXA4 levels and high WC/VFA might optimize the prediction of incident Mets in middle-aged Chinese population [OR 4.897/4.967, P = 0.009/0.003]. Decrease in serum LXA4 level and increase in VFA are independent predictors of incident Mets in a population-based cohort, and a combination of them enhances the prognostic value of incident Mets. Taken together, our data suggest that serum LXA4 levels might be useful for early detection and prevention of Mets.