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中心性肥胖与农村正常体重和超重中国女性糖尿病前期和胰岛素敏感性降低的相关性。

Association of central adiposity with prediabetes and decreased insulin sensitivity in rural Chinese normal-weight and overweight women.

机构信息

Mary Ann and J. Milburn Smith Child Health Research Program, Children's Memorial Hospital and Children's Memorial Research Cente, Chicago, IL 60614-3394, USA.

出版信息

Metabolism. 2010 Jul;59(7):1047-53. doi: 10.1016/j.metabol.2009.10.029. Epub 2010 Jan 4.

Abstract

This study investigated whether high central adiposity was associated with prediabetes and decreased insulin sensitivity (IS) in both normal-weight (body mass index [BMI] <23 kg/m(2)) and overweight (BMI >or=23 kg/m(2)) rural Chinese women. Adipose variables measured by dual-energy x-ray absorptiometry (percentage body fat, percentage lower-body fat [%LF], and percentage trunk fat [%TF]) and general adipose variables (BMI and waist circumference) were used for examining the association of adiposity with prediabetes among 4071 rural Chinese women aged 20 to 60 years. Furthermore, the association of adiposity with IS was tested in both normal- and overweight women with normal glucose tolerance. BMI was highly correlated with percentage body fat and waist circumference, but was weakly correlated with %LF and %TF. Both high %TF (top quartile of %TF) and low %LF (lower 3 quartiles of %LF) were associated with higher prevalence of prediabetes in both normal- and overweight women. Compared with normal-weight women in low %TF, the odds of prediabetes were similarly increased for women with high %TF regardless of whether they were overweight (odds ratio [95% confidence interval] = 1.6 [1.3-2.0]) or not (odds ratio [95% confidence interval] = 1.5 [1.2-2.0]). Similarly, among 3280 women with normal glucose tolerance, high %TF was associated with increased fasting insulin, 2-hour oral glucose tolerance test insulin, and homeostasis model assessment of insulin resistance regardless of weight status (normal or overweight). Among relatively lean, rural Chinese women, high %TF was associated with increased odds of prediabetes and lower IS regardless of weight status (normal or overweight).

摘要

本研究旨在探讨在中国农村,无论体重正常(BMI<23kg/m²)还是超重(BMI≥23kg/m²)的女性中,高中心性肥胖是否与糖尿病前期和胰岛素敏感性(IS)降低相关。通过双能 X 射线吸收仪(体脂百分比、下半身体脂百分比 [%LF]和躯干脂肪百分比 [%TF])和一般脂肪变量(BMI 和腰围)测量的脂肪变量用于检查脂肪量与 4071 名 20 至 60 岁农村中国女性中糖尿病前期的相关性。此外,在糖耐量正常的正常体重和超重女性中还测试了脂肪量与 IS 的相关性。BMI 与体脂百分比和腰围高度相关,与 %LF 和 %TF 弱相关。高 %TF(%TF 最高四分位)和低 %LF(%LF 较低的 3 个四分位)与正常体重和超重女性的糖尿病前期患病率均升高相关。与低 %TF 的正常体重女性相比,无论超重与否(比值比 [95%置信区间] = 1.6 [1.3-2.0]),高 %TF 的女性糖尿病前期的可能性都同样增加(比值比 [95%置信区间] = 1.5 [1.2-2.0])。同样,在 3280 名糖耐量正常的女性中,无论体重状况(正常或超重)如何,高 %TF 均与空腹胰岛素、2 小时口服葡萄糖耐量试验胰岛素和稳态模型评估的胰岛素抵抗增加相关。在中国农村相对较瘦的女性中,无论体重状况(正常或超重)如何,高 %TF 与糖尿病前期的几率增加和 IS 降低相关。

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