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目的评价内脏脂肪厚度(VAT)和心外膜脂肪组织厚度(EAT)对代谢综合征(MS)的诊断预测价值。方法对210例符合入选标准的健康体检对象进行腰围、空腹血生化测定并用超声测量VAT、EAT。根据国际糖尿病联盟MS标准,分为MS组和非MS组,用SPSS12.0软件进行比较分析。结果男女VAT在MS组均高于非MS组(P<0.01),而EAT在男性MS组高于非MS组(P<0.05),女性则两组之间无显著差异;无论男女VAT和EAT均和腰围成正相关。经年龄、性别、腰围调整后,VAT和收缩压、舒张压、甘油三酯、载脂蛋白B、空腹胰岛素、胰岛素抵抗指数成正相关,和胰岛素敏感指数成负相关;EAT和空腹胰岛素、胰岛素抵抗指数成正相关,和胰岛素敏感指数成负相关。经超声测量的VAT、EAT诊断MS的ROC曲线下面积分别为男性为0.74、0.73,女性为0.79、0.63,诊断切点值分别为男性为43.5mm、5.53mm,女性为23.8mm、7.95mm。两种方法ROC曲线下面积比较,无论男女均无显著差异。结论由超声测量的VAT、EAT均可作为内脏型肥胖简便、可靠和实用的评价指标,和MS关系密切,可作为MS患者无创的协同诊断方法之一。
Objective To evaluate the predictive value of visceral fat thickness (VAT) and epicardial fat tissue thickness (EAT) in the diagnosis of metabolic syndrome (MS). Methods A total of 210 healthy subjects who met the inclusion criteria were measured for waist circumference, fasting blood biochemistry and ultrasonography for VAT and EAT. According to the International Diabetes Federation MS standards, divided into MS group and non-MS group, SPSS12.0 software for comparative analysis. Results Both male and female VAT were higher in MS group than in non-MS group (P <0.01), but EAT was higher in male MS group than in non-MS group (P <0.05), while female was not significantly different between two groups Are and waist circumference are positively correlated. VAT and systolic blood pressure, diastolic blood pressure, triglyceride, apolipoprotein B, fasting insulin and insulin resistance index were positively correlated with age, sex and waist circumference, and negatively correlated with insulin sensitivity index. EAT and fasting insulin and insulin resistance The index is positively correlated and negatively correlated with the insulin sensitivity index. The areas under the ROC curves of VAT and EAT diagnosed by ultrasound were 0.74 and 0.73 for males and 0.79 and 0.63 for females respectively. The diagnostic cut-off values were 43.5 mm and 5.53 mm respectively for males and 23.8 mm and 7.95 mm for females. The area under the ROC curve of the two methods, no significant difference between men and women. Conclusion Both VAT and EAT measured by ultrasound can be used as a simple, reliable and practical evaluation index for visceral obesity and have close relationship with MS, which can be used as a noninvasive collaborative diagnostic method for MS patients.