Association between sarcopenic obesity and type 2 diabetes, hypertension as well as dyslipidemia in overweight and obese adults
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摘要:目的 评估肌肉减少性肥胖(SO)在超重和肥胖成年人群中的流行程度及其与2型糖尿病(T2DM)、高血压和高脂血症的关系。方法 回顾性分析减重门诊的156例超重和肥胖成年患者以及46名年龄相仿的正常体质量者的临床资料，均进行人体测量学指标检测、生化指标测定，使用生物电阻抗分析仪进行人体成分检测评估。然后将超重和肥胖的患者分为SO组或非SO组，比较2组的一般情况、生化指标及人体成分。采用Logistic回归分析SO与T2DM、高血压和高脂血症的关系。结果 在156例超重/肥胖患者中，有23例(14.74%)符合SO的标准，其患T2DM、高血压及高脂血症的概率显著高于非SO患者。Logistic回归分析显示，相较于非SO患者, SO患者患T2DM、高血压、高脂血症的风险概率分别达344.20%、302.20%、515.60%, 在调整了年龄、性别构成、已婚与否及吸烟史后，风险概率仍有344.20%、298.30%、510.50%。结论 超重和肥胖人群中, SO与T2DM、高血压及高脂血症的发生有着密切联系，在这一人群中进行SO筛查是非常必要的。Abstract:Objective To assess the prevalence of sarcopenic obesity(SO) in overweight and obese adults and the its association with type 2 diabetes, hypertension, and dyslipidemia.Methods The clinical data of 156 overweight and obese adults and 46 normal-weight participants of similar age in our hospital were retrospectively analyzed. The measurements of anthropometry, blood biochemical metabolism, body composition assessment were performed. The overweight and obese patients were then divided into SO group or non-SO group. The general data of two groups were analyzed, and Logistic regression analysis was used to analyze the association between SO and type 2 diabetes, hypertension, dyslipidemia.Results Of 156 overweight or obese participants, 23(14.74%) met the criteria of SO, who had a higher incidence of type 2 diabetes, hypertension, and dyslipidemia than those without SO. Logistic regression analysis showed that ratios of type 2 diabetes, hypertension and dyslipidemia were 344.20%, 302.20% and 515.60%, respectively, in SO patients, when compared to those without SO. After adjusting for age, gender, marriage and smoking, the ratios were 344.20%, 298.30% and 510.50%, respectively.Conclusions SO seems to be strongly associated with type 2 diabetes, hypertension, and dyslipidemia. Therefore, it is clinically useful to screen SO in this population.
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Keywords:
- body composition /
- sarcopenic obesity /
- type 2 diabetes /
- hypertension /
- dyslipidemia
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表 1 超重/肥胖组患者与对照组的一般情况及生化指标比较(x±s)[n(%)][M(IQR)]
指标 超重/肥胖组(n=156) 对照组(n=46) t/Z/χ2 P 年龄/岁 37.73±11.67 40.30±10.36 -1.347 0.180 女性 46(29.49) 17(36.96) 0.924 0.367 已婚 115(73.72) 35(76.09) 0.104 0.849 吸烟史 83(53.21) 21(45.65) 0.811 0.404 T2DM 22(14.10) 3(6.52) 1.883 0.210 高血压 53(33.97) 12(26.09) 1.013 0.371 高脂血症 95(60.90) 24(52.17) 1.117 0.310 TG/(mmol/L) 1.75(1.21~2.63) 1.59(1.17~2.88) -0.449 0.653 CHOL/(mmol/L) 4.69±0.85 4.83±1.02 -0.969 0.334 FPG/(mmol/L) 5.40(5.05~5.95) 5.20(4.90~5.80) -1.202 0.229 T2DM: 2型糖尿病; TG: 甘油三酯; CHOL: 总胆固醇; FPG: 空腹血糖。 
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表 2 超重/肥胖患者中SO与非SO患者一般情况及生化指标比较(x±s)[n(%)][M(IQR)]
指标 SO组(n=23) 非SO组(n=133) t/Z/χ2 P 年龄/岁 37.91±10.60 37.70±11.89 0.081 0.936 女性 4(17.39) 42(31.58) 1.898 0.219 已婚 18(78.26) 97(72.93) 0.287 0.798 吸烟史 14(60.87) 69(51.88) 0.637 0.501 T2DM 7(30.43) 15(11.28) 5.940 0.023 高血压 13(56.52) 40(30.08) 6.114 0.018 高脂血症 20(86.96) 75(56.39) 7.693 0.005 TG/(mmol/L) 2.03(1.49~2.47) 1.68(1.19~2.73) -0.485 0.628 CHOL/(mmol/L) 4.90±0.79 4.65±0.86 1.290 0.199 FPG/(mmol/L) 5.40(5.15~7.45) 5.40(5.00~5.90) -1.136 0.256 SO: 肌肉减少性肥胖; T2DM: 2型糖尿病; TG: 甘油三酯; CHOL: 总胆固醇; FPG: 空腹血糖。
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表 3 超重/肥胖组患者与对照组观察对象的身体成分比较(x±s)[M(IQR)]
指标 超重/肥胖组(n=156) 对照组(n=46) t/Z/χ2 P BMI/(kg/m2) 28.95±3.95 22.57±0.98 18.331 < 0.001 WHR 0.94(0.91~0.98) 0.90(0.86~0.93) -5.672 < 0.001 TBW/L 40.66±7.45 33.83±5.54 5.770 < 0.001 BFM/kg 25.70(22.35~29.65) 16.90(14.60~18.80) -9.066 < 0.001 PBF/% 32.90±6.68 26.97±5.82 5.433 < 0.001 FFM/kg 55.40±10.20 46.02±7.54 5.783 < 0.001 FFM%/% 67.10±6.68 73.03±5.82 -5.433 < 0.001 VFA/cm2 116.45(93.75~147.40) 72.45(60.90~86.70) -7.992 < 0.001 ALM/kg 23.31±4.61 19.21±3.83 5.495 < 0.001 (ALM/BMI)/m2 0.81±0.15 0.85±0.17 -1.615 0.108 BMI: 体质量指数; WHR: 腰臀比; TBW: 身体总水分; BFM: 体脂肪; PBF: 体脂百分比; FFM: 去脂体质量; FFM%: 去脂体质量百分比; VFA: 内脏脂肪面积; ALM: 四肢瘦体质量。
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表 4 超重/肥胖患者中SO与非SO患者的身体成分比较(x±s)[M(IQR)]
指标 SO组(n=23) 非SO组(n=133) t/Z/χ2 P BMI/(kg/m2) 32.73±5.88 28.29±3.11 3.535 0.002 WHR 0.98(0.95~1.01) 0.94(0.91~0.97) -2.703 0.007 TBW/L 39.64±7.31 40.84±7.48 -0.713 0.477 BFM/kg 28.70(25.30~36.90) 25.40(22.00~29.20) -3.317 0.002 PBF/% 37.88±7.00 32.03±6.26 4.060 < 0.001 FFM/kg 53.83±9.94 55.67±10.26 -0.798 0.426 FFM%/% 62.12±7.00 67.97±6.26 -4.060 < 0.001 VFA/cm2 131.40(114.05~186.20) 113.40(92.60~142.40) -2.974 0.003 ALM/kg 22.45±4.52 23.46±4.63 -0.968 0.334 (ALM/BMI)/m2 0.69±0.11 0.83±0.15 -4.358 < 0.001 SO: 肌肉减少性肥胖; BMI: 体质量指数; WHR: 腰臀比; TBW: 身体总水分; BFM: 体脂肪; PBF: 体脂百分比; FFM: 去脂体质量; FFM%: 去脂体质量百分比; VFA: 内脏脂肪面积; ALM: 四肢瘦体质量。
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表 5 超重/肥胖患者中SO与代谢性疾病发生的Logistic回归分析
疾病 模型1 模型2 OR 95%CI P OR 95%CI P T2DM 3.442 1.219~9.718 0.020 3.442 1.219~9.718 0.020 高血压 3.022 1.224~7.463 0.016 2.983 1.194~7.451 0.019 高脂血症 5.156 1.461~18.193 0.011 5.105 1.426~18.153 0.012 SO: 肌肉减少性肥胖; T2DM: 2型糖尿病。
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