文章摘要
钱蕾行,付真真,蒋琬姿,周红文,王晓东.利用高胰岛素⁃正葡萄糖钳夹技术评估腰高比与胰岛素抵抗的相关性[J].南京医科大学学报,2020,(6):858~862
利用高胰岛素⁃正葡萄糖钳夹技术评估腰高比与胰岛素抵抗的相关性
Assessing the correlation of waist⁃to⁃height ratio with insulin resistance by hyperinsulinemic⁃euglycemic clamp
投稿时间:2020-01-17  
DOI:10.7655/NYDXBNS20200615
中文关键词: 高胰岛素⁃正葡萄糖钳夹试验  胰岛素抵抗  腰高比
英文关键词: hyperinsulinemic⁃euglycemic clamp  insulin resistance  waist⁃to⁃height ratio
基金项目:国家重点研发计划专项(2018YFA0506904);国家自然科学基金(91854122,81670723)
作者单位
钱蕾行 南京医科大学第一附属医院内分泌科江苏 南京 210029 
付真真 南京医科大学第一附属医院内分泌科江苏 南京 210029 
蒋琬姿 南京医科大学第一附属医院内分泌科江苏 南京 210029 
周红文 南京医科大学第一附属医院内分泌科江苏 南京 210029 
王晓东 南京医科大学第一附属医院内分泌科江苏 南京 210029 
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中文摘要:
      目的:通过高胰岛素?正葡萄糖钳夹试验验证腰高比在评估胰岛素抵抗中的临床应用价值。方法:共纳入154例受试者,检测空腹血脂谱及其他重要生化指标。所有受试者均行高胰岛素?正葡萄糖钳夹试验,并计算葡萄糖代谢率、体重指数(body mass index,BMI)、腰围、腰臀比、腰高比及HOMA指数。比较各指数预测评估受试者胰岛素抵抗的能力。结果:相关分析结果显示,腰高比(r=-0.730,P < 0.001)、腰臀比(r=-0.651,P < 0.001)、BMI指数(r=-0.717,P < 0.001)、腰围(r=-0.716,P < 0.001)均与高胰岛素?正葡萄糖钳夹试验所得葡萄糖代谢率显著相关。以葡萄糖代谢率为标准绘制ROC曲线,不同指数曲线下面积为HOMA?IR(0.860)>腰高比(0.850)> BMI(0.846)>腰围(0.837)>腰臀比(0.749)。腰高比诊断胰岛素抵抗的最佳值为0.56,此值在ROC曲线中对应了最高的灵敏度(93.9%)和特异度(66.7%)。结论:腰高比与高胰岛素?正葡萄糖钳夹试验所得的葡萄糖代谢率有较好的相关性,相较于BMI、腰围、腰臀比等有较高的敏感度及特异度,是较好评估胰岛素抵抗的简易指数,可广泛应用于流行病学研究或大型临床试验。
英文摘要:
      Objective:This study aims to evaluate the clinical value of the anthropometric waist?to?height ratio(WHtR) through the hyperinsulinemic?euglycemic clamp. Methods:A total of 154 subjects was included in the study. Lipid profiles and other biochemical markers were measured from the fasting blood sample. All the patients underwent hyperinsulinemic?euglycemic clamp,and the glucose metabolic rate,body mass index(BMI),waist circumference(WC),waist?to?hip ratio(WHR),WHtR and HOMA index were calculated. The ability of each index to predict the assessment of insulin resistance was compared. Results:Correlation analysis showed that WHtR(r=-0.730,P < 0.001),WHR(r=-0.651,P < 0.001),BMI(r=-0.717,P < 0.001),WC(r=-0.716,P < 0.001)were all significantly correlated with the glucose metabolic rate obtained in the hyperinsulinemic?euglycemic clamp. The area under ROC curve was HOMA?IR(0.860)> WHtR(0.850)> BMI(0.846)> WC(0.837)> WHt(0.749). The best value of WHtR for the diagnosis of insulin resistance was 0.56,which showed the highest sensitivity(93.9%)and specificity(66.7%)in the ROC curve. Conclusion:WHtR has a significant correlation with the glucose metabolic rate obtained from the hyperinsulinemic?euglycemic clamp,and has a higher sensitivity and specificity than BMI,WC and WHR,suggesting that it could be widely used in epidemiological studies or some large?scale clinical trials.
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