2022 年第 4 期 第 17 卷

西宁地区不同类型肥胖患者2型糖尿病患病情况分析

Analysis on the prevalence of type 2 diabetes mellitus in patients with different types of obesity in Xining 

作者：蒋艳苹罗玮姚勇利范培云王淑琼范晓霞宋康林丽君李亚楠谢延玲赵玲玲王贝贝党芳王静媛马文岩魏红

英文作者：Jiang Yanping Luo Wei Yao Yongli Fan Peiyun Wang Shuqiong Fan Xiaoxia Song Kang Lin Lijun Li Yanan Xie Yanling Zhao Lingling Wang Beibei Dang Fang Wang Jingyuan Ma Wenyan Wei Hong

单位：青海省人民医院内分泌Ⅱ病区，西宁810000

英文单位：Ⅱ Ward Department of Endocrine Qinghai Provincial People′s Hospital Xining 810000 China

关键词：2型糖尿病；肥胖；肥胖类型；患病率

英文关键词：Type2diabetesmellitus;Obesity;Typeofobesity;Prevalencet:minor-fareast;mso-hansi-font-family:Calibri;mso-hansi-theme-font:minor-latin'>′sHospital,Xining810000,China

• 摘要：

• 目的 探讨西宁地区不同类型肥胖患者2型糖尿病（T2DM）的患病情况。方法 选取2019年10月至2020年10月于青海省人民医院就诊的肥胖患者（体重指数≥28 kg/m2）420例作为肥胖组1，选取同期于青海省人民医院体检中心体检的210例作为体重指数正常对照组（体重指数＜24 kg/m2）。再将总体人群按照是否存在全身性肥胖和/或向心性肥胖分为非肥胖对照组（体重指数和腰围均正常，114例）和单纯全身性肥胖组（166例）、单纯向心性肥胖组（96例）、全身性肥胖合并向心性肥胖组（254例），后三者又合称肥胖组2。通过病史追踪及口服葡萄糖耐量试验，确定所有研究对象T2DM的患病情况；统计分析不同类型肥胖人群实验室指标和T2DM的患病情况及差异。结果 肥胖组1患者稳态模型胰岛素抵抗指数（HOMA-IR）、空腹血糖、餐后2 h血糖（2 hPG）、糖化血红蛋白（HbA1c）、低密度脂蛋白水平高于体重指数正常对照组，差异均有统计学意义（均P＜0.05）。HOMA-IR、空腹血糖、2 hPG、HbA1c水平在非肥胖对照组、单纯全身性肥胖组、单纯向心性肥胖组、全身性肥胖合并向心性肥胖组间依次增高，两两比较差异均有统计学意义（均P＜0.05）。肥胖组1 T2DM患病率明显高于体重指数正常对照组［20.5%（86/420）比13.3%（28/210）］（χ2=4.82，P=0.03）。肥胖组2 T2DM患病率明显高于非肥胖对照组［20.2%（104/516）比8.8%（10/114）］（χ2=7.94，P<0.01）。非肥胖对照组［8.8%（10/114）］、单纯全身性肥胖组［13.9%（23/166）］、单纯向心性肥胖组［18.8%（18/96）］、全身性肥胖合并向心性肥胖组［24.8%（63/254）］T2DM患病率逐渐升高，其中全身性肥胖合并向心性肥胖组与非肥胖对照组、单纯全身性肥胖组差异均有统计学意义（均P<0.05）。结论 体重指数达到肥胖标准人群T2DM的患病率明显高于体重指数正常人群，同时不同类型肥胖人群T2DM的患病率存在差异。

• Objective To investigate the prevalence of type 2 diabetes mellitus(T2DM) in patients with different types of obesity in Xining. Methods From October 2019 to October 2020, 420 patients with obesity［body mass index （BMI）≥28 kg/m2］ admitted to Qinghai Provincial People′s Hospital were selected as obesity group 1, and 210 people who underwent physical examination in the physical examination center of the hospital in the same period were selected as BMI normal control group(BMI <24 kg/m2). The whole population was divided into non obesity control group(114 cases with normal BMI and waist circumference), simple systemic obesity group(166 cases), simple centripetal obesity group(96 cases) and systemic obesity combined with centripetal obesity group(254 cases); the latter three were also known as obesity group 2. The prevalence of T2DM was determined by history tracking and oral glucose tolerance test; the laboratory indexes, prevalence of T2DM and those differences among different types of obesity people were statistically analyzed. Results The levels of Homa model insulin resistance index(HOMA-IR), fasting blood glucose, 2 h postprandial blood glucose(2 hPG), glycosylated hemoglobin(HbA1c) and low-density lipoprotein in the obesity group 1 were significantly higher than those in the BMI normal control group(all P<0.05). The levels of HOMA-IR, fasting blood glucose, 2 hPG and HbA1c increased successively among non obesity control group, simple systemic obesity group, simple centripetal obesity group and systemic obesity combined with centripetal obesity group; there were significant differences between any two groups(all P<0.05). The prevalence of T2DM in obesity group 1 was significantly higher than that in BMI normal control group［20.5%(86/420) vs 13.3%(28/210)］（χ2=4.82, P=0.03）. The prevalence of T2DM in obese group 2 was significantly higher than that in non obese control group［20.2%(104/516) vs 8.8%(10/114)］(χ2=7.94, P<0.01）. The prevalence of T2DM increased gradually in non obesity control group［8.8%（10/114）］, simple systemic obesity group［13.9%(23/166)］, simple centripetal obesity group［18.8%(18/96)］ and systemic obesity combined with centripetal obesity group［24.8%(63/254)］; there were significant differences between systemic obesity combined with centripetal obesity group and non obesity control group, simple systemic obesity group(all P<0.05). Conclusion The prevalence of T2DM in people with obesity is significantly higher than that in people with normal BMI, and there are differences in the prevalence of T2DM in people with different types of obesity.