成年人脂质蓄积指数、内脏脂肪指数与超敏C反应蛋白的相关性研究

摘要

目的 探讨成年人脂质蓄积指数(LAP)、内脏脂肪指数(VAI)与超敏C反应蛋白(hs-CRP)的相关性,并研究LAP、VAI与hs-CRP之间的相关性是否优于体重指数(BMI)、腰围(WC)、腰臀比(WHR)等常用体脂指标与hs-CRP的相关性.方法 采用横断面研究,选取重庆市城市社区501例成年人,其中男321例,女180例,检测身高、体重、WC、臀围(HC)、血压、血糖、空腹胰岛素(Fins)、血脂谱、hs-CRP等,计算BMI、WHR、稳态模型评价胰岛素抵抗指数(HOMA-IR)、LAP、VAI等,并探讨hs-CRP与各变量之间的相关性.结果 根据hs-CRP浓度将研究对象按三分位分组,随着hs-CRP浓度升高,受试者的年龄、BMI、WC、WHR、血压、血糖、Fins、HOMA-IR、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白B(ApoB)、LAP、VAI均显著升高(p＜0.05),而高密度脂蛋白胆固醇(HDL-C)、载脂蛋白A1(ApoA1)显著下降(P＜0.0001).Pearson相关分析显示,hs-CRP与TC、LDL-C无明显相关,与HDL-C、ApoA1呈显著负相关(P＜0.0001),而与其余变量均呈显著正相关(P＜0.01).以hs-CRP为应变量行多元线性逐步回归分析显示,仅WC进入回归方程,提示WC为hs-CRP的主要影响因素.结论 LAP、VAI在成年人中与BMI、WC、WHR等临床常用体脂指标一样与hs-CRP存在相关性,但WC仍是hs-CRP的主要影响因素,是炎症反应的独立预测因子.%Objective To investigate the correlation between lipid accumulation product (LAP), visceral adiposity index (VAI) and high-sensitivity C-reactive protein (hs-CRP) in adults, and explore whether to use such correlation as indications is superior to the traditional body fat index based on body mass index (BMI), waist circumference (WC), waist-hip ratio (WHR) and waist-height ratio (WHtR). Methods The present work was a cross-sectional study involving 501 healthy adults (321 males and 180 females) from the community of Chongqing Municipality. Anthropometric indexes [height, weight, WC, hip circumference (HC)], blood pressure (BP), fasting lipid profile and levels of fasting and post-load glucose, insulin and hs-CRP were measured, and BMI, WHR, WHtR, fasting insulin resistant homeostasis model assessment (HOMA-IR), LAP and VAI were calculated. The correlations between hs-CRP and other variables were analyzed. Results Following the elevation of titer of the hs-CRP, LAP, VAI, BMI, WC, WHR, WHtR, BP, glucose level, HOMA-IR, insulin, triglyceride (TG), low-density lipoprotein cholesterol (LDL-C) and apolipoprotein B (ApoB) increased (P<0.05), while high-density lipoprotein cholesterol (HDL-C) and apolipoprotein A, (ApoA1) levels declined (P<0.000l). Pearson's correlation analysis demonstrated that hs-CRP was correlated with all variances (P<0.0) except for total cholesterol (TC) (P=0.18l) and LDL-C (P=0.325). According to forward stepwise multiple regression analysis with hs-CRP as the dependent variance, WC was the only variance entering the regression model. Conclusion LAP, VAI levels are correlated with hs-CRP level but not the major determinant factors of hs-CRP. WC is stronger than other variances in the association with hs-CRP in adults, and is still an independent predictor of inflammation.