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刘芊.脂质积累产物和内脏脂肪指数对2型糖尿病有预测价值[J].内科急危重症杂志,2026,32(1):52-56
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| DOI：10.11768/nkjwzzzz20260112 |
| 中文关键词: 脂质积累产物 内脏脂肪指数 2型糖尿病 筛查 |
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| 摘要点击次数: 71 |
| 全文下载次数: 60 |
| 中文摘要: |
| 摘要 目的：探讨脂质积累产物（LAP）和内脏脂肪指数（VAI）对2型糖尿病（T2DM）的预测价值。方法：纳入T2DM无视网膜病变患者为T2DM组，T2DM视网膜病变患者为阳性对照组，体检中心健康成人作为阴性对照组，检测受试者LAP和VAI，采用Pearson相关性分析LAP和VAI与T2DM的相关性。单因素及多因素Logistic回归分析比较3组空腹血糖（FPG）、空腹胰岛素（FINS）、糖化血红蛋白（HbA1c）、C反应蛋白（CRP）、同型半胱氨酸（Hcy）、腰围（WC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、体质指数（BMI）、总胆固醇（TC）、总胆红素(TBIL)、血肌酐（SCr）、颈动脉斑块、脂肪肝、降脂药物服用史等。采用受试者工作特征曲线（ROC)和曲线下面积(AUC)评估LAP、VAI、WC、BMI预测患T2DM的评估价值。结果：单因素Logistic回归分析显示，T2DM 组及 T2DM 视网膜病变组的 VAI(3.38±3.69，3.98±3.85 vs 2.90±2.18)和 LAP(36.12±42.01，34.93±31.65 vs 26.67±13.44)均显著高于健康成人组（P均<0.05），多因素Logistic回归发现LAP、VAI和FPG是T2DM的独立危险因素。LAP预测患者发生T2DM的ROC曲线的AUC为0.79，当在最佳截断点51.61处时，灵敏度为78%，特异性为80%； VAI对预测患者患T2DM的ROC曲线的AUC为0.80，在最佳截断点4.24处时，灵敏度为74%，特异性为80%。结论：LAP和VAI是发生T2DM的独立危险因素，且对发生T2DM的预测优于WC和BMI，其可能成为筛查T2DM高风险人群的新方法。 |
| 英文摘要: |
| Abstract Objective: To investigate the correlation and predictive value of lipid accumulation product (LAP) and visceral adiposity index (VAI) in type 2 diabetes mellitus (T2DM). Methods: Based on inclusion/exclusion criteria, healthy adults from the Health Examination Center of Gansu Provincial Hospital were enrolled as the negative control group, T2DM patients with retinopathy as the positive control group, and T2DM without retinopathy as the T2DM group. LAP and VAI were analyzed as exposure factors. Pearson correlation analysis was used to assess the correlation between exposures and outcomes. Univariate and multivariate logistic regression analyses were performed to compare other metabolic indicators potentially influencing the outcome. Receiver operating characteristic (ROC) curves and area under the curve (AUC) were employed to evaluate the predictive value of LAP, VAI, waist circumference (WC), and body mass index (BMI) for T2DM. Results: Univariate logistic regression revealed that VAI and LAP were positively associated with T2DM (P< 0.05). Multivariate logistic regression identified LAP, VAI, and fasting plasma glucose (FPG) as independent positive predictors of T2DM. However, LAP and VAI showed no significant association with diabetic retinopathy. The AUC of LAP for predicting T2DM was 0.79, with sensitivity of 78% and specificity of 80% at the optimal cutoff of 51.61. The AUC of VAI was 0.80, with sensitivity of 74% and specificity of 80% at the cutoff of 4.24. Conclusion: LAP and VAI are independent positive predictors of T2DM. Both indices demonstrated superior predictive value compared to WC and BMI, suggesting their potential as novel tools for large-scale screening of high-risk T2DM populations in general communities. |
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