Lipid accumulation product as an effective index for accessing insulin resistance in patients with adult growth hormone deficiency
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Lipid accumulation product as an effective index for accessing insulin resistance in patients with adult growth hormone deficiency
Journal of Chongqing Medical UniversityVol. 40, Issue 7, Pages: 975-980(2015)
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重庆医科大学附属第一医院内分泌科,重庆,400016
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Published:2015,
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Liu Chan, Xia Jiajia, Li Linman, et al. Lipid accumulation product as an effective index for accessing insulin resistance in patients with adult growth hormone deficiency. [J]. Journal of Chongqing Medical University 40(7):975-980(2015)
DOI:
Liu Chan, Xia Jiajia, Li Linman, et al. Lipid accumulation product as an effective index for accessing insulin resistance in patients with adult growth hormone deficiency. [J]. Journal of Chongqing Medical University 40(7):975-980(2015)DOI:
Lipid accumulation product as an effective index for accessing insulin resistance in patients with adult growth hormone deficiency
目的:探讨成人生长激素缺乏症(adult growth hormone deficiency,AGHD)患者脂质蓄积指数(lipid accumulation prod-uct,LAP)水平与人体测量学参数、糖脂代谢、胰岛素抵抗(insulin resistance,IR)之间的关系。方法:收集42例AGHD患者及42例健康人群,测量2组人群人体测量学参数及糖脂生化指标,计算体质指数(body mass index,BMI)、腰臀比(waist-hip ratio,WHR)、LAP、稳态模型评价胰岛素抵抗指数(homeostasis model assessment of insulin resistance,HOMA-IR)。结果:AGHD组人群LAP高于对照组人群,而且与对照组比较腰围(waist circumference,WC)、WHR、空腹胰岛素(fasting insulin,FINS)、HOMA-IR、甘油三酯(triglyceride,TG)升高,高密度脂蛋白(high density lipoprotein-cholesterol,HDL-C)降低(P<0.05)。根据AGHD人群LAP水平四分位数分组进行比较,体质量、BMI、WC、WHR、收缩压(systemic blood pressure,SBP)、舒张压(diastolic blood pressure,DBP)、FINS、HOMA-IR、TG随LAP增高而递增(P<0.05)。Pearson相关性分析显示,LAP与年龄、BMI、WC、臀围(hip circumfer-ence,HC)、WHR、SBP、DBP、FINS、HOMA-IR、TG、低密度脂蛋白胆固醇(low density lipoprotein-cholesterol,LDL-C)呈正相关(P<0.05);HOMA-IR与BMI、WC、TG呈正相关(P<0.05)。IR人群LAP明显增高,ROC曲线下面积分析,LAP 曲线下面积最大,LAP 的最佳界限值为31.32,有较高的灵敏度与特异度。进一步进行多元线性回归分析发现LAP与BMI、SBP、HOMA-IR独立相关(β=0.414,0.249,0.329,均P<0.05)。结论:AGHD患者LAP高于健康人群,与IR及血脂相关指标显著相关。与其他体脂指标相比,有较好的IR评价价值。
Abstract
Objective:To investigate the correlation of lipid accumulation product(LAP) with anthropometrics,glucolipid metabolic markers and insulin resistance(IR) in patients with adult growth hormone deficiency(AGHD). Methods:Totally 42 patients with AGHD and 42 control subjects matched with the age and gender were enrolled. The general anthropometries and blood biochemical indexes were measured. Body mass index(BMI),waist-hip ratio(WHR),LAP and HOMA-IR were calculated. Results:Compared with those in control group,the waist circumference(WC),WHR,fasting insulin(FINS),homeostasis model assessment of insulin resistance(HOMA-IR),triglyceride(TG) and LAP were increased in AGHD group,while high density lipoprotein-cholesterol(HDL-C) level was lower in AGHD group(P<0.05). Weight,BMI,WC,WHR,SBP,DBP,FINS,HOMA-IR and TG increased as LAP increased(P<0.05). Pearson analysis revealed that LAP was positively related with age,BMI,WC,HC,WHR,systemic blood pressure(SBP),dias-tolic blood pressure(DBP),FINS,HOMA-IR,TG and low density lipoprotein cholesterol(LDL-C)(P<0.05). After age was adjusted,the positive correlations were still existed(except DBP). In ad-dition,HOMA-IR was positively correlated with BMI,WC and TG(P<0.05). LAP was higher in AGHD patients with IR. ROC analysis showed that LAP was a significant discriminator for IR in AGHD patients,and the optimal cutoff point of LAP to pre-dict IR was 31.32(90.9% sensitivity,61.30% specificity). Fur-ther more,multivariable linear regression models revealed that BMI,SBP,HOMA-IR were independently related with the LAP(β=0.414,0.249,0.329,resp,P<0.05). Conclusion:The LAP is sig-nificantly higher in AGHD patients than control subjects. LAP is associated with IR and had a strong and reliable diagnostic accuracy for IR in AGHD patients.
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