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目的:通过双源CT(DSCT)测量心外膜脂肪组织(epicardial adipose tissue,EAT)体积,探讨2型糖尿病(type 2 diabetes mellitus,T2DM)患者EAT体积/年龄比值与胰岛素抵抗(insulin resistance,IR)的相关性。方法:选取新入院T2DM患者73例,正常对照者(NC组)21例。记录患者性别、年龄、体重指数(BMI)、腰围(WC)、收缩压(SBP)、舒张压(DBP)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖(FSG)及胰岛素(FSI)水平,计算稳态模型胰岛素抵抗指数(HOMA-IR)。通过DSCT测量EAT体积和冠状动脉钙化积分(CACS),计算EAT体积/年龄比值。结果:T2MD组EAT体积/年龄比值、EAT体积、BMI、SBP、TC、LDL-C、HOMA-IR明显高于NC组,差异均有统计学意义(P<0.05),而T2MD组HDL-C低于NC组(P<0.05);EAT体积/年龄比值与HOMA-IR相关性(r=0.419,P<0.001),强于EAT体积、BMI、WC、TG、TC、LDL-C与HOMA-IR相关性(r值分别为0.405、0.027、0.309、0.204、0.289、0.206,P<0.05)。结论:EAT体积/年龄比值能够很好地反映IR的程度,可作为评估IR的指标。
OBJECTIVE: To measure the volume of epicardial adipose tissue (EAT) in patients with type 2 diabetes mellitus (T2DM) through double-source CT (DSCT) and to investigate the association between EAT volume / age ratio and insulin resistance (IR) ) Relevance. Methods: 73 cases of newly admitted T2DM patients and 21 cases of normal control group (NC group) were selected. Patients’ gender, age, body mass index (BMI), WC, SBP, DBP, TG, TC, C, LDL-C, FSG and FSI were calculated. The homeostasis model insulin resistance index (HOMA-IR) was calculated. EAT volume and coronary artery calcification scores (CACS) were measured by DSCT to calculate the EAT volume / age ratio. Results: The volume / age ratio of EAT, EAT volume, BMI, SBP, TC, LDL-C and HOMA-IR in T2MD group were significantly higher than those in NC group (P < (P <0.05). The correlation between EAT volume / age and HOMA-IR (r = 0.419, P <0.001) was stronger than that of NC group IR correlation (r values were 0.405,0.027,0.309,0.204,0.289,0.206, P <0.05). Conclusion: The volume / age ratio of EAT can well reflect the degree of IR, which can be used as an index to evaluate IR.