| 陈颖,徐军青,吴巧萍,等.BMI正常老年腹型肥胖人群脂代谢异常及中医辨证治疗的研究[J].浙江中医药大学学报,2020,44(5):467-471. |
| BMI正常老年腹型肥胖人群脂代谢异常及中医辨证治疗的研究 |
| Investigation on Lipid Metabolism and Chinese Medicine Treatments of Abdominal Obesity in Elders with Normal BMI |
| DOI：10.16466/j.issn1005-5509.2020.05.015 |
| 中文关键词: 腹型肥胖 内脏脂肪 身体质量指数 老年人群 人体成分分析 中医疗法 湿阻 痰饮 |
| 英文关键词: abdominal obesity visceral fat body mass index the elderly body composition analysis Chinese medicine therapy retention of dampness phlegm |
| 基金项目:浙江省医药卫生科技计划项目(2012KYB024) |
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| 中文摘要: |
| [目的]探讨身体质量指数 (Body Mass Index，BMI)正常的老年腹型肥胖人群人体成分及血脂水平的特点，为其中医辨证治疗及血脂管理提供参考。[方法]选择2018年10月至2019年6月于浙江省人民院健康促进中心体检的260例 BMI正常的老年人作为研究对象，根据腰臀比分为腹型肥胖组(n=140)和非腹型肥胖组(n=120)，纳入患者的年龄、身高、体重、人体成分数据、脂代谢相关指标等。腹型肥胖组均符合单纯性肥胖的胃热湿阻型、脾肾两虚型、肝郁气滞型、阴虚内热型和脾虚湿阻型 5 个证型。在排除BMI影响的基础上，探讨老年腹型肥胖人群人体成分、脂代谢的特点。[结果]超重肥胖老年人群因机体代谢功能衰退，脏腑功能失调，尤其是脾胃运化无力可致脂浊痰湿蓄积。中医体质学认为，个体体质的差异性决定个体对不同疾病的易感性。本研究发现，与BMI正常的非腹型肥胖组相比，BMI正常的腹型肥胖组较年轻，其人体成分指标(体重、体脂肪、体脂率、腰臀比、BMI、内脏脂肪面积、蛋白质、无机盐、上肢肌肉量、躯干肌肉量)均较非腹型肥胖组高(P＜0.05)，但两组的血脂相关指标无统计学差异。对两组性别进行进一步比较后发现，BMI正常的腹型肥胖男性较非腹型肥胖男性的甘油三酯高。此外，BMI正常的腹型肥胖女性的内脏脂肪面积较腹型肥胖男性高(P＜0.05)，其脂代谢指标(总胆固醇、低密度脂蛋白胆固醇及高密度脂蛋白胆固醇)也较腹型肥胖男性高(P＜0.05)。Logistic回归分析发现，女性、高内脏脂肪面积、高腰臀比是BMI正常的老年腹型肥胖人群发生高脂血症的独立危险因素(P＜0.05)。腹型肥胖在中医上属于阳气虚衰，痰湿偏盛。[结论]在BMI正常的老年人群中，腹型肥胖患者相对较年轻，发生高脂血症的风险远较非腹型肥胖人群高。BMI正常的老年腹型肥胖人群，尤其是老年女性应重视人体成分、脂代谢相关指标的监测。考虑腹型肥胖老年人群因自身疾病、身体条件耐受差而导致活动量受限，建议通过中医药物、针刺及埋线等治疗，来减少脂肪，改善腹型肥胖及血脂水平，以减少心血管事件的发生。 |
| 英文摘要: |
| [Objective] To explore the relationship between body composition， lipid level and the Chinese medicine treatments in abdominal obesity elders with normal body mass index(BMI) and to provide reference for Chinese medicine treatment.260 elderly patients with normal BMI were divided into abdominal obesity group(n=140) and non-abdominal obesity group (n=120) according to the waist-hip ratio. Data on the height， weight， body composition and lipid levels were measured. The abdominal obesity group all met the syndrome types of simple obesity.[Results]According to the theory of traditional Chinese medicine constitution， the difference of individuals determined their susceptibility to different diseases. Compared with the non-abdominal obesity group， the abdominal obesity group were younger， and the body composition including body weight， body fat， body fat percentage， waist-hip ratio， BMI， visceral fat， protein， inorganic salt， muscle mass of upper limbs and trunk muscle mass were significantly higher than those in the non-abdominal obesity group(P<0.05). There was no significant difference in the lipid level between two groups. In addition， the triglyceride level of abdominal obese men with normal BMI was higher than those of non-abdominal obese men. Compared with the abdominal obese men with normal BMI， the visceral fat and lipid levels of abdominal obese women were higher(P<0.05). Logistic regression analysis showed that the females' waist-hip ratio， high visceral fat were the independent influences for the occurrence of hyperlipidemia in abdominal obesity group(P<0.05).Abdominal obesity belongs to the category of " the retention of dampness " or "the phlegm " in traditional Chinese medicine.Overweight and obese elderly population due to the decline of the body's metabolic function， visceral dysfunction， especially the weakness function of the spleen and stomach could cause the obesity. In the elderly people with normal BMI， the age of onset of abdominal obesity is younger. The risk of hyperlipidemia' incidence is much higher than that of non-abdominal obesity due to the high visceral fat. Therefore， elderly abdominal obese people with normal BMI， especially elderly women， should pay attention to the body composition and lipid level.Considering the obese elderly' chronic diseases and poor physical conditions， we suggest the use of Chinese traditional medicines to reduce the occurrence of cardiovascular events. |
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