目的:应用超声检测多部位内脏脂肪与颈动脉粥样硬化的关系,期待寻找出更多可能影响动脉粥样硬化的指标,从而帮助临床医生更加准确地评估心脑血管疾病。方法:选取2021年6月-2022年3月在皖南医学院弋矶山医院超声科确诊为颈动脉粥样硬化(carotid atherosclerosis, CAS)的患者95例及健康志愿者39例。将患者按照内膜-中膜厚度(intima-media thickness, IMT)分为IMT ≤0.9 mm组和IMT ＞0.9 mm组,测量多个部位内脏脂肪参数,并进行比较。结果:两组心外膜脂肪组织(epicardial adipose tissue,EAT)、皮下脂肪厚度(subcutaneous fat thickness,SCFT)、腹膜前脂肪厚度(preperitoneal fat thickness, PPFT)、内脏脂肪厚度(visceral fat thickness, VFT)、右肾后周脂肪厚度(posterior right perinephric fat thickness, PRPFT)、VFT/SCFT、内脏脂肪体积(visceral adipose tissue, VAT)及左右肾脂肪囊厚度相比,差异有统计学意义(P＜0.05);多因素logistic回归分析发现,EAT、PPFT、VFT、PRPFT及右肾脂肪囊值越大患CAS的风险越高,差异具有统计学意义(P＜0.05),在调整了多变量后再进行分析,差异仍然有统计学意义(P＜0.05);ROC曲线分析确定VFT、PRPFT的AUC值分别为0.943、0.843,有较高的敏感性,确定其临界值分别为6.25 mm、59.45 mm。结论:内脏脂肪与CAS有关,EAT、PPFT、VFT、PRPFT及右肾脂肪囊均是CAS的独立影响因素,其中PRPFT、VFT诊断效能好。
Objective: To study the correlation between ultrasound detection of multi-site visceral fat and atherosclerosis, with the purpose to find more indicators that may affect atherosclerosis, so as to help clinicians evaluate cardiovascular and cerebrovascular diseases more accurately. Methods: From June 2021 to March 2022, 95 patients who were diagnosed with Carotid Atherosclerosis (CAS) in the Ultrasound Department of Yijishan Hospital, Anhui South Medical College, and 39 healthy volunteers were selected as the research objects. All research objects were grouped into the IMT ≤0.9mm group and the IMT >0.9mm group according to the intima-media thickness (IMT). Visceral fat parameters in multiple sites of the two groups were measured and compared. Results: Epicardial adipose tissue (EAT), subcutaneous fat thickness (SCFT), preperitoneal fat thickness (PPFT), visceral fat thickness (VFT), the difference in right perineal periphery fat thickness (PRPFT), VFT/SCFT, visceral adipose tissue (VAT) and left and right renal fat sac thickness of the two groups were statistically significant (P＜0.05). The multivariate logistic regression analysis found that the larger the value of EAT, PPFT, VFT, PRPFT, VFT/SCFT and right renal fat sac, the higher the risk of CAS, and the difference was statistically significant (P＜0.05), and the difference was still statistically significant after adjusting the multivariate(P＜0.05). ROC curve analysis determined that the AUC values of VFT and PRPFT were 0.943 and 0.843 respectively, which had high sensitivity, and the critical values were 6.25mm and 59.45mm respectively. Conclusion: Visceral fat is related to CAS, while EAT, PPFT, VFT, PRPFT and right kidney fat sac thickness are independent influencing factors of CAS, among which PRPFT and VFT have good diagnostic efficacy.
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