Neck Circumference And Its Correlation With Metabolism And Insulin Resistance In Patients With Type 2 Diabetes Mellitus

Objective:The major pathogenesis of type 2 diabetes are insulin resistance and the relative lack of insulin secretion.Overweight and obesity are important factors for leading to insulin resistance.Clinical methods such as body mass index make impossible to estimate total body fat but not regional adiposity; waist circumference,waist to hip ratio are influenced by diet. So it is very necessary to find a accurate, specific and simple index to evaluate the fat content and distribution.At present, the research on neck circumference found that the upper body fat distribution can be reflected by neck circumference, which can be used as a predictor of overweight, obesity and insulin resistance, and even better than waist circumference.Some research found that neck circumference can be used as an important predictor of sleep apnea syndrome in patients with cardiovascular disease and assessment of cardiovascular risk.Most type 2 diabetic patients with obesity, overweight, and more likely with the problems of lipid, uric acid metabolic disorders,and lead to cardiovascular events and serious complications.The research on the association between neck circumference and fat content and metaboli-sm state, islet function is still not enough.In our study, we studied that neck circumference and its correlation with metabolism and insulin resistance in patients with type 2 diabetes mellitus.Methods:Choices of 340 outpatients and inpatients who with type 2 diabetes from August 2015 to February 2016.Record patients age, sex and course of diabetes, measured for height, weight, neck circumference, waist circumference, hip circumference.Fasting 10-12 hours, in the morning of the next day to extract venous blood for testing blood glucose, HbAlc, C peptide, insulin, total cholesterol, triglyceride, high density lipoprotein. low density lipoprotein, uric acid, and calculated W/H,BMI,HOMA-β,HOMA-IR,IAI,McAuley index.The population was divided into four groups according to gender and BMI,and then according to the median of the neck circumference of normal BMI patients divided patients into four groups.Analysis date by software SPSS 19.0.Results:1.With the increase of BMI, the median of neck circumference is increased.Height, body weight, waist circumference, hip circumference, BMI, waist ratio to hip in group B were higher than group A,indexes mentioned above in group D were higher than group C. In both genders there have a positive correlation between neck circumference and weight, waist circumference, hip circumference, BMI and W/H.2.1n both genders neck circumference have a positive correlation with uric acid, negative correlation with HDL,no correlation with TC,TG,LDL and HbAlc.HDL in group A is higher than that in B,UA is lower than group B,and is similar to group C and D. Prevalence rate of abdominal obesity, overweight, obesity, blood lipid, uric acid metabolism disorders, insulin resistance in group B were higher than group A.Group C,D is similar to group A,B.3.In both genders HOMA-IR were have positive correlated with weight,neck circumference,waist circumference,hip circumference,BMI and W/H, the level of insulin and UA,in the female also positive to the level of blood glucose.HOMA- β have positive correlated with the level of blood glucose,HbAlc and insulin,but no relationship with weight,neck circumference,waist circumference,hip circumference,BMI and W/H.IAI have a negative correlation with weight,neck circumference,waist circumference,hip circumference,BMI,W/H and the level of blood glucose, insulin and TG,and positive correlation with the level of HDL,in the female also negative to the level of UA.4.With HOMA-IR as dependent variable, BMI and UA as independent variables, the multiple linear regression for all objectives showed Y=-0.109 0.021xBMI 0.001xUA.With HOMA-IR as dependent variable, all body fat measurements and UA as independent variables respectively on male, female group the multiple stepwise regression analysis respectively showed that:Y=-1.185 0.041xNC, Y=-0.994 0.033xNC 0.001xUA.5.The correlation between neck circumference and body weight, waist circumference, BMI, hip circumference, W/H isattenuated, R values respectively were 0.688,0.659,0.653,0.554,0.404.Conclusion:1.With the increase of neck circumference,the body fat content increased, the level of HDL declined and UA rised, the prevalence rate of lipid, uric acid metabolism disorders increased.2.Neck circumstance is related to insulin resistance,but no relationship between neck circumstance and the secretion of pancreatic beta cells.Among body fat measurement indexes, neck circumference in the assessment of insulin resistance is better than others.