Tatsukawa M, Kurokawa M, Tamari Y, Yoshimatsu H, Sakata T
Department of Internal Medicine I, School of Medicine, Oita Medical University, Hasama, Japan.
Proc Soc Exp Biol Med. 2000 Feb;223(2):156-62. doi: 10.1046/j.1525-1373.2000.22321.x.
To examine the pathological role of regional fat deposition in development of metabolic and cardiovascular disorders, regional fat distribution was evaluated using metabolites and hormones as measures of obesity-related disorders. The subjects enrolled were 100 sex-matched inpatients, who were admitted, regardless of their body mass index values, for further examination of unusual results from periodic medical screening tests, and for examination of obesity-induced complications and treatment of obesity. Body fat distribution was analyzed using dual energy X-ray absorptiometry (DEXA). Analysis of parameters regarding fat distribution showed that gender was one of the determinants affecting correlation between fat distribution and metabolites of fasting plasma glucose (FPG), hemoglobin A1c (HbA1c), total cholesterol (TC), or triglyceride (TG). However, regardless of gender, both leg trunk fat (L/Tr) and arm trunk fat (A/Tr) ratios negatively correlated with a total body fat (% total fat) ratio, whereas the intercept value of female regression line in L/Tr was greater than that in males, but not in A/Tr. Percentage total fat, L/Tr, and A/Tr in males correlated significantly with FPG, TC, TG, low-density lipoprotein (LDL), very low density lipoprotein (VLDL), atherogenic index (A.I.), and apoB/A1 only low density lipoprotein (LDL) was significantly correlated solely to L/Tr and A/Tr. These results indicate that regional fat distribution in males may not be a major determinant for development of metabolic disorders in obese patients. Unlike male regional fat distribution, female L/Tr correlated significantly not only with TC, TG, and LDL, but also with FPG and HbA1c, although both of the latter 2 glucose-related parameters in males showed no correlation with any parameters of fat deposition. The remaining female parameters of fasting plasma insulin, VLDL, A.I., and ApoB/A1 correlated with each of the three parameters of fat deposition, as similarly shown in males. The powerful and negative correlation was thus evident, particularly in females, between leg fat deposition and parameters of glucose and lipid metabolites. The resulting information provides a novel insight that regional fat deposition at the legs is useful as a marker for metabolic and cardiovascular disorders associated with obesity.
为研究局部脂肪沉积在代谢和心血管疾病发生发展中的病理作用，我们使用代谢物和激素作为肥胖相关疾病的指标来评估局部脂肪分布。研究对象为100名性别匹配的住院患者，他们因定期体检结果异常、肥胖相关并发症检查及肥胖治疗而入院，无论其体重指数如何。采用双能X线吸收法（DEXA）分析体脂分布。脂肪分布参数分析表明，性别是影响脂肪分布与空腹血糖（FPG）、糖化血红蛋白（HbA1c）、总胆固醇（TC）或甘油三酯（TG）代谢物之间相关性的决定因素之一。然而，无论性别如何，腿部躯干脂肪（L/Tr）和手臂躯干脂肪（A/Tr）比率均与全身脂肪（%总脂肪）比率呈负相关，而女性L/Tr回归线的截距大于男性，但A/Tr并非如此。男性的总脂肪百分比、L/Tr和A/Tr与FPG、TC、TG、低密度脂蛋白（LDL）、极低密度脂蛋白（VLDL）、动脉粥样硬化指数（A.I.）和载脂蛋白B/A1显著相关，仅低密度脂蛋白（LDL）仅与L/Tr和A/Tr显著相关。这些结果表明，男性的局部脂肪分布可能不是肥胖患者代谢紊乱发生的主要决定因素。与男性局部脂肪分布不同，女性的L/Tr不仅与TC、TG和LDL显著相关，还与FPG和HbA1c显著相关，尽管男性后两个与葡萄糖相关的参数与任何脂肪沉积参数均无相关性。其余女性空腹血浆胰岛素、VLDL、A.I.和载脂蛋白B/A1参数与三个脂肪沉积参数均相关，与男性情况类似。因此，腿部脂肪沉积与葡萄糖和脂质代谢物参数之间存在显著的负相关，尤其是在女性中。这些结果提供了一个新的见解，即腿部的局部脂肪沉积可作为肥胖相关代谢和心血管疾病的标志物。
