Snijder M B, Visser M, Dekker J M, Goodpaster B H, Harris T B, Kritchevsky S B, De Rekeneire N, Kanaya A M, Newman A B, Tylavsky F A, Seidell J C
Institute for Research in Extramural Medicine, VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands.
Diabetologia. 2005 Feb;48(2):301-8. doi: 10.1007/s00125-004-1637-7. Epub 2005 Jan 20.
We investigated whether low subcutaneous thigh fat is an independent risk factor for unfavourable glucose and lipid levels, and whether these associations differ between sexes, and between white and black adults. Our secondary aim was to investigate which body composition characteristics (lean tissue, fat tissue) are reflected by anthropometric measures (waist and thigh circumference).
Anthropometric measurements and computed tomography of the abdomen and of the thigh were performed for all participants of the Health, Aging and Body Composition Study, who were aged 70-79 years. Fasting glucose, triglycerides and HDL-cholesterol, and 2-h postload glucose were determined.
After excluding those already diagnosed with diabetes or dyslipidaemia, we analysed data from 2,106 participants. After adjustment for abdominal subcutaneous and visceral fat, and intermuscular thigh fat, larger thigh subcutaneous fat area was statistically significantly associated with lower ln-transformed triglycerides [standardised beta (95% CI) -0.12 (-0.20 to -0.04) in men and -0.13 (-0.21 to -0.05) in women] and higher ln-HDL-cholesterol [0.10 (0.02 to 0.19) and 0.09 (0.01 to 0.18), respectively]. The associations with lower glucose levels were strong in men [-0.11 (-0.20 to -0.02) for fasting and -0.14 (-0.23 to -0.05) for postload glucose], but not statistically significant in women [-0.02 (-0.10 to 0.07) and -0.04 (-0.13 to 0.05), respectively]. There were no differences in the associations between white and black persons. Waist circumference was more strongly associated with abdominal subcutaneous fat, and this association became stronger with increasing BMI, whereas the association with visceral fat became weaker. Thigh circumference was equally dependent on thigh fat and thigh muscle in men, whereas in women the fat component was the main contributor.
Larger subcutaneous thigh fat is independently associated with more favourable glucose (in men) and lipid levels (in both sexes) after accounting for abdominal fat depots, which are associated with unfavourable glucose and lipid levels. Anthropometric measures reflect different fat depots at different levels of BMI at the abdomen, and reflect both fat and lean tissue at the thigh. These results emphasise the importance of accurate measures of regional body composition when investigating potential health risks.
我们研究了大腿皮下脂肪含量低是否是血糖和血脂水平不良的独立危险因素，以及这些关联在性别之间以及白人和黑人成年人之间是否存在差异。我们的次要目的是研究人体测量指标（腰围和大腿围）反映了哪些身体成分特征（瘦组织、脂肪组织）。
对健康、衰老和身体成分研究中所有年龄在70 - 79岁的参与者进行人体测量以及腹部和大腿的计算机断层扫描。测定空腹血糖、甘油三酯、高密度脂蛋白胆固醇以及负荷后2小时血糖。
在排除那些已被诊断患有糖尿病或血脂异常的参与者后，我们分析了2106名参与者的数据。在调整腹部皮下脂肪、内脏脂肪和大腿肌间脂肪后，较大的大腿皮下脂肪面积与较低的经自然对数转换的甘油三酯水平在统计学上显著相关[男性标准化β（95%置信区间）为 - 0.12（ - 0.20至 - 0.04），女性为 - 0.13（ - 0.21至 - 0.05）]，以及较高的自然对数转换的高密度脂蛋白胆固醇水平[分别为0.10（0.02至0.19）和0.09（0.01至0.18）]。与较低血糖水平的关联在男性中较强[空腹血糖为 - 0.11（ - 0.20至 - 0.02），负荷后血糖为 - 0.14（ - 0.23至 - 0.05）]，但在女性中无统计学意义[分别为 - 0.02（ - 0.10至0.07）和 - 0.04（ - 0.13至0.05）]。白人和黑人之间的关联没有差异。腰围与腹部皮下脂肪的关联更强，且随着体重指数（BMI）的增加这种关联变得更强，而与内脏脂肪的关联则变弱。大腿围在男性中同样依赖于大腿脂肪和大腿肌肉，而在女性中脂肪成分是主要贡献者。
在考虑与不良血糖和血脂水平相关的腹部脂肪储存后，较大的大腿皮下脂肪与更有利的血糖水平（男性）和血脂水平（男女皆然）独立相关。人体测量指标在腹部不同BMI水平下反映不同的脂肪储存，在大腿则反映脂肪和瘦组织。这些结果强调了在调查潜在健康风险时准确测量局部身体成分的重要性。
