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通过双能X线吸收法评估的腹部脂肪量可提供老年人胰岛素敏感性的性别独立预测指标。

Abdominal adiposity assessed by dual energy X-ray absorptiometry provides a sex-independent predictor of insulin sensitivity in older adults.

作者信息

Lee Cathy C, Glickman Scott G, Dengel Donald R, Brown Michael D, Supiano Mark A

机构信息

Department of Internal Medicine, Division of Geriatrics, University of Michigan Health System, and the GRECC VA Ann Arbor Healthcare System, 48105, USA.

出版信息

J Gerontol A Biol Sci Med Sci. 2005 Jul;60(7):872-7. doi: 10.1093/gerona/60.7.872.

Abstract

BACKGROUND

An increase in total adiposity and in particular an abdominal distribution of adiposity may contribute to the decline in metabolic insulin sensitivity observed in older men and women. The objective of this cross-sectional study was to determine which measure of abdominal adiposity would provide the best sex-independent predictor of metabolic insulin sensitivity in older men and women.

METHODS

Insulin sensitivity and abdominal adiposity were measured in healthy, nondiabetic older (64 +/- 6 years; mean +/- standard deviation) men (n = 23) and women (n = 31). Metabolic Insulin Sensitivity Index (S(I)) was determined from a frequently sampled insulin-assisted intravenous glucose tolerance test. Body fat mass and abdominal fat mass were determined from dual energy X-ray absorptiometry (DXA) scans. Anthropometric measures included waist and hip circumferences, height, and body weight.

RESULTS

Although waist circumference, waist index (waist circumference divided by height), and waist-hip ratio (WHR) were all lower in women than in men, there was no sex difference in DXA L1-L4 fat mass. In univariate analyses, S(I) was significantly inversely related with body weight, body mass index, waist circumference, waist index, percentage of total body and abdominal fat, and DXA L1-L4 fat mass but not with WHR. The DXA L1-L4 fat mass was identified as the best independent predictor of S(I), accounting for 41.2% of the variance (p <.0001) in a stepwise multiple regression model that controlled for sex.

CONCLUSIONS

WHR is not associated with S(I) in either men or women. Abdominal adiposity measured by DXA L1-L4 fat mass provides a sex-independent predictor of S(I) in older men and women.

摘要

背景

总体肥胖尤其是腹部肥胖的增加,可能导致老年男性和女性出现代谢性胰岛素敏感性下降。这项横断面研究的目的是确定哪种腹部肥胖测量指标能为老年男性和女性的代谢性胰岛素敏感性提供最佳的性别独立预测指标。

方法

对健康、非糖尿病的老年(64±6岁;均值±标准差)男性(n = 23)和女性(n = 31)进行胰岛素敏感性和腹部肥胖测量。通过频繁采样胰岛素辅助静脉葡萄糖耐量试验确定代谢胰岛素敏感性指数(S(I))。通过双能X线吸收法(DXA)扫描确定体脂量和腹部脂肪量。人体测量指标包括腰围、臀围、身高和体重。

结果

尽管女性的腰围、腰指数(腰围除以身高)和腰臀比(WHR)均低于男性,但DXA测量的L1-L4节段脂肪量在性别上无差异。在单变量分析中,S(I)与体重、体重指数、腰围、腰指数、全身和腹部脂肪百分比以及DXA测量的L1-L4节段脂肪量显著负相关,但与WHR无关。DXA测量的L1-L4节段脂肪量被确定为S(I)的最佳独立预测指标,在控制性别的逐步多元回归模型中解释了41.2%的方差(p <.0001)。

结论

无论男性还是女性,WHR均与S(I)无关。通过DXA测量的L1-L4节段脂肪量所反映的腹部肥胖,可为老年男性和女性的S(I)提供性别独立预测指标。

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