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超声检查和人体测量法用于测量HIV感染患者的局部体脂

Ultrasonography and anthropometry for measuring regional body fat in HIV-infected patients.

作者信息

Padilla Sergio, Gallego Juan A, Masiá Mar, Ardoy Francisco, Hernández Ildefonso, Gutiérrez Félix

机构信息

Infectious Diseases Unit, Internal Medicine Department, Hospital General Universitario de Elche, Alicante, Spain.

出版信息

Curr HIV Res. 2007 Sep;5(5):459-66. doi: 10.2174/157016207781662461.

Abstract

To evaluate ultrasonography and anthropometry for the measurement of regional body fat in HIV infected patients. In a cross-sectional study, 61 patients receiving antiretroviral therapy underwent ultrasonography and anthropometry for measuring body fat at abdominal, peripheral and facial levels. Reproducibility and accuracy of the measurements at the different compartments were determined using quantitative computed tomography (CT) and clinical evaluation of lipodystrophy as reference standard. Intraabdominal and subcutaneous abdominal fat assessed by ultrasonography correlated with visceral and subcutaneous abdominal fat quantified by CT (r=0.74, P<0.001, and r=0.84, P<0.001, respectively). Ultrasound-determined subcutaneous fat at mid-thigh level correlated with adipose tissue area measured by CT (r = 0.84, P<0.001). Waist-to-hip ratio (r=0.69, P<0.001), suprailiac skinfold (r=0.78, P<0.001) and mid-thigh skinfold thickness (r=0.83, P<0.001) were also significantly correlated with visceral abdominal fat, subcutaneous abdominal fat, and with subcutaneous leg fat quantified by CT, respectively. Poorer correlations were found between ultrasonographic and anthropometric assessments of facial fat, and adipose tissue measured by CT (r=0.15, P=0.25, and r=0.58; P<0.001; respectively). Reproducibility was higher for anthropometry than for ultrasonography in most body regions. The highest variability was observed for ultrasonographic assessment of facial fat (median inter-observer coefficient of variation, 32.10%). Using the clinical diagnosis of lipodystrophy as reference, the best accuracy was observed for ultrasound-determined intraabdominal fat, waist-to-hip ratio and subcutaneous crural fat measured by ultrasonography. Ultrasonography and anthropometry are fairly accurate and reproducible methods for the evaluation of intraabdominal and peripheral fat. Its role for assessing facial fat seems to be more limited.

摘要

评估超声检查和人体测量学在测量HIV感染患者局部体脂方面的应用。在一项横断面研究中,61名接受抗逆转录病毒治疗的患者接受了超声检查和人体测量学检查,以测量腹部、外周和面部的体脂。使用定量计算机断层扫描(CT)和脂肪代谢障碍的临床评估作为参考标准,确定不同部位测量的可重复性和准确性。超声检查评估的腹内和腹部皮下脂肪与CT定量的内脏和腹部皮下脂肪相关(分别为r = 0.74,P < 0.001和r = 0.84,P < 0.001)。超声测定的大腿中部皮下脂肪与CT测量的脂肪组织面积相关(r = 0.84,P < 0.001)。腰臀比(r = 0.69,P < 0.001)、髂上皮肤褶(r = 0.78,P < 0.001)和大腿中部皮肤褶厚度(r = 0.83,P < 0.001)也分别与内脏腹部脂肪、腹部皮下脂肪以及CT定量的腿部皮下脂肪显著相关。面部脂肪的超声检查和人体测量学评估与CT测量的脂肪组织之间的相关性较差(分别为r = 0.15,P = 0.25和r = 0.58;P < 0.001)。在大多数身体部位,人体测量学的可重复性高于超声检查。面部脂肪的超声检查评估观察到的变异性最高(观察者间变异系数中位数为32.10%)。以脂肪代谢障碍的临床诊断为参考,超声测定的腹内脂肪、腰臀比和超声检查测量的小腿皮下脂肪的准确性最佳。超声检查和人体测量学是评估腹内和外周脂肪的相当准确且可重复的方法。其在评估面部脂肪方面的作用似乎更为有限。

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