Department of Cardiology, Cerrahpaşa Medical Faculty, Istanbul University, Istanbul, Turkey.
Nutrition. 2010 Apr;26(4):382-9. doi: 10.1016/j.nut.2009.05.019. Epub 2009 Jul 24.
We investigated the predictive values of visceral adipose tissue area (VAT) and body fat mass for a composite endpoint consisting of type 2 diabetes and coronary heart disease and for incident metabolic syndrome.
We analyzed at 4-y follow-up 157 middle-aged men and women in whom body composition analyzer and single-scan computerized tomography had been used.
Sex- and age-adjusted mean areas of visceral fat were 1.5-fold greater in individuals with than without the composite endpoint (P<0.001), whereas abdominal subcutaneous fat was similar. Analysis of receiver operating characteristics for the optimal criterion regarding the composite endpoint (in 37 participants) indicated a VAT of 130 cm(2) and accuracies of 60% in men and 85% in women. Whereas age-adjusted VAT alone significantly predicted the composite endpoint in men, body fat mass or VAT predicted it in women (with 2.2- to 2.6-fold relative risks for 1-SD increment). Age-adjusted incident metabolic syndrome was significantly predicted by each parameter in men but only by fat mass in women.
Visceral adiposity in men and body fat mass in women seem to be of greater relevance in cardiometabolic risk for the prediction of which 130 cm(2) of VAT in both sexes and/or 27 kg of fat mass in women are useful cutoffs. Sex differences may reflect the predominating role of visceral adiposity in men and of insulin resistance in women in this risk.
我们研究了内脏脂肪组织面积(VAT)和体脂肪质量对包括 2 型糖尿病和冠心病在内的复合终点以及代谢综合征发病的预测价值。
我们对 157 名中年男女进行了为期 4 年的随访,他们接受了身体成分分析仪和单次计算机断层扫描。
与复合终点无个体相比,经性别和年龄校正的内脏脂肪平均面积更大(P<0.001),而腹部皮下脂肪相似。对复合终点最佳标准(37 名参与者)的接收者操作特征分析表明,VAT 为 130 cm²,男性的准确性为 60%,女性的准确性为 85%。尽管仅在男性中,经年龄校正的 VAT 单独显著预测了复合终点,但在女性中,体脂肪质量或 VAT 也预测了该终点(1-SD 增量的相对风险为 2.2-2.6 倍)。在男性中,经年龄校正的新发代谢综合征显著受每个参数预测,但在女性中仅受脂肪质量预测。
男性内脏肥胖和女性体脂肪质量似乎与心血管代谢风险更相关,预测该风险时,男女的 VAT 为 130 cm² 和/或女性脂肪质量为 27 kg 是有用的截断值。性别差异可能反映了内脏肥胖在男性和胰岛素抵抗在女性中的主导作用在该风险中。