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采用 MRI 对 2 型糖尿病高危人群进行单一切面的脂肪组织定量分析,以估算相关脂肪组织腔室的体积:一项与人体测量数据进行比较的大样本队列研究。

Quantitative analysis of adipose tissue in single transverse slices for estimation of volumes of relevant fat tissue compartments: a study in a large cohort of subjects at risk for type 2 diabetes by MRI with comparison to anthropometric data.

机构信息

Section on Experimental Radiology, Department of Diagnostic and Interventional Radiology, Eberhard-Karls University, Tübingen, Germany.

出版信息

Invest Radiol. 2010 Dec;45(12):788-94. doi: 10.1097/RLI.0b013e3181f10fe1.

Abstract

OBJECTIVES

Aim of the study was to assess the potential value of cross-sectional adipose tissue evaluation in well defined single transverse slices for estimation of volumes of metabolically important adipose tissue compartments as visceral adipose tissue (VAT), nonvisceral adipose tissue (NVAT), and total body adipose tissue (TAT). In addition, validity of easily accessible anthropometric indices (waist-to-hip-ratio [WHR] and body mass index [BMI]) for prediction of volumes of those adipose tissue compartments were validated and compared.

MATERIALS AND METHODS

True volumes of main adipose tissue compartments VAT, TAT, and NVAT were carefully assessed based on whole-body magnetic resonance (MR) examinations in 367 volunteers (227 females, 140 males, age 18-69 years) at increased risk for type 2 diabetes. Volumes of VAT, NVAT, and TAT were compared with cross-sectional areas of adipose tissue in single transverse slices recorded on the level of (1) umbilicus (u), (2) head of humerus (h), (3) head of femur (f), and anthropometric data such as BMI and WHR. Separate analyses were performed in males and females.

RESULTS

In both genders, strong correlations were found between TAT and the cross-sectional areas: subcutaneous adipose tissue (u) with r = 0.88 in females and r = 0.92 in males, TAT(h) with r = 0.80 in females and r = 0.82 in males, and TAT(f) with r = 0.90 in females and r = 0.90 in males. VAT assessed by MR single slice evaluation at the umbilical level (VAT(u)) showed a strong correlation with total VAT in both genders (r = 0.93 in females, r = 0.87 in males). Suitable algorithms for predicting VAT in liter from fat planimetry in a slice recorded at the umbilical level were derived: VAT = 0.16 x (VAT(u) x body height) + 0.3 in women and VAT = 0.15 x (VAT(u) x body height) + 1.2 in men. Disregarding the body height, the best equations were as follows: VAT = 0.03 x VAT(u) + 0.3 in women and VAT = 0.02 x VAT(u) + 1.4 in men. In contrast, BMI versus VAT showed a lower correlation in both genders: r = 0.71 in females, r = 0.56 in males, and WHR versus VAT was only weakly correlated in females and in males (r = 0.49 and r = 0.55, respectively). For WHR versus TAT, significant results were only found in males (r = 0.44).

CONCLUSIONS

Axial MRI at the umbilical level allowed for a fast and reliable estimation, especially for VAT and TAT in a collective at risk for type 2 diabetes. WHR and BMI were found clearly worse in prediction of VAT volumes compared with single slice evaluation at the umbilical level.

摘要

目的

本研究旨在评估在明确的单个横断面上评估横截面脂肪组织对于估计代谢重要脂肪组织隔室(如内脏脂肪组织[VAT]、非内脏脂肪组织[NVAT]和全身脂肪组织[TAT])体积的潜在价值。此外,还验证并比较了易于获得的人体测量学指标(腰臀比[WHR]和体重指数[BMI])预测这些脂肪组织隔室体积的有效性。

材料和方法

在患有 2 型糖尿病风险增加的 367 名志愿者(227 名女性,140 名男性,年龄 18-69 岁)中,通过全身磁共振(MR)检查仔细评估了主要脂肪组织隔室 VAT、TAT 和 NVAT 的真实体积。将 VAT、NVAT 和 TAT 的体积与在水平(1)脐部(u)、(2)肱骨头部(h)、(3)股骨头部(f)记录的单个横断面上的脂肪组织横截面积进行比较,并与 BMI 和 WHR 等人体测量数据进行比较。在男性和女性中分别进行了单独的分析。

结果

在两性中,TAT 与横截面积之间均存在很强的相关性:女性中皮下脂肪组织(u)为 r = 0.88,男性为 r = 0.92,TAT(h)为 r = 0.80,男性为 r = 0.82,TAT(f)为 r = 0.90,男性为 r = 0.90。在两性中,通过 MR 单层评估在脐部水平评估的 VAT(VAT(u))与总 VAT 之间存在很强的相关性(女性 r = 0.93,男性 r = 0.87)。从脐部水平记录的切片中通过脂肪描记术预测 VAT 的合适算法为:VAT = 0.16 x(VAT(u)x 身高)+ 0.3,女性;VAT = 0.15 x(VAT(u)x 身高)+ 1.2,男性。不考虑身高,最佳公式如下:VAT = 0.03 x VAT(u)+ 0.3,女性;VAT = 0.02 x VAT(u)+ 1.4,男性。相比之下,BMI 与 VAT 的相关性在两性中均较低:女性 r = 0.71,男性 r = 0.56,WHR 与 VAT 的相关性仅在女性和男性中较弱(r = 0.49 和 r = 0.55)。对于 WHR 与 TAT,仅在男性中发现显著结果(r = 0.44)。

结论

在脐部水平的轴向 MRI 可快速可靠地进行评估,特别是在 2 型糖尿病风险较高的人群中进行评估。与脐部水平的单层评估相比,WHR 和 BMI 明显更差,预测 VAT 体积。

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