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肥胖男女性患者肝、胰外脂肪堆积的预测因子。

Predictors of ectopic fat accumulation in liver and pancreas in obese men and women.

机构信息

Department of Biomedical and Surgical Science, Division of Geriatric Medicine, University of Verona, Verona, Italy.

出版信息

Obesity (Silver Spring). 2011 Sep;19(9):1747-54. doi: 10.1038/oby.2011.114. Epub 2011 May 19.

Abstract

UNLABELLED

The aim of the present study was to determine the relationship between body fat distribution, adipocytokines, inflammatory markers, fat intake and ectopic fat content of liver and pancreas in obese men and women. A total of 12 lean subjects (mean age 47.25 ± 14.88 years and mean BMI 22.85 ± 2), 38 obese subjects (18 men and 20 women) with mean age 49.1 ± 13.0 years and mean BMI 34.96 ± 4.21 kg/m2 were studied.

MEASUREMENTS

weight, height, BMI, waist circumference, as well as glucose, insulin, HOMA (homeostasis model assessment of insulin resistance), cholesterol, triglycerides, high-density lipoprotein cholesterol, high sensitivity C-reactive protein, daily energy intake, leptin, and adiponectin. Magnetic resonance was used to evaluate visceral, subcutaneous adipose tissue (SCAT) as well as liver and pancreas lipid content using in-phase and out-of-phase magnetic resonance imaging (MRI) sequence. Obese subjects had significantly higher weight, waist circumference, SCAT, deep SCAT, visceral adipose tissue (VAT), liver and pancreatic lipid content than lean subjects. Obese women had significantly lower VAT, liver and pancreas lipid content regardless of same BMI. In multiple regression analyses, the variance of liver lipid content explained by gender and VAT was 46%. When HOMA was added into a multiple regression, a small increase in the proportion of variance explained was observed. A 59.2% of the variance of pancreas lipid content was explained by gender and VAT. In conclusion, obese men show higher VAT and ectopic fat deposition in liver and pancreas than obese women despite same BMI. Independent of overall adiposity, insulin resistance, adiponectin and fat intake, VAT, measured with MRI, is the main predictor of ectopic fat deposition in both liver and pancreas.

摘要

目的

本研究旨在确定肥胖男性和女性的体脂分布、脂肪细胞因子、炎症标志物、脂肪摄入量与肝胰腺异位脂肪含量之间的关系。

方法

共纳入 12 名瘦受试者(平均年龄 47.25±14.88 岁,BMI 22.85±2)和 38 名肥胖受试者(18 名男性和 20 名女性,平均年龄 49.1±13.0 岁,BMI 34.96±4.21kg/m2)。

评估指标

体重、身高、BMI、腰围、血糖、胰岛素、稳态模型评估胰岛素抵抗指数(HOMA)、胆固醇、甘油三酯、高密度脂蛋白胆固醇、高敏 C 反应蛋白、每日能量摄入、瘦素和脂联素。采用磁共振成像(MRI)技术评估内脏脂肪、皮下脂肪(SCAT)以及肝胰腺脂肪含量,包括同相位和反相位 MRI 序列。

结果

肥胖受试者的体重、腰围、SCAT、深 SCAT、内脏脂肪(VAT)、肝胰腺脂质含量显著高于瘦受试者。肥胖女性无论 BMI 如何,VAT、肝胰腺脂质含量均显著降低。多元回归分析显示,性别和 VAT 解释了肝脂肪含量 46%的变异性。当将 HOMA 纳入多元回归分析时,观察到解释比例略有增加。性别和 VAT 可解释胰腺脂肪含量 59.2%的变异性。

结论

尽管肥胖女性 BMI 较高,但 VAT 及肝胰腺异位脂肪沉积仍显著高于肥胖男性。与总体肥胖、胰岛素抵抗、脂联素和脂肪摄入无关,MRI 测量的 VAT 是肝和胰腺异位脂肪沉积的主要预测因素。

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