Department of Endocrinology, Singapore General Hospital, Singapore, Singapore.
Nutr Diabetes. 2012 Aug 6;2(8):e38. doi: 10.1038/nutd.2012.12.
Visceral adipose tissue (VAT) is an independent risk factor in cardiometabolic diseases and is commonly measured by computed tomography (CT). It is measured clinically by waist circumference (WC). The L4/5 intervertebral space VAT (L4/5 VAT) is traditionally used to represent total VAT volume. We set out to determine (1) the level of intervertebral space on CT that best approximates the total VAT volume; (2) compare the association between WC and VAT in Singaporean Chinese and Indian; and (3) examine the correlation between VAT and cardiometabolic risk factors.
A total of 60 Chinese and 60 Asian Indian men older than 60 years were recruited. Their medical history was taken and anthropometry was measured. Fasting glucose, insulin, lipids, adipokines and inflammatory markers were measured. Insulin resistance was evaluated by homeostasis model assessment-insulin resistance. VAT was determined by CT. Total VAT volume was calculated in 22 patients from VAT areas at seven intervertebral levels. The optimal VAT area most representative of total VAT volume was determined and used for all patients to approximate total VAT volume.
The VAT area at L2/3 intervertebral space (L2/3 VAT) correlated almost perfectly with VAT volume (R(2)=0.974 and 0.946 for Chinese and Indians, respectively). SUBJECTS from the two races had similar height, weight, body mass index (BMI), WC and L2/3 VAT but more Indian men had hypertension, hyperlipidemia and type 2 diabetes mellitus. WC was correlated with the L2/3 VAT area in both Chinese (r=0.484, P<0.001) and Indian subjects (r=0.366, P=0.004) without racial difference (P=0.2 for interaction term). L2/3 VAT also correlated better with cardiometabolic risk factors, adipokines and C-reactive protein than WC, BMI or L4/5 VAT.
The L2-L3 intervertebral space was the best anatomic level for a single-slice CT cross-sectional area measurement of VAT to approximate total body visceral adipose volume in this population of Chinese and Asian Indian men older than 60 years. L2/3 VAT was better correlated with multiple cardiovascular risk factors, adipokines and inflammatory marker than either L4/5 VAT, WC or BMI.
内脏脂肪组织（VAT）是心血管代谢疾病的独立危险因素，通常通过计算机断层扫描（CT）进行测量。临床上通过腰围（WC）进行测量。L4/5 椎间空间 VAT（L4/5 VAT）传统上用于代表总 VAT 体积。我们旨在确定（1）CT 上最接近总 VAT 体积的椎间空间水平；（2）比较新加坡华人与印度人 WC 与 VAT 之间的关联；（3）检查 VAT 与心血管代谢危险因素之间的相关性。
共招募了 60 名年龄大于 60 岁的华人男性和 60 名亚裔印度男性。他们接受了病史采集和人体测量。测量空腹血糖、胰岛素、血脂、脂肪因子和炎症标志物。通过稳态模型评估胰岛素抵抗来评估胰岛素抵抗。通过 CT 确定 VAT。在 22 名患者中，从七个椎间水平的 VAT 区域计算总 VAT 体积。确定最能代表总 VAT 体积的最佳 VAT 区域，并用于所有患者来近似总 VAT 体积。
L2/3 椎间空间的 VAT 面积（L2/3 VAT）与 VAT 体积几乎完全相关（华人的 R(2)=0.974 和 0.946，印度人的 R(2)=0.974 和 0.946）。这两个种族的受试者身高、体重、体重指数（BMI）、WC 和 L2/3 VAT 相似，但更多的印度男性患有高血压、高血脂和 2 型糖尿病。在华人（r=0.484，P<0.001）和印度受试者（r=0.366，P=0.004）中，WC 与 L2/3 VAT 区域均相关，且种族间无差异（交互项 P=0.2）。L2/3 VAT 与心血管代谢危险因素、脂肪因子和 C 反应蛋白的相关性也优于 WC、BMI 或 L4/5 VAT。
在该 60 岁以上华人及亚裔印度男性人群中，L2-L3 椎间水平是单次 CT 横断面面积测量 VAT 以近似全身内脏脂肪体积的最佳解剖水平。L2/3 VAT 与多种心血管危险因素、脂肪因子和炎症标志物的相关性优于 L4/5 VAT、WC 或 BMI。
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