Shiina Yutaka, Homma Yasuhiko
Department of Clinical Health Science, Tokai University School of Medicine, Japan.
Intern Med. 2013;52(16):1775-80. doi: 10.2169/internalmedicine.52.9190. Epub 2012 Mar 1.
The visceral fat area (VFA) was measured, and the relationships between the VFA and the body mass index (BMI), waist circumference, blood pressure, and indices of lipid and sugar metabolism were evaluated.
The subjects included 607 consecutive patients who underwent VFA examinations using computed tomography (CT) scans. In addition to the routine examination parameters, the levels of adiponectin and homeostasis model assessment as an index of insulin resistance (HOMA-IR) were measured in all subjects, and the levels of malondialdehyde-modified low-density lipoprotein (MDA-LDL), remnant-like particles (RLP), lipoprotein (a) (Lp(a)), apolipoprotein (Apo) AI, ApoB and ApoE were measured in 270 subjects.
In both men and women, the VFA showed significant positive correlations with the age, BMI, waist circumference, subcutaneous fat area, visceral fat area/subcutaneous fat area (v/s) ratio, systolic blood pressure, diastolic blood pressure, the fasting blood sugar (FBS), the hemoglobin A1c (HbA1c), high-density lipoprotein cholesterol (HDLC), triglyceride (TG), uric acid, HOMA-IR and ApoB and the ApoB/LDLC ratio and significant negative correlations with the levels of HDLC and adiponectin. The levels of the total cholesterol (TC), low-density lipoprotein cholesterol (LDLC), non-HDLC, MDA-LDL and Lp(a) and the ApoB/ApoAI ratio were not correlated with the VFA in either men or women. The RLP exhibited a significant positive correlation with the VFA in women.
The VFA exhibited high positive correlations with the waist circumference, blood pressure and TG level and a negative correlation with the HDLC level, regardless of gender, supporting the validity of the present diagnostic method for evaluating metabolic syndrome (MS). Although the LDLC level is not included in the diagnostic criteria for MS, the positive correlations between the VFA and the ApoB level and ApoB/LDLC ratio observed in both men and women indicate qualitative abnormalities of lipoproteins, such as an increase in the amount of small dense LDL. Measuring the levels of apolipoproteins in addition to lipoproteins during health screening is therefore useful for evaluating of atherogenicity.
测量内脏脂肪面积（VFA），并评估VFA与体重指数（BMI）、腰围、血压以及脂质和糖代谢指标之间的关系。
研究对象包括607例连续接受计算机断层扫描（CT）进行VFA检查的患者。除常规检查参数外，还测量了所有受试者的脂联素水平和作为胰岛素抵抗指标的稳态模型评估（HOMA-IR），并在270例受试者中测量了丙二醛修饰的低密度脂蛋白（MDA-LDL）、残粒样颗粒（RLP）、脂蛋白（a）[Lp（a）]、载脂蛋白（Apo）AI、ApoB和ApoE的水平。
在男性和女性中，VFA均与年龄、BMI、腰围、皮下脂肪面积、内脏脂肪面积/皮下脂肪面积（v/s）比值、收缩压、舒张压、空腹血糖（FBS）、糖化血红蛋白（HbA1c）、高密度脂蛋白胆固醇（HDLC）、甘油三酯（TG）、尿酸、HOMA-IR以及ApoB和ApoB/LDLC比值呈显著正相关，与HDLC和脂联素水平呈显著负相关。总胆固醇（TC）、低密度脂蛋白胆固醇（LDLC）、非HDLC、MDA-LDL和Lp（a）水平以及ApoB/ApoAI比值在男性和女性中均与VFA无关。RLP在女性中与VFA呈显著正相关。
无论性别如何，VFA与腰围、血压和TG水平呈高度正相关，与HDLC水平呈负相关，这支持了目前用于评估代谢综合征（MS）的诊断方法的有效性。虽然LDLC水平未纳入MS的诊断标准，但在男性和女性中均观察到VFA与ApoB水平和ApoB/LDLC比值呈正相关，这表明脂蛋白存在定性异常，如小而密LDL数量增加。因此，在健康筛查期间除了测量脂蛋白水平外还测量载脂蛋白水平，对于评估动脉粥样硬化性是有用的。
