Lesser Iris A, Gasevic Danijela, Lear Scott A
Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Vancouver, BC V6B 5K3, Canada.
Appl Physiol Nutr Metab. 2013 Jul;38(7):701-6. doi: 10.1139/apnm-2012-0125. Epub 2013 Jan 30.
This study aimed to examine the differences in body fat distribution and cardiometabolic risk between individuals of Chinese and European origin and the role of body fat distribution on ethnic differences in cardiometabolic risk. A total of 418 participants from the Multicultural Community Health Assessment Trial were assessed for visceral adipose tissue (VAT), subcutaneous abdominal adipose tissue (SAT), anthropometric variables, blood pressure, and lipid, insulin, and glucose levels. Multiple regression analyses were split by sex and adjusted for appropriate covariates in model 1a and further adjusted for VAT in model 1b or SAT in model 1c. A secondary model replaced body mass index (BMI) with waist circumference (WC). Chinese males had higher levels of triglycerides, insulin, homeostasis model assessment, and SAT than European males, as well as higher total cholesterol (TC), glucose, and VAT in the model adjusted for WC. Chinese females had higher glucose levels than European females after adjustment for either BMI or WC. When VAT was added to the models, differences in cardiometabolic risk factors remained significant but were attenuated between Chinese and European males and females; SAT did not attenuate the ethnic difference in cardiometabolic risk. These findings suggest that the higher VAT levels seen in the Chinese population do not fully account for the ethnic disparities in these risk factors. Given the observed interethnic difference in body composition, current BMI and WC cutoffs might be misleading when it comes to identifying Chinese individuals at risk for type 2 diabetes or cardiovascular disease.
本研究旨在探讨中国和欧洲裔个体在体脂分布和心血管代谢风险方面的差异，以及体脂分布在心血管代谢风险种族差异中的作用。对来自多文化社区健康评估试验的418名参与者进行了内脏脂肪组织（VAT）、腹部皮下脂肪组织（SAT）、人体测量变量、血压以及血脂、胰岛素和血糖水平的评估。多元回归分析按性别进行划分，并在模型1a中对适当的协变量进行了调整，在模型1b中进一步对VAT进行了调整，或在模型1c中对SAT进行了调整。第二个模型用腰围（WC）取代了体重指数（BMI）。在调整WC的模型中，中国男性的甘油三酯、胰岛素、稳态模型评估值和SAT水平高于欧洲男性，总胆固醇（TC）、血糖和VAT水平也更高。在调整BMI或WC后，中国女性的血糖水平高于欧洲女性。当将VAT添加到模型中时，心血管代谢风险因素的差异仍然显著，但在中国和欧洲的男性及女性之间有所减弱；SAT并未减弱心血管代谢风险的种族差异。这些发现表明，中国人群中较高的VAT水平并不能完全解释这些风险因素中的种族差异。鉴于观察到的不同种族在身体组成方面的差异，在识别有2型糖尿病或心血管疾病风险的中国个体时，目前的BMI和WC临界值可能会产生误导。
