Ferrara L A, Capaldo B, Mancusi C, Lee E T, Howard B V, Devereux R B, de Simone G
Department of Clinical Medicine and Surgery, Federico II University Hospital, Via S. Pansini 5, 80131 Naples, Italy.
Department of Clinical Medicine and Surgery, Federico II University Hospital, Via S. Pansini 5, 80131 Naples, Italy.
Nutr Metab Cardiovasc Dis. 2014 Mar;24(3):271-6. doi: 10.1016/j.numecd.2013.08.009. Epub 2013 Oct 9.
Sarcopenia is a condition mainly due to loss of fat-free mass (FFM) in elderly individuals. RFFMD, however, is also frequent in obese subjects due to abnormal body composition. Objective of this study was to evaluate the impact of relative fat-free mass deficiency (RFFMD) on cardiometabolic (CM) risk in obese normoglycemic individuals.
Overweight/obese American Indians from the Strong Heart Study population, without diabetes and with FBG ≤ 110 mg/dL and with GFR >60 mg/mL/1.73 m(2) were selected for this analysis (n = 742). RFFMD was defined on the basis of a multivariable equation previously reported. Fasting glucose and 2 h-OGTT were measured together with urine albumin/creatinine excretion, laboratory and anthropometric parameters. In addition to lower FFM and greater adipose mass, participants with RFFMD had higher body mass index, waist circumference, C-reactive protein, fibrinogen, insulin resistance and urinary albumin/creatinine than participants with normal FFM (all p < 0.001); they also had a greater prevalence of hypertension, impaired glucose tolerance (IGT) or OGTT-diabetes than participants with normal FFM (all p < 0.003) and a near 2-fold greater probability of significant proteinuria (p < 0.01). RFFMD was more frequent in women than in men: significant sex-RFFMD interactions were found for BMI and waist circumference (both p < 0.0001).
RFFMD in overweight/obese normoglycemic individuals is associated with greater probability of hypertension, abnormalities of glucose tolerance and proteinuria. Assessment of RFFRMD might, therefore, help stratifying cardiometabolic risk among normoglycemic individuals with overweight/obesity.
肌肉减少症主要是老年个体中无脂肪量（FFM）流失所致的一种状况。然而，由于身体成分异常，相对无脂肪量缺乏症（RFFMD）在肥胖个体中也很常见。本研究的目的是评估相对无脂肪量缺乏症（RFFMD）对肥胖血糖正常个体心脏代谢（CM）风险的影响。
从强心脏研究人群中选取超重/肥胖的美国印第安人，这些人无糖尿病，空腹血糖（FBG）≤110mg/dL且肾小球滤过率（GFR）>60mg/mL/1.73m²进行本分析（n = 742）。RFFMD根据先前报道的多变量方程定义。测量空腹血糖和2小时口服葡萄糖耐量试验（OGTT）以及尿白蛋白/肌酐排泄、实验室和人体测量参数。除了较低的FFM和较高的脂肪量外，与FFM正常的参与者相比，患有RFFMD的参与者体重指数、腰围、C反应蛋白、纤维蛋白原、胰岛素抵抗和尿白蛋白/肌酐更高（所有p<0.001）；他们患高血压、糖耐量受损（IGT）或OGTT糖尿病的患病率也高于FFM正常的参与者（所有p<0.003），蛋白尿显著的可能性几乎高出2倍（p<0.01）。RFFMD在女性中比男性更常见：在体重指数和腰围方面发现了显著的性别-RFFMD相互作用（均p<0.0001）。
超重/肥胖血糖正常个体中的RFFMD与高血压、糖耐量异常和蛋白尿的更高可能性相关。因此，评估RFFRMD可能有助于对超重/肥胖血糖正常个体的心脏代谢风险进行分层。
