[中国老年人腹部脂肪分布的计算机断层扫描与体重指数及代谢综合征的关联]

Wang Chuanhai, Wang Xinjiang, Tian Hui, Fang Fusheng, Han Xiaofei

Department of Geriatric Endocrinology, Chinese PLA General Hospital, Beijing 100853, China.

Department of Geriatric Endocrinology, Chinese PLA General Hospital, Beijing 100853, China. Email:

Zhonghua Yi Xue Za Zhi. 2014 Apr 1;94(12):908-12.

OBJECTIVE

To explore the gender and age difference of abdominal fat distribution in Chinese older adults and examine the effects of metabolic syndrome (MS) on abdominal fat distribution by computed tomography (CT).

METHODS

Chinese elders (aged ≥ 65 years old) undergoing abdominal CT scanning at our hospital from January 2009 to December 2010 were collected through retrospective analysis. A total of 52 healthy normal-weight subjects and gender-specific body mass index (BMI)-matched middle-aged adults were selected (28 males, 24 females) to compare the difference of abdominal fat during the same period. Visceral fat area (VFA) and subcutaneous fat area (SFA) were measured at the cross-sections of L4 and L5 intervertebral space.

RESULTS

A total of 390 subjects were enrolled. There were 252 males and 138 females. Total abdominal fat (TAF) was not significantly different in both genders [female (323 ± 122 cm²) vs male (303 ± 141 cm²) , P = 0.146]. However, females had higher TAF than males after height correction (128 ± 49 vs 105 ± 49 cm²/m², P = 0.000). VFA and SFA were higher with higher BMI values across lean, normal weight, overweight and obese groups in both genders. VFA and SFA were not significantly different in both genders among 3 different age groups (>65-75, >75-85, >85 years; P > 0.05). Compared with healthy normal weight elders and BMI-matched middle-aged adults, VFA and SFA increased with more components of MS except in only one component group. When the patients were excluded suffering from 2 or more components of MS, VFA was not significantly different between normal weight elders and those with only one component of MS (diabetes/hyperlipidemia/hypertension). Logistic regression analysis showed VFA was a risk factor for elders with MS (male: OR = 1.03, 95%CI: 1.012- 1.047; female: OR = 1.06, 95%CI: 1.026-1.088) . However, SFA and age were not.

CONCLUSIONS

The elder females have more TAF than the elder males while abdominal fat does not increase with age in elders. TAF, VFA and SFA have a highly positively correlation with BMI. Visceral fat, not subcutaneous fat, is a risk factor for elders with MS and it increases with an increment of more than 2 components of MS.

目的

探讨中国老年人腹部脂肪分布的性别和年龄差异，并通过计算机断层扫描（CT）研究代谢综合征（MS）对腹部脂肪分布的影响。

方法

通过回顾性分析收集2009年1月至2010年12月在我院接受腹部CT扫描的中国老年人（年龄≥65岁）。共选取52名健康正常体重受试者和按性别匹配体重指数（BMI）的中年成年人（28名男性，24名女性）来比较同期腹部脂肪的差异。在L4和L5椎间隙横断面测量内脏脂肪面积（VFA）和皮下脂肪面积（SFA）。

结果

共纳入390名受试者，其中男性252名，女性138名。两性的腹部总脂肪（TAF）无显著差异[女性（323±122cm²）对男性（303±141cm²），P = 0.146]。然而，身高校正后女性的TAF高于男性（128±49对105±49cm²/m²，P = 0.000）。在男性和女性的瘦、正常体重、超重和肥胖组中，VFA和SFA均随BMI值升高而升高。在3个不同年龄组（>65 - 75岁、>75 - 85岁、>85岁）中，两性的VFA和SFA无显著差异（P>0.05）。与健康正常体重老年人和BMI匹配的中年成年人相比，除仅有一种MS组分的组外，VFA和SFA随MS组分增多而增加。当排除患有2种或更多种MS组分的患者后，正常体重老年人和仅有一种MS组分（糖尿病/高脂血症/高血压）的老年人之间VFA无显著差异。逻辑回归分析显示VFA是患有MS老年人的危险因素（男性：OR = 1.03，95%CI：1.012 - 1.047；女性：OR = 1.06，95%CI：1.026 - 1.088）。然而，SFA和年龄不是。