Sasai Hiroyuki, Brychta Robert J, Wood Rachel P, Rothney Megan P, Zhao Xiongce, Skarulis Monica C, Chen Kong Y
Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA.
Computational Biology and Biostatistics Laboratory, GE Global Research Center, Niskayuna, NY, USA.
J Diabetes Sci Technol. 2015 Jul;9(4):917-24. doi: 10.1177/1932296815577424. Epub 2015 Mar 23.
Abdominal visceral fat, typically measured by computer tomography (CT) or magnetic resonance imaging (MRI), has been shown to correlate with cardiometabolic risks. The purpose of this study was to examine whether a newly developed and validated visceral fat measurement from dual-energy X-ray absorptiometry (DXA) provides added predictive value to the cross-sectional differences of cardiometabolic parameters beyond the traditional anthropometric and DXA adiposity parameters.
A heterogeneous cohort of 194 adults (81 males and 113 females) with a BMI of 19 to 54 kg/m(2) participated in this cross-sectional study. Body composition was measured with a DXA densitometer. Visceral fat was then computed with a proprietary algorithm. Insulin sensitivity index (SI, measured by intravenous glucose tolerance test), blood pressures, and lipid profiles, and peak oxygen uptake were also measured as cardiometabolic risk parameters.
DXA-estimated visceral fat mass was associated with HDL cholesterol (regression coefficient [β] = -5.15, P < .01, adjusted R(2) = .21), triglyceride (β = 26.01, P < .01, adjusted R(2) = .14), and peak oxygen uptake (β = -3.15, P < .01, adjusted R(2) = .57) after adjusting for age, gender, and ethnicity. A subanalysis stratifying gender-specific BMI tertiles showed visceral fat, together with ethnicity, was independently associated with SI in overweight men and moderately obese women (second tertile).
Without requiring additional CT or MRI-based measurements, visceral fat detected by DXA might offer certain advantages over the traditional DXA adiposity parameters as means of assessing cardiometabolic risks.
腹部内脏脂肪通常通过计算机断层扫描(CT)或磁共振成像(MRI)测量,已被证明与心脏代谢风险相关。本研究的目的是检验一种新开发并经验证的双能X线吸收法(DXA)内脏脂肪测量方法,是否能在传统人体测量和DXA肥胖参数之外,为心脏代谢参数的横断面差异提供额外的预测价值。
194名BMI为19至54kg/m²的成年人(81名男性和113名女性)组成的异质性队列参与了这项横断面研究。使用DXA骨密度仪测量身体成分。然后用专有算法计算内脏脂肪。还测量了胰岛素敏感性指数(通过静脉葡萄糖耐量试验测量)、血压、血脂谱和峰值摄氧量作为心脏代谢风险参数。
在调整年龄、性别和种族后,DXA估计的内脏脂肪量与高密度脂蛋白胆固醇(回归系数[β]=-5.15,P<.01,调整后R²=.21)、甘油三酯(β=26.01,P<.01,调整后R²=.14)和峰值摄氧量(β=-3.15,P<.01,调整后R²=.57)相关。一项按性别特异性BMI三分位数分层的亚分析显示,在内脏脂肪与种族方面,超重男性和中度肥胖女性(第二三分位数)的胰岛素敏感性指数与之独立相关。
无需额外基于CT或MRI的测量,DXA检测到的内脏脂肪作为评估心脏代谢风险的手段,可能比传统的DXA肥胖参数具有某些优势。