Bouchi Ryotaro, Nakano Yujiro, Ohara Norihiko, Takeuchi Takato, Murakami Masanori, Asakawa Masahiro, Sasahara Yuriko, Numasawa Mitsuyuki, Minami Isao, Izumiyama Hajime, Hashimoto Koshi, Yoshimoto Takanobu, Ogawa Yoshihiro
Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan.
Center for Medical Welfare and Liaison Services, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan.
Cardiovasc Diabetol. 2016 Apr 14;15:64. doi: 10.1186/s12933-016-0384-7.
Whole body dual-energy X-ray absorptiometry (DXA) can simultaneously measure both regional fat and non-fat mass. Android-to-gynoid (A/G) ratio measured by DXA has been reported to be associated with cardiovascular risks and visceral adiposity; however, little is known regarding its relationship with fatty liver disease and atherosclerosis among patients with diabetes. This study was designed to investigate the association of android and gynoid fat mass measured by DXA with fatty liver disease and atherosclerosis in patients with type 2 diabetes.
This is a cross-sectional study of 259 patients with type 2 diabetes (mean age 64 ± 13 years; 40.2 % female). Android and gynoid fat mass (kg) were measured by DXA. Skeletal muscle index (SMI) was calculated as appendicular non-fat mass (kg) divided by height (m(2)). Visceral fat area (VFA, cm(2)), subcutaneous fat area (SFA, cm(2)), and liver attenuation index (LAI) were assessed by abdominal computed tomography. Intima media thickness (IMT, mm) in common carotid arteries was determined by carotid ultrasonography.
A/G ratio was significantly correlated with VFA (r = 0.72, p < 0.001), SFA (r = 0.32, p < 0.001) and LAI (r = -0.26, p < 0.001). A/G ratio (standardized β -0.223, p = 0.002) as well as VFA (standardized β -0.226, p = 0.001) were significantly associated with LAI in the univariate model. A/G ratio remained to be significantly associated with LAI (standardized β -0.224, p = 0.005) after adjusting for covariates including body mass index and transaminases. Among patients with low SMI (SMI < 7.0 in male and < 5.4 in female), A/G ratio was significantly associated with carotid IMT in the multivariate model (standardized β 0.408, p = 0.014).
DXA can be used to simultaneously estimate the risks for both fatty liver disease and atherosclerosis in patients with type 2 diabetes.
全身双能X线吸收法（DXA）可同时测量局部脂肪和非脂肪质量。据报道，通过DXA测量的男性型与女性型脂肪比例（A/G）与心血管风险和内脏脂肪增多有关；然而，对于其与糖尿病患者脂肪肝疾病和动脉粥样硬化之间的关系知之甚少。本研究旨在调查通过DXA测量的男性型和女性型脂肪量与2型糖尿病患者脂肪肝疾病和动脉粥样硬化之间的关联。
这是一项对259例2型糖尿病患者（平均年龄64±13岁；40.2%为女性）的横断面研究。通过DXA测量男性型和女性型脂肪量（kg）。计算骨骼肌指数（SMI），即四肢非脂肪质量（kg）除以身高（m²）。通过腹部计算机断层扫描评估内脏脂肪面积（VFA，cm²）、皮下脂肪面积（SFA，cm²）和肝脏衰减指数（LAI）。通过颈动脉超声测定颈总动脉内膜中层厚度（IMT，mm）。
A/G比例与VFA（r = 0.72，p < 0.001）、SFA（r = 0.32，p < 0.001）和LAI（r = -0.26，p < 0.001）显著相关。在单变量模型中，A/G比例（标准化β -0.223，p = 0.002）以及VFA（标准化β -0.226，p = 0.001）与LAI显著相关。在调整包括体重指数和转氨酶在内的协变量后，A/G比例与LAI仍显著相关（标准化β -0.224，p = 0.005）。在低SMI（男性SMI < 7.0且女性SMI < 5.4）的患者中，在多变量模型中A/G比例与颈动脉IMT显著相关（标准化β 0.408，p = 0.014）。
DXA可用于同时评估2型糖尿病患者脂肪肝疾病和动脉粥样硬化的风险。
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