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肝内脂肪、腹部脂肪组织与代谢状态:磁共振成像研究

Intrahepatic fat, abdominal adipose tissues, and metabolic state: magnetic resonance imaging study.

作者信息

Yaskolka Meir Anat, Tene Lilac, Cohen Noa, Shelef Ilan, Schwarzfuchs Dan, Gepner Yftach, Zelicha Hila, Rein Michal, Bril Nitzan, Serfaty Dana, Kenigsbuch Shira, Chassidim Yoash, Sarusy Benjamin, Dicker Dror, Thiery Joachim, Ceglarek Uta, Stumvoll Michael, Blüher Matthias, Stampfer Meir J, Rudich Assaf, Shai Iris

机构信息

Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.

Soroka University Medical Center, Beer-Sheva, Israel.

出版信息

Diabetes Metab Res Rev. 2017 Jul;33(5). doi: 10.1002/dmrr.2888. Epub 2017 Mar 14.

Abstract

BACKGROUND

Intrahepatic fat (IHF) is best known to associate with waist circumference (WC) and visceral adipose tissue (VAT), but its relation to abdominal subcutaneous adipose tissue is controversial. While IHF ≥ 5% dichotomously defines fatty liver, %IHF is rarely considered as a continuous variable that includes the normal range. In this study, we aimed to evaluate %IHF association with abdominal fat subdepots, pancreatic, and renal-sinus fats.

METHODS

We evaluated %IHF, abdominal fat subdepots, %pancreatic, and renal-sinus fats, among individuals with moderate abdominal obesity, using 3-Tesla magnetic resonance imaging.

RESULTS

Among 275 participants, %IHF widely ranged (0.01%-50.4%) and was lower in women (1.6%) than men (7.3%; P < .001). In an age, sex, and WC-adjusted models, VAT area (P < .006) was directly associated with %IHF, while superficial-subcutaneous adipose tissue proportion was inversely associated with %IHF (P < .006). In these models, renal-sinus fat was positively associated with %IHF (P = .005). In an age, sex, WC, and VAT-adjusted models, elevated liver enzymes, glycemic, lipid, and inflammatory biomarkers were associated with increased %IHF (P < .003 for all). In these models, the associations remained robust even within the normal range strata of IHF < 5% for triglycerides and chemerin (P ≤ .004 for all). For the diagnosis of fatty liver, the joint area under the curve of WC, alanine-aminotransferase, triglycerides/high-density lipoprotein cholesterol, and homeostasis model assessment of insulin resistance was 0.84(95% CI, 0.79-0.89).

CONCLUSIONS

Intrahepatic fat is differentially associated with abdominal fat subdepots. Intrahepatic-fat as a continuous variable could be predicted by specific traditional parameters, even within the current normal range, and partially independent of VAT.

摘要

背景

肝内脂肪(IHF)与腰围(WC)和内脏脂肪组织(VAT)的关联最为人所知,但其与腹部皮下脂肪组织的关系存在争议。虽然IHF≥5%可二分法定义脂肪肝,但很少将%IHF视为包括正常范围在内的连续变量。在本研究中,我们旨在评估%IHF与腹部脂肪亚库、胰腺和肾窦脂肪的关联。

方法

我们使用3特斯拉磁共振成像评估了中度腹部肥胖个体的%IHF、腹部脂肪亚库、%胰腺和肾窦脂肪。

结果

在275名参与者中,%IHF范围广泛(0.01%-50.4%),女性(1.6%)低于男性(7.3%;P<.001)。在年龄、性别和WC调整模型中,VAT面积(P<.006)与%IHF直接相关,而浅表皮下脂肪组织比例与%IHF呈负相关(P<.006)。在这些模型中,肾窦脂肪与%IHF呈正相关(P=.005)。在年龄、性别、WC和VAT调整模型中,肝酶、血糖、脂质和炎症生物标志物升高与%IHF增加相关(所有P<.003)。在这些模型中,即使在甘油三酯和chemerin的IHF<5%的正常范围分层内,关联仍然很强(所有P≤.004)。对于脂肪肝的诊断,WC、丙氨酸转氨酶、甘油三酯/高密度脂蛋白胆固醇和胰岛素抵抗稳态模型评估的联合曲线下面积为0.84(95%CI,0.79-0.89)。

结论

肝内脂肪与腹部脂肪亚库的关联存在差异。即使在当前正常范围内,肝内脂肪作为连续变量也可通过特定传统参数预测,且部分独立于VAT。

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