性别差异对身体成分的影响及其与心血管代谢风险的关联。
Sex differences in body composition and association with cardiometabolic risk.
机构信息
Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Bulfinch 457B, 55 Fruit Street, Boston, MA, 02114, USA.
Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Yawkey 6E, 55 Fruit Street, Boston, MA, 02114, USA.
出版信息
Biol Sex Differ. 2018 Jun 27;9(1):28. doi: 10.1186/s13293-018-0189-3.
BACKGROUND
Body composition differs between men and women, with women having proportionally more fat mass and men more muscle mass. Although men and women are both susceptible to obesity, health consequences differ between the sexes. The purpose of our study was to assess sex differences in body composition using anatomic and functional imaging techniques, and its relationship to cardiometabolic risk markers in subjects with overweight/obesity.
METHODS
After written informed consent, we prospectively recruited 208 subjects with overweight/obesity who were otherwise healthy (94 men, 114 women, age 37 ± 10 years, BMI 35 ± 6 kg/m). Subjects underwent dual-energy X-ray absorptiometry (DXA) and computed tomography (CT) for fat and muscle mass, proton MR spectroscopy (1H-MRS) for intrahepatic (IHL) and intramyocellular lipids (IMCL), an oral glucose tolerance test, serum insulin, lipids, and inflammatory markers. Men and women were compared by Wilcoxon signed rank test. Linear correlation and multivariate analyses between body composition and cardiometabolic risk markers were performed.
RESULTS
Women and men were of similar mean age and BMI (p ≥ 0.2). Women had higher %fat mass, extremity fat, and lower lean mass compared to men (p ≤ 0.0005). However, men had higher visceral adipose tissue (VAT) and IMCL and higher age-and BMI-adjusted IHL (p < 0.05). At similar age and BMI, men had a more detrimental cardiometabolic risk profile compared to women (p < 0.01). However, VAT in women, and IMCL in men, were more strongly associated with cardiometabolic risk markers, while more lower extremity fat was associated with a more favorable cardiometabolic profile in women compared to men (p ≤ 0.03).
CONCLUSIONS
Although the male pattern of fat distribution is associated with a more detrimental cardiometabolic risk profile compared to women of similar age and BMI, VAT is more strongly associated with cardiometabolic risk markers in women, while IMCL are more detrimental in men. Lower extremity fat is relatively protective, in women more than in men. This suggests that detailed anatomic and functional imaging, rather than BMI, provides a more complete understanding of metabolic risk associated with sex differences in fat distribution.
背景
男性和女性的身体成分存在差异，女性的脂肪量比例更高，男性的肌肉量比例更高。尽管男性和女性都容易肥胖，但性别之间的健康后果不同。我们的研究目的是使用解剖和功能成像技术评估超重/肥胖人群的身体成分的性别差异，并评估其与心脏代谢风险标志物的关系。
方法
在书面知情同意后，我们前瞻性地招募了 208 名超重/肥胖但健康的受试者（94 名男性，114 名女性，年龄 37±10 岁，BMI 35±6kg/m²）。受试者接受双能 X 射线吸收法（DXA）和计算机断层扫描（CT）测量脂肪和肌肉量，质子磁共振波谱（1H-MRS）测量肝内（IHL）和肌内脂肪（IMCL），口服葡萄糖耐量试验，血清胰岛素、脂质和炎症标志物。通过 Wilcoxon 符号秩检验比较男性和女性。对身体成分与心脏代谢风险标志物之间的线性相关性和多元分析。
结果
女性和男性的平均年龄和 BMI 相似（p≥0.2）。与男性相比，女性的脂肪百分比、四肢脂肪和瘦体重更高（p≤0.0005）。然而，男性的内脏脂肪组织（VAT）和 IMCL 更高，年龄和 BMI 调整后的 IHL 更高（p<0.05）。在相似的年龄和 BMI 下，与女性相比，男性的心脏代谢风险特征更具危害性（p<0.01）。然而，女性的 VAT 和男性的 IMCL 与心脏代谢风险标志物的相关性更强，而与男性相比，女性的下肢脂肪与更有利的心脏代谢特征相关（p≤0.03）。
结论
尽管与相似年龄和 BMI 的女性相比，男性的脂肪分布模式与更具危害性的心脏代谢风险特征相关，但 VAT 在女性中与心脏代谢风险标志物的相关性更强，而 IMCL 在男性中更具危害性。下肢脂肪相对具有保护作用，女性比男性更明显。这表明，详细的解剖和功能成像而不是 BMI 提供了对与性别相关的脂肪分布差异相关的代谢风险的更全面的理解。
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