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超重和肥胖受试者肾周及肾旁脂肪与心外膜脂肪和代谢参数的关系。

Relationship of para- and perirenal fat and epicardial fat with metabolic parameters in overweight and obese subjects.

作者信息

Manno Carlo, Campobasso Nicla, Nardecchia Adele, Triggiani Vincenzo, Zupo Roberta, Gesualdo Loreto, Silvestris Franco, De Pergola Giovanni

机构信息

Section of Nephrology, Department of Emergency and Organ Transplantation, School of Medicine, University of Bari, Piazza Giulio Cesare 11, 70124, Bari, Italy.

Clinical Nutrition Unit, Medical Oncology, Department of Biomedical Science and Human Oncology, School of Medicine, University of Bari, Piazza Giulio Cesare 11, 70124, Bari, Italy.

出版信息

Eat Weight Disord. 2019 Feb;24(1):67-72. doi: 10.1007/s40519-018-0532-z. Epub 2018 Jun 28.

Abstract

BACKGROUND

The accumulation of visceral body fat, has been shown to be associated with higher risk of metabolic and cardiovascular disease. This study was addressed to examine whether para- and perirenal fat thickness and epicardial fat thickness were correlated with anthropometric- and cardiometabolic risk factors.

METHODS

A cohort of 102 uncomplicated overweight and obese patients was examined. BMI, waist circumference, blood pressure, fasting insulin, glucose, triglycerides, total cholesterol, HDL-cholesterol, LDL-cholesterol serum levels, and insulin resistance (assessed by HOMA) were measured. Para- and perirenal fat thickness (PUFT) and epicardial fat thickness (EUFT) were measured by ultrasounds.

RESULTS

PUFT was positively correlated with BMI (p < 0.001), waist circumference (p < 0.001), insulin (p < 0.001), HOMA (p < 0.001), triglycerides (p < 0.05), systolic (p < 0.05) and diastolic (p < 0.05) blood pressure, and negatively correlated with HDL-cholesterol (p < 0.01). EUFT was positively associated with age (p < 0.01), BMI (p < 0.001), waist circumference (p < 0.001), systolic (p < 0.01) and diastolic (p < 0.001) blood pressure, and LDL-cholesterol (p < 0.05). A multivariate analysis by multiple linear regression was performed, and the final model showed a direct association of waist circumference with both PUFT and EUFT, a correlation of PUFT with HOMA (positive) and HDL-cholesterol (negative), and a direct association of EUFT (both long axis and short axis) with LDL-cholesterol. All these correlations were independent of other anthropometric, metabolic and hemodynamic parameters.

CONCLUSIONS

This study shows that accumulation of central fat in apparently healthy overweight and obese subjects is associated to a simultaneous increase of pararenal, perirenal and epicardial fat. Moreover, it shows that only para- and perirenal fat is independently associated to insulin resistance and lower HDL-cholesterol, and only epicardial fat is independently associated to higher LDL cholesterol. Level of evidence Level V, cross-sectional descriptive study.

摘要

背景

内脏脂肪堆积已被证明与代谢和心血管疾病的较高风险相关。本研究旨在探讨肾旁和肾周脂肪厚度以及心外膜脂肪厚度是否与人体测量和心脏代谢风险因素相关。

方法

对102例无并发症的超重和肥胖患者进行了队列研究。测量了体重指数(BMI)、腰围、血压、空腹胰岛素、血糖、甘油三酯、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇血清水平以及胰岛素抵抗(通过稳态模型评估)。通过超声测量肾旁和肾周脂肪厚度(PUFT)以及心外膜脂肪厚度(EUFT)。

结果

PUFT与BMI(p < 0.001)、腰围(p < 0.001)、胰岛素(p < 0.001)、稳态模型评估(HOMA)(p < 0.001)、甘油三酯(p < 0.05)、收缩压(p < 0.05)和舒张压(p < 0.05)呈正相关,与高密度脂蛋白胆固醇(p < 0.01)呈负相关。EUFT与年龄(p < 0.01)、BMI(p < 0.001)、腰围(p < 0.001)、收缩压(p < 0.01)和舒张压(p < 0.001)以及低密度脂蛋白胆固醇(p < 0.05)呈正相关。通过多元线性回归进行了多变量分析,最终模型显示腰围与PUFT和EUFT均呈直接关联,PUFT与HOMA(正相关)和高密度脂蛋白胆固醇(负相关)相关,EUFT(长轴和短轴)与低密度脂蛋白胆固醇呈直接关联。所有这些相关性均独立于其他人体测量、代谢和血流动力学参数。

结论

本研究表明,在明显健康的超重和肥胖受试者中,中心脂肪堆积与肾旁、肾周和心外膜脂肪的同时增加相关。此外,研究表明只有肾旁和肾周脂肪与胰岛素抵抗和较低的高密度脂蛋白胆固醇独立相关,只有心外膜脂肪与较高的低密度脂蛋白胆固醇独立相关。证据级别:V级,横断面描述性研究。

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