Yu Ju-Yeon, Choi Won-Jun, Lee Hye-Sun, Lee Ji-Won
Department of Family Medicine, Gangnam Severance Hospital.
Biostatistics Collaboration Unit, Department of Research Affairs, Yonsei University College of Medicine, Seoul, Republic of Korea.
Medicine (Baltimore). 2019 Mar;98(9):e14740. doi: 10.1097/MD.0000000000014740.
Obesity is now considered a state of chronic low-grade inflammation. We investigated the relationship between several inflammatory markers and body composition for identifying patients with an increased risk of visceral obesity and compared the predictive values of inflammatory indices in visceral obesity.Six hundred individuals who received health checkups for obesity-related risk factors in Severance Hospital between January 2008 and March 2017 were included in our study. Serum inflammatory markers, such as white blood cell (WBC), high-sensitivity C-reactive protein (hsCRP), neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR) levels were assessed. Intra-abdominal visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) areas were measured with computed tomography. We performed analysis of covariance, trend analysis, Steiger's Z tests, and multiple linear regression analysis to investigate associations between abdominal adiposity indices and inflammatory markers.Pearson's correlation analysis revealed a stronger association of VAT with WBC counts (r = 0.157, P < .001) than with levels of NLR (r = 0.108, P = .11; Steiger's Z test, P = .04) and PLR (r = 0.036, P = .39; Steiger's Z test, P = .003). WBC and hsCRP levels linearly increased with VAT area (overall P < .001 and trend P < .001) and VAT/SAT ratio (overall P = .001 and trend P = .002; overall P < .001 and trend P < .001, respectively) but linearly decreased with SAT (overall P = .02 and trend P = .17; overall P = .03 and trend P = .01, respectively). Visceral adipose tissue area was more highly associated with WBC and hsCRP levels than with NLR and PLR. Only VAT area was significantly associated with WBC, hsCRP, and NLR levels after adjusting for confounding variables.We found that VAT, but not SAT area is independently associated with several inflammatory markers. WBC and hsCRP are more strongly correlated with VAT compared with NLR and PLR. Thus, WBC and hsCRP could be useful parameters for identifying individuals at risk for visceral obesity and cardiometabolic diseases.
肥胖现在被认为是一种慢性低度炎症状态。我们研究了几种炎症标志物与身体成分之间的关系,以识别内脏肥胖风险增加的患者,并比较了炎症指标在内脏肥胖中的预测价值。
2008年1月至2017年3月期间在Severance医院接受肥胖相关风险因素健康检查的600人纳入我们的研究。评估了血清炎症标志物,如白细胞(WBC)、高敏C反应蛋白(hsCRP)、中性粒细胞与淋巴细胞比值(NLR)和血小板与淋巴细胞比值(PLR)水平。用计算机断层扫描测量腹内内脏脂肪组织(VAT)和皮下脂肪组织(SAT)面积。我们进行了协方差分析、趋势分析、Steiger Z检验和多元线性回归分析,以研究腹部肥胖指数与炎症标志物之间的关联。
Pearson相关性分析显示,VAT与白细胞计数的相关性更强(r = 0.157,P <.001),高于与NLR水平(r = 0.108,P =.11;Steiger Z检验,P =.04)和PLR水平(r = 0.036,P =.39;Steiger Z检验,P =.003)的相关性。白细胞和hsCRP水平随VAT面积(总体P <.001,趋势P <.001)和VAT/SAT比值(总体P =.001,趋势P =.002;总体P <.001,趋势P <.001)呈线性增加,但随SAT呈线性下降(总体P =.02,趋势P =.17;总体P =.03,趋势P =.01)。内脏脂肪组织面积与白细胞和hsCRP水平的相关性高于与NLR和PLR的相关性。在调整混杂变量后,只有VAT面积与白细胞、hsCRP和NLR水平显著相关。
我们发现,VAT而非SAT面积与几种炎症标志物独立相关。与NLR和PLR相比,白细胞和hsCRP与VAT的相关性更强。因此,白细胞和hsCRP可能是识别内脏肥胖和心血管代谢疾病风险个体的有用参数。