Department of Nuclear Medicine, Korea University Anam Hospital, Seoul, Republic of Korea.
Center for Obesity and Metabolic Disease, Korea University Anam Hospital, Seoul, Republic of Korea.
Obes Res Clin Pract. 2020 Jul-Aug;14(4):339-344. doi: 10.1016/j.orcp.2020.05.008. Epub 2020 Jun 17.
Traditionally, obesity has been regarded as protective against osteoporosis. However, recent accumulating evidences suggest that visceral obesity can increase the risk of osteoporosis and obesity-driven dysfunctional metabolic activity in visceral adipose tissue (VAT) is considered as a key underlying mechanism. Visceral obesity is known to increase during menopausal transition.F-fluorodeoxyglucose positron emission tomography/computed tomography (F-FDG PET/CT) is an established method to assess the degree of VAT metabolic activity. We aimed to investigate the association between VAT metabolic activity evaluated by F-FDG PET/CT and osteoporosis in healthy postmenopausal Korean women.
A total of 115 postmenopausal women who underwent routine health check-up were enrolled in this study, retrospectively. They all underwent dual-energy X-ray absorptiometry and F-FDG PET/CT. Osteoporosis was defined as bone mineral density (BMD) T-score ≤ -2.5 at either lumbar spine or femoral neck. VAT metabolic activity was defined as the maximum standardized uptake value (SUVmax) of VAT divided by the SUVmax of subcutaneous adipose tissue (V/S ratio).
The participants with osteoporosis showed significantly higher V/S ratio, age, body mass index, waist circumference, and postmenopausal period than the participants without osteoporosis. V/S ratio of 1.33 was proposed as an optimal cut-off value for identifying osteoporosis. Furthermore, V/S ratio was the most significant predictive factor for osteoporosis in postmenopausal woman by uni-and multivariate analyses. Interestingly, V/S ratio showed significant positive correlation with high sensitivity C-reactive protein, a surrogate marker for systemic inflammation.
VAT metabolic activity assessed by F-FDG PET/CT is associated with osteoporosis in healthy postmenopausal Korean women.
传统上，肥胖被认为可以预防骨质疏松症。然而，最近越来越多的证据表明，内脏肥胖会增加骨质疏松症的风险，而内脏脂肪组织（VAT）中肥胖驱动的功能失调代谢活动被认为是一个关键的潜在机制。绝经过渡期已知内脏肥胖会增加。18F-氟代脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（F-FDG PET/CT）是评估 VAT 代谢活性程度的一种既定方法。我们旨在研究通过 F-FDG PET/CT 评估的 VAT 代谢活性与健康绝经后韩国女性骨质疏松症之间的关联。
本研究回顾性纳入了 115 名接受常规健康检查的绝经后女性。她们均接受了双能 X 线吸收法和 F-FDG PET/CT 检查。骨质疏松症定义为腰椎或股骨颈的骨矿物质密度（BMD）T 评分≤-2.5。VAT 代谢活性定义为 VAT 的最大标准化摄取值（SUVmax）除以皮下脂肪组织的 SUVmax（V/S 比）。
患有骨质疏松症的参与者的 V/S 比、年龄、体重指数、腰围和绝经时间明显高于没有骨质疏松症的参与者。V/S 比 1.33 被提议作为识别骨质疏松症的最佳临界值。此外，通过单变量和多变量分析，V/S 比是绝经后女性骨质疏松症的最显著预测因素。有趣的是，V/S 比与高敏 C 反应蛋白呈显著正相关，高敏 C 反应蛋白是全身炎症的替代标志物。
通过 F-FDG PET/CT 评估的 VAT 代谢活性与健康绝经后韩国女性的骨质疏松症有关。
