Shetty Sahana, Kapoor Nitin, Thomas Nihal, Paul Thomas Vizhalil
Department of Endocrinology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, (MAHE), Manipal, India.
Department of Endocrinology, Diabetes & Metabolism, Christian Medical College, Vellore, India.
J Clin Densitom. 2021 Jan-Mar;24(1):146-155. doi: 10.1016/j.jocd.2020.06.001. Epub 2020 Jun 12.
Visceral fat is the pathogenic fat depot associated with diabetes, dyslipidemia, and cardiovascular diseases. Estimation of visceral adipose tissue (VAT) by dual energy-X-ray absorptiometry (DXA) is a newer technique with less radiation exposure, shorter scanning time, and lower cost. In this study, we attempted to look at relationship between cardiometabolic risk factors and VAT, total body fat percent (TBF%) and anthropometry. We also studied the changes in body composition and metabolic parameters with menopause. The familial resemblance of VAT and TBF% in mother-daughter pair was also compared. This was a cross sectional community study of 300 women (150 postmenopausal mothers and 150 premenopausal daughters). Body composition indices by DXA and metabolic parameters were assessed. The association between DXA-VAT, TBF%, anthropometric measures, and cardiometabolic risk factors were studied by correlation, receiver operating characteristics curves, and logistic regression analysis. VAT indices were significantly higher and lean indices lower in postmenopausal women as compared to premenopausal women. One fourth of postmenopausal women were categorized as metabolically obese normal weight. DXA-VAT was a better predictor of cardiometabolic risk factors as compared to waist circumference, body mass index, and TF% in postmenopausal women (AUC:0.68 vs 0.62, 0.60 & 0.5, respectively), whereas body mass index had a better prediction in premenopausal women(AUC:0.68). VAT area >100 cm² had a significant association with the presence of ≥2 cardiometabolic risk factors (p = 0.04, OR: 2.2, CI:1.0-4.7) in the postmenopausal women. Daughters of the mothers with higher TBF% were found to have a higher TBF% compared to daughters of mothers with normal TBF% (36.2 ± 4.2 vs 32.2 ± 4.4, p = 0.03), similar resemblance was not seen for VAT. The study showed that the VAT increases and lean mass decreases with age and menopause. DXA measured VAT is a better predictor of cardiometabolic risk in postmenopausal women but not in premenopausal women. Total body fat may have a familial resemblance, but not the VAT which is determined by age, menopause, and probable life style factors.
内脏脂肪是与糖尿病、血脂异常和心血管疾病相关的致病性脂肪储存库。通过双能X线吸收法(DXA)估算内脏脂肪组织(VAT)是一种新技术,辐射暴露更少、扫描时间更短且成本更低。在本研究中,我们试图探讨心脏代谢危险因素与VAT、全身脂肪百分比(TBF%)和人体测量学之间的关系。我们还研究了绝经后身体成分和代谢参数的变化。同时比较了母女对中VAT和TBF%的家族相似性。这是一项对300名女性(150名绝经后母亲和150名绝经前女儿)进行的横断面社区研究。评估了通过DXA得出的身体成分指数和代谢参数。通过相关性分析、受试者工作特征曲线和逻辑回归分析研究了DXA-VAT、TBF%、人体测量指标与心脏代谢危险因素之间的关联。与绝经前女性相比,绝经后女性的VAT指数显著更高,瘦体重指数更低。四分之一的绝经后女性被归类为代谢性肥胖正常体重。在绝经后女性中,与腰围、体重指数和TF%相比,DXA-VAT是心脏代谢危险因素的更好预测指标(AUC分别为:0.68对0.62、0.60和0.5),而在绝经前女性中体重指数有更好的预测能力(AUC:0.68)。在绝经后女性中,VAT面积>100 cm²与存在≥2种心脏代谢危险因素显著相关(p = 0.04,OR:2.2,CI:1.0 - 4.7)。与TBF%正常的母亲的女儿相比,TBF%较高的母亲所生女儿的TBF%更高(36.2±4.2对32.2±4.4,p = 0.03),而VAT未观察到类似的相似性。该研究表明,VAT随年龄和绝经增加,瘦体重随年龄和绝经减少。DXA测量的VAT是绝经后女性心脏代谢风险的更好预测指标,但不是绝经前女性的。全身脂肪可能具有家族相似性,但VAT并非如此,VAT由年龄、绝经和可能的生活方式因素决定。