Department of Medicine, University of Otago, Dunedin, New Zealand.
Department of Human Nutrition, University of Otago, Dunedin, New Zealand.
Int J Obes (Lond). 2021 Apr;45(4):808-817. doi: 10.1038/s41366-021-00743-3. Epub 2021 Jan 20.
Although excess visceral fat (VAT) is associated with numerous cardio-metabolic risk factors, measurement of this fat depot has historically been difficult. Recent dual X-ray absorptiometry approaches have provided an accessible estimate of VAT that has shown acceptable validity against gold standard methods. The aims of this study were to (i) evaluate DXA measured VAT as a predictor of elevated blood lipids and blood pressure and (ii) calculate thresholds associated with these cardio-metabolic risk factors.
SUBJECTS/METHODS: The sample comprised 1482 adults (56.4% women) aged 18-66 years. Total body scans were performed using a GE Lunar Prodigy, and VAT analyses were enabled through Corescan software (v 16.0). Blood pressure and blood lipids were measured by standard procedures. Regression models assessed how VAT mass was associated with each cardio-metabolic risk factor compared to other body composition measures. Measures of sensitivity and specificity were used to determine age- and sex-specific cut points for VAT mass associated with high cardio-metabolic risk.
Similar to waist circumference, VAT mass was a strong predictor of cardio-metabolic risk especially in men over age 40. Four cut-offs for VAT mass were proposed, above which the cardio-metabolic risk increased: 700 g in women <40 yrs; 800 g in women 40+ yrs; 1000g in men <40 yrs; and 1200 g in men 40+ yrs. In general, these cut-offs discriminated well between those with high and low cardio-metabolic risk.
In both sexes, DXA measured VAT was associated with traditional cardio-metabolic risk factors, particularly high blood pressure in those 40+ yrs and low HDL < 40 yrs. These reference values provide a simple, accessible method to assess cardio-metabolic risk in adults.
尽管内脏脂肪过多（VAT）与许多心血管代谢危险因素有关，但历史上一直难以测量这种脂肪库。最近的双 X 射线吸收法方法提供了一种易于获得的 VAT 估计值，该值与金标准方法相比具有可接受的有效性。本研究的目的是：（i）评估 DXA 测量的 VAT 作为升高的血脂和血压的预测因子；（ii）计算与这些心血管代谢危险因素相关的阈值。
受试者/方法：该样本包括 1482 名年龄在 18-66 岁的成年人（56.4%为女性）。使用通用电气 Lunar Prodigy 进行全身扫描，通过 Corescan 软件（v16.0）进行 VAT 分析。通过标准程序测量血压和血脂。回归模型评估了与其他身体成分测量值相比，VAT 质量与每个心血管代谢危险因素之间的关系。使用敏感性和特异性来确定与高心血管代谢风险相关的 VAT 质量的年龄和性别特异性切点。
与腰围相似，VAT 质量是心血管代谢风险的强有力预测因子，尤其是在 40 岁以上的男性中。提出了四个 VAT 质量的截止值，超过这些值心血管代谢风险增加：<40 岁的女性为 700g；40 岁以上的女性为 800g；<40 岁的男性为 1000g；40 岁以上的男性为 1200g。一般来说，这些截止值在高心血管代谢风险和低心血管代谢风险之间有很好的区分。
在两性中，DXA 测量的 VAT 与传统的心血管代谢危险因素相关，尤其是 40 岁以上的人血压升高和<40 岁的人 HDL 降低。这些参考值为评估成年人的心血管代谢风险提供了一种简单、可及的方法。
