应用双能 X 射线吸收仪诊断库欣综合征女性和肥胖女性中心性肥胖指标的截断点值。

Diagnostic Central Obesity Indexes Cut - Off Point Values Determined with Dual-Energy X-Ray Absorptiometry in Cushing's and Obese Women.

机构信息

University Clinic of Endocrinology, Diabetes and Metabolic Disorders, Faculty of Medicine, University Ss Cyril and Methodius, Skopje, R. N. Macedonia.

University Clinic of Rheumatology, Faculty of Medicine, University Ss Cyril and Methodius, Skopje, R. N. Macedonia.

出版信息

Pril (Makedon Akad Nauk Umet Odd Med Nauki). 2020 Dec 8;41(3):13-21. doi: 10.2478/prilozi-2020-0041.

DOI:10.2478/prilozi-2020-0041

PMID:33500372

Abstract

AIM

The aim of this study was to develop quantiative criteria for defining visceral obesity and to establish dual-energy X-ray absorptiometric (DXA) diagnostic cut-off points (CP) for normal and abnormal values of the central obesity indexes (COI) that best differentiate extreme visceral obesity in Cushing's syndrome (CS) from non CS obese and non obese women.

MATERIAL AND METHODS

COI1-4 values calculated as a ratio of android to gynoid tissue mass, fat mass and their % were determined in 4 groups, each consisting of 18 women: 1st group of CS, 2nd group of obese women (O1) not different according to their age and BMI from CS, 3rd group of obese women (O2) with BMI of 35 ± 1.2 kg and 4th group of non obese healthy women (C) with normal BMI. Diagnostic accuracy (DG) of CP values of COI1m-4m indexes of abdominal obesity and CP values of COI1n-4n indexes of normal body fat distribution (BFD) was determined.

RESULTS

COI1-4 indexes values were highly significantly different among the 4 examined groups and were significantly highest in CS patients and lowest in group C (p < 0.0001). COI1m-4m CP values differentiated extreme visceral, abdominal obesity in CS with highest DG as well as COI1n-4n CP values differentiated normal BFD in group C. COI1m CP of 0.55 best differentiated CS from O1 for DG of 100%. COI2n of 0.38 best differentiated C from CS and O2 for highest DG of 100% compared to O1 because of the significantly higher BMI and COI1n-4n values in O2 that were associated with more pronounced abdominal obesity and highly significantly positive correlation with BMI.

CONCLUSIONS

DXA cut-off point values of indexes COI1m-4m and COI1n-4n were established as diagnostic indexes and criteria useful in discovering extreme abdominal and normal BFD. COI1m CP value of 0.55 was discovered as a diagnostic criterion of extreme abdominal obesity and COI2n of 0.38 as a diagnostic criterion of normal BFD that excluded abdominal obesity. The other indexes COI1m-4m and COI1n-4n CP values had also high DG in discovering abdominal and normal body fat distribution.

摘要

目的

本研究旨在制定定量标准来定义内脏肥胖，并建立双能 X 射线吸收法（DXA）诊断切点（CP），以确定中央肥胖指数（COI）的正常和异常值，最好能区分库欣综合征（CS）患者极度内脏肥胖与非 CS 肥胖和非肥胖女性。

材料和方法

我们在 4 组中分别测定了 18 名女性的 COI1-4 值，这些值是作为男性和女性组织质量、脂肪质量及其百分比的比值计算出来的，每组 18 名女性：第 1 组为 CS 患者，第 2 组为肥胖女性（O1），她们的年龄和 BMI 与 CS 患者没有差异，第 3 组为 BMI 为 35±1.2kg 的肥胖女性（O2），第 4 组为 BMI 正常的非肥胖健康女性（C）。确定了 COI1m-4m 腹部肥胖指数和 COI1n-4n 正常体脂分布（BFD）指数的 CP 值的诊断准确性（DG）。

结果

4 组受检者的 COI1-4 指数值差异显著，CS 患者最高，C 组最低（p<0.0001）。COI1m-4m CP 值可很好地区分 CS 患者的极度内脏肥胖，其 DG 也最高，COI1n-4n CP 值可很好地区分 C 组的正常 BFD。COI1m CP 值为 0.55 时，CS 患者的 DG 最高，为 100%，而 COI1m CP 值为 0.55 时，CS 患者与 O1 患者的 DG 最高，为 100%。COI2n CP 值为 0.38 时，C 组与 CS 组和 O2 组的 DG 最高，为 100%，而 O2 组的 BMI 和 COI1n-4n 值较高，与更明显的腹部肥胖呈正相关，与 BMI 呈显著正相关。

结论

我们建立了 COI1m-4m 和 COI1n-4n 指数的 DXA 截断值作为诊断指标和标准，有助于发现极度腹部肥胖和正常 BFD。COI1m CP 值为 0.55 可作为极度腹部肥胖的诊断标准，COI2n CP 值为 0.38 可作为排除腹部肥胖的正常 BFD 的诊断标准。其他 COI1m-4m 和 COI1n-4n CP 值在发现腹部和正常体脂分布方面也具有较高的 DG。