Health Management Center, The First Affiliated Hospital of Zhengzhou University, Jianshe Road, Zhengzhou, China.
Radiology Department, The First Affiliated Hospital of Zhengzhou University, Jianshe Road, Zhengzhou, China.
Sci Rep. 2021 May 26;11(1):11076. doi: 10.1038/s41598-021-90641-5.
Obesity, especially abdominal obesity, is correlated to increased risk of cardiovascular morbidity and mortality. It is urgent to search a simply method to predict visceral fat area (VFA). Herein, we evaluated the correlation of waist circumference (WC) measured by anthropometry and bioelectrical impedance analysis (BIA), and VFA estimated by BIA or measured by quantitative computed tomography (QCT) in China. The mean body mass index (BMI) was 25.09 ± 3.31 kg/m and the mean age was 49.16 ± 9.19 years in 2754 subjects. VFA-BIA were significantly smaller than VFA-QCT in both BMI and age subgroups between male and female (p < 0.001). High correlation was observed for WC between BIA and manually (r = 0.874 for all, r = 0.865 for male and r = 0.806 for female) and for VFA between BIA and QCT (r = 0.512 for all). The intraclass correlation coefficient (ICC) showed the perfect agreement between BIA and manually to measure WC (ICC = 0.832 for all, 0.845 for male and 0.697 for female) and implied a good reliability for VFA between BIA and QCT with women among subgroups (ICC = 0.623 for all, ICC = 0.634 for age < 50 years and ICC = 0.432 for BMI > 24 kg/m), whereas the good reliability was lost in men (ICC = 0.174). The kappa analysis showed a moderate consistency for VFA measured by BIA and QCT (Kappa = 0.522 with age < 50 years, 0.565 with age ≥ 50 years in male; Kappa = 0.472 with age < 50 years, 0.486 with age ≥ 50 years in female). In addition, BIA to estimate VFA (r = 0.758 in male, r = 0.727 in female, P < 0.001) has a stronger correlation with VFA measured by QCT than BMI and WC according to gender categories. Furthermore, ROC analysis showed the cut-off point of VFA measured by BIA for predicting visceral obesity was: 101.90 cm, 119.96 cm and 118.83 cm and the Youden's index was 0.577, 0.577 and 0.651, respectively and the Kappa value was 0.532, 0.536 and 0.611 in unadjusted model, model 1 and model 2. In conclusion, being non-invasive and free of radiation, BIA can be used as a safe and convenient tool to estimate VFA in female; especially for monitoring the VFA of the same person, the BIA has superiority to a certain extent. However, the consistency is not most ideal between BIA and QCT. When using BIA to assess whether a person is visceral obesity, we must take into consideration age, BMI and WC. Therefore, we established a regression formula to reflect VFA-QCT by VFA-BIA, age, BMI, and WC. In addition, a more accurate formula is needed to match the CT data in China.
肥胖，尤其是腹部肥胖，与心血管发病率和死亡率的增加相关。因此，迫切需要寻找一种简单的方法来预测内脏脂肪面积（VFA）。在此，我们评估了人体测量法和生物电阻抗分析法（BIA）测量的腰围（WC）与 BIA 或定量计算机断层扫描（QCT）测量的 VFA 之间的相关性，在中国人群中进行了研究。2754 名受试者的平均体重指数（BMI）为 25.09±3.31 kg/m，平均年龄为 49.16±9.19 岁。在男性和女性中，BIA 测量的 VFA 明显小于 BIA 和 QCT 测量的 VFA（p<0.001）。无论男性还是女性，BIA 和手动测量的 WC 之间的相关性均很高（r=0.874，r=0.865 和 r=0.806），BIA 和 QCT 测量的 VFA 之间的相关性也很高（r=0.512）。组内相关系数（ICC）显示，BIA 与手动测量 WC 之间具有极好的一致性（ICC=0.832，ICC=0.845 和 ICC=0.697），BIA 和 QCT 之间的 VFA 也具有良好的可靠性，在女性亚组中（ICC=0.623，ICC=0.634 和 ICC=0.432），而在男性中可靠性则降低（ICC=0.174）。Kappa 分析显示，BIA 和 QCT 测量的 VFA 之间具有中度一致性（男性年龄<50 岁时 Kappa=0.522，年龄≥50 岁时 Kappa=0.565；女性年龄<50 岁时 Kappa=0.472，年龄≥50 岁时 Kappa=0.486）。此外，根据性别类别，BIA 估计的 VFA（男性 r=0.758，女性 r=0.727，P<0.001）与 QCT 测量的 VFA 相比，与 BMI 和 WC 的相关性更强。此外，ROC 分析显示，BIA 测量的 VFA 预测内脏肥胖的截断点为：男性 101.90 cm、119.96 cm 和 118.83 cm，女性 101.90 cm、119.96 cm 和 118.83 cm，Youden 指数分别为 0.577、0.577 和 0.651，在未调整模型、模型 1 和模型 2中 Kappa 值分别为 0.532、0.536 和 0.611。总之，BIA 作为一种非侵入性且无辐射的方法，可用于女性中安全且方便地估计 VFA；特别是对于监测同一人的 VFA，BIA 在一定程度上具有优势。然而，BIA 和 QCT 之间的一致性并不是最理想的。当使用 BIA 来评估一个人是否患有内脏肥胖时，必须考虑年龄、BMI 和 WC。因此，我们建立了一个回归公式，以反映 QCT 和 BIA 之间的关系。此外，还需要一个更准确的公式来匹配中国的 CT 数据。
