Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA.
Department of Movement Sciences, College of Education, Health and Human Sciences, University of Idaho, Moscow, ID, USA.
Diabetes Metab J. 2021 Jul;45(4):482-491. doi: 10.4093/dmj.2020.0277. Epub 2021 Jul 30.
The role of ectopic adipose tissue infiltration into skeletal muscle (i.e., myosteatosis) for metabolic disorders has received considerable and increasing attention in the last 10 years. The purpose of this review was to evaluate and summarize existing studies focusing on computed tomography (CT)-derived measures of myosteatosis and metabolic disorders. There is consistent evidence that CT-derived myosteatosis contributes to dysglycemia, insulin resistance, type 2 diabetes mellitus, and inflammation, and, to some extent, dyslipidemia, independent of general obesity, visceral fat, and other relevant risk factors, suggesting that it may serve as a tool for metabolic risk prediction. Identification of which muscles should be examined, and the standardized CT protocols to be employed, are necessary to enhance the applicability of findings from epidemiologic studies of myosteatosis. Additional and longer longitudinal studies are necessary to confirm a role of myosteatosis in the development of type 2 diabetes mellitus, and examine these associations in a variety of muscles across multiple race/ethnic populations. Given the emerging role of myosteatosis in metabolic health, well-designed intervention studies are needed to investigate relevant lifestyle and pharmaceutical approaches.
过去 10 年来，异位脂肪组织浸润骨骼肌（即肌内脂肪增多症）与代谢紊乱的关系引起了相当大且日益增加的关注。本综述的目的是评估和总结目前聚焦于基于计算机断层扫描（CT）的肌内脂肪增多症与代谢紊乱的相关研究。有充分证据表明，CT 检测的肌内脂肪增多症与血糖异常、胰岛素抵抗、2 型糖尿病和炎症有关，在一定程度上还与血脂异常有关，且独立于一般肥胖、内脏脂肪和其他相关危险因素，这提示肌内脂肪增多症可能是一种用于代谢风险预测的工具。有必要明确应检查哪些肌肉，以及应采用何种标准化 CT 方案，以增强肌内脂肪增多症的流行病学研究结果的适用性。还需要开展更多且更长期的纵向研究，以确认肌内脂肪增多症在 2 型糖尿病发展中的作用，并在多种族裔人群的多种肌肉中检验这些关联。鉴于肌内脂肪增多症在代谢健康中的新兴作用，需要开展精心设计的干预研究，以探索相关的生活方式和药物干预方法。
