Stratrova Slavica Shubeska, Mishevska Sasha Jovanovska, Efremovska Ljudmila, Bitoska Iskra, Spasovski Dejan
University Clinic of Endocrinology, Diabetes, and Metabolic Disorders, Faculty of Medicine, University "Sts. Cyril and Methodius", Skopje, R N Macedonia.
Department of MEP Physiology and Anthropology, Faculty of Medicine, University "Sts. Cyril and Methodius", Skopje, N Macedonia.
Pril (Makedon Akad Nauk Umet Odd Med Nauki). 2021 Oct 26;42(2):37-50. doi: 10.2478/prilozi-2021-0020.
: Cushing's syndrome (CS) is associated with weight gain and extreme central, visceral, abdominal obesity which is confirmed with dual-energy X-rays absorptiometric (DXA) diagnostic cut-off point (CP) values of central obesity indexes (COI), determined as an android to gynoid tissue and fat mass ratios. These best differentiate CS from non-CS obese women matched with CS according to their age and BMI. The aim of this study was to determine the CP values of new DXA indexes of central, abdominal obesity as a ratio of android and trunk to legs as well as trunk and legs to total tissue and fat mass that best differentiate CS and matched non-CS obese women in order to confirm central abdominal obesity, and to determine their normal CP values that best differentiate healthy non-obese women from CS and non-CS obese women, and to exclude abdominal obesity completely. : DXA indexes of abdominal obesity, calculated as а ratio of regional body fat and tissue mass compartments android to legs (A/L), trunk to legs (Tr/L), trunk to total (Tr/To) and legs to total (L/To) values were determined among 4 groups. Each group consisted of 18 women: 1 group of CS, 2 group of obese women (O) not different according to their age and BMI from CS, 3 group of obese women (O) with higher BMI of 35 ± 1.2 kg and a 4 group of non-obese, healthy women (C) with a normal BMI. Diagnostic accuracy (DG) of CP values of DXA indexes of abdominal obesity and indexes of normal body fat distribution (BFD) were determined. : A/L, Tr/L, Tr/To, and L/To DXA indexes were significantly different between CS and O as well as between non-CS women O compared to O and C. These indexes had a highly significant correlation among each other and also in relation to their BMI (p < 0.0001). A/L-Tm CP value of 0.3 best differentiated the CS from group O, with the highest DG of 100 % and an A/L-Fm CP value of 0.26 differentiated them with a DG of 94.44% and sensitivity of 100 %. An A/L-Tn CP value of 0.23 and an A/L-Fn CP value of 0.25 best differentiated CS and C as well as O and C for the highest DG of 100 %. : DXA indexes A/L, Tr/L, Tr/To and L/To values were significantly different among the four groups. These values correlated significantly among them and with their BMI in non-CS groups, thus confirming a BMI increase association with a more pronounced abdominal BFD. An A/L-Tm CP value of 0.3 and an A/L-Fm CP value of 0.26 were discovered as the best DXA diagnostic indexes of extreme abdominal obesity in CS and these could also be used in discovering abdominal BFD in non-CS obese women with metabolic syndrome (MS). An A/L-Tn CP value of 0.23 and an A/L-Fn CP value of 0.25 were discovered as the best DXA diagnostic indexes of normal BFD which completely excluded abdominal obesity.
库欣综合征(CS)与体重增加以及严重的中心性、内脏性、腹部肥胖有关,这通过双能X线吸收法(DXA)诊断切点(CP)值得到证实,该值用于确定中心性肥胖指数(COI),即男性型组织与女性型组织及脂肪量的比率。这些指标能最好地将CS与根据年龄和体重指数(BMI)匹配的非CS肥胖女性区分开来。本研究的目的是确定新的DXA中心性和腹部肥胖指数的CP值,即男性型与腿部、躯干与腿部以及躯干和腿部与总组织及脂肪量的比率,以最好地区分CS与匹配的非CS肥胖女性,从而确认中心性腹部肥胖,并确定能最好地区分健康非肥胖女性与CS及非CS肥胖女性且能完全排除腹部肥胖的正常CP值。
在4组女性中测定了腹部肥胖的DXA指数,该指数计算为身体区域脂肪和组织质量分区中男性型与腿部(A/L)、躯干与腿部(Tr/L)、躯干与总体(Tr/To)以及腿部与总体(L/To)的值的比率。每组由18名女性组成:1组为CS患者,2组为年龄和BMI与CS患者无差异的肥胖女性(O),3组为BMI较高(35±1.2 kg)的肥胖女性,4组为BMI正常的非肥胖健康女性(C)。确定了腹部肥胖DXA指数和正常身体脂肪分布(BFD)指数的CP值的诊断准确性(DG)。
CS组与O组之间以及非CS女性O组与O组和C组相比,A/L、Tr/L、Tr/To和L/To DXA指数存在显著差异。这些指数相互之间以及与她们的BMI均具有高度显著的相关性(p<0.0001)。A/L-Tm CP值为0.3时能最好地将CS组与O组区分开,诊断准确性最高达100%,A/L-Fm CP值为0.26时区分两者的诊断准确性为94.44%,敏感性为100%。A/L-Tn CP值为0.23和A/L-Fn CP值为0.25时能最好地区分CS组与C组以及O组与C组,诊断准确性最高达100%。
四组之间的DXA指数A/L、Tr/L、Tr/To和L/To值存在显著差异。在非CS组中,这些值相互之间以及与她们的BMI均存在显著相关性,从而证实BMI增加与更明显的腹部BFD相关。发现A/L-Tm CP值为0.3和A/L-Fm CP值为0.26是CS中极端腹部肥胖的最佳DXA诊断指标,这些指标也可用于发现患有代谢综合征(MS)的非CS肥胖女性的腹部BFD。发现A/L-Tn CP值为0.23和A/L-Fn CP值为0.25是正常BFD的最佳DXA诊断指标,可完全排除腹部肥胖。