ProSciento, San Diego, California, USA.
Scripps Center for Organ Transplantation, La Jolla, California, USA.
Endocrinol Diabetes Metab. 2022 May;5(3):e00335. doi: 10.1002/edm2.335. Epub 2022 Apr 6.
Excess body fat is linked to higher risks for metabolic syndrome, type 2 diabetes mellitus (T2DM), and cardiovascular disease (CV), among other health conditions. However, it is not only the level but also the distribution of body fat that contributes to increased disease risks. For example, an increased level of abdominal fat, or visceral adipose tissue (VAT), is associated with a higher risk of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH).
A review of the most relevant primary and secondary sources on body composition from the last 25 years was conducted. Relevant articles were identified using PUBMED and Google Scholar. Narrative synthesis was performed as statistical pooling was not possible due to the heterogeneous nature of the studies.
The body mass index (BMI) is commonly used as a proxy measure of body fatness. However, BMI does not reflect the level and distribution of body fat. Other anthropometric methods such as waist circumference measurement and waist-hip ratio, as well as methodologies like hydro densitometry, bioelectrical impedance, and isotope dilution are also limited in their ability to determine body fat distribution. Imaging techniques to define body composition have greatly improved performance over traditional approaches. Ultrasound (US), computed tomography (CT), dual-energy X-ray absorptiometry (DXA), magnetic resonance imaging (MRI), are now commonly used in clinical research. Of these, MRI can provide the most accurate and high-resolution measure of body composition. In addition, MRI techniques are considered the best for the determination of fat at the organ level. On the other hand, imaging modalities require specialized, often expensive equipment and expert operation.
Anthropometric methods are suitable for rapid, high-volume screening of subjects but do not provide information on body fat distribution. Imaging techniques are more accurate but are expensive and do not lend themselves for high throughput. Therefore, successful trial strategies require a tiered approach in which subjects are first screened using anthropometric methods followed by more sophisticated modalities during the execution of the trial. This article provides a brief description of the most clinically relevant adipose tissue measurement techniques and discusses their value in obesity, diabetes, and NAFLD/NASH clinical research.
过多的体脂肪与代谢综合征、2 型糖尿病（T2DM）和心血管疾病（CV）等健康状况的风险增加有关。然而，导致疾病风险增加的不仅是体脂肪的水平，还有其分布。例如，腹部脂肪或内脏脂肪组织（VAT）水平的增加与非酒精性脂肪肝（NAFLD）和非酒精性脂肪性肝炎（NASH）的风险增加有关。
对过去 25 年中关于身体成分的最相关主要和次要来源进行了综述。使用 PUBMED 和 Google Scholar 确定了相关文章。由于研究的异质性，无法进行统计汇总，因此进行了叙述性综合。
体重指数（BMI）通常用作体脂的替代测量指标。然而，BMI 并不能反映体脂肪的水平和分布。其他人体测量方法，如腰围测量和腰臀比，以及水比重测定法、生物电阻抗法和同位素稀释法等方法，在确定体脂肪分布方面也存在局限性。用于定义身体成分的成像技术在性能上大大优于传统方法。超声（US）、计算机断层扫描（CT）、双能 X 射线吸收测定法（DXA）、磁共振成像（MRI）现在在临床研究中经常使用。在这些方法中，MRI 可以提供最准确和高分辨率的身体成分测量。此外，MRI 技术被认为是确定器官水平脂肪的最佳方法。另一方面，成像方式需要专门的、通常昂贵的设备和专业的操作。
人体测量方法适合于对受试者进行快速、大容量的筛查，但不能提供体脂肪分布的信息。成像技术更准确，但价格昂贵，不适合高通量。因此，成功的试验策略需要采用分层方法，首先使用人体测量方法对受试者进行筛查，然后在试验执行过程中使用更复杂的方式。本文简要描述了最具临床相关性的脂肪组织测量技术，并讨论了它们在肥胖、糖尿病和 NAFLD/NASH 临床研究中的价值。
