Yang Minglan, Chen Jie, Yue Jiang, He Shenyun, Fu Jingjing, Qi Yicheng, Liu Wen, Xu Hua, Li Shengxian, Lu Qing, Ma Jing
Department of Endocrinology and Metabolism, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Radiology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Diabetes Obes Metab. 2023 Mar;25(3):716-725. doi: 10.1111/dom.14918. Epub 2022 Nov 24.
To investigate the distribution of abdominal fat, particularly ectopic fat accumulation, in relation to glucose metabolism in overweight/obese patients.
This study included 257 overweight/obese subjects with body mass index ≥23 kg/m . All the subjects underwent an oral glucose tolerance test. Magnetic resonance imaging-proton density fat fraction was used to measure fat accumulation in the liver, pancreas and abdomen. Impaired glucose regulation (IGR) was defined as the presence of prediabetes or diabetes.
Liver fat content (LFC) and visceral adipose tissue (VAT) were higher in overweight/obese subjects with diabetes than in those with normal glucose tolerance (NGT). No significant differences were observed in the pancreas fat content and subcutaneous fat area between subjects with NGT and IGR. LFC was an independent risk factor of IGR (odds ratio = 1.824 per standard deviation unit, 95% CI 1.242-2.679, p = .002). Compared with the lowest tertile of LFC, the multivariate-adjusted odds ratio for the prevalence of IGR in the highest tertile was 2.842 (95% CI 1.205-6.704). However, no association was observed between the VAT per standard deviation increment and tertiles after adjusting for multiple factors. For discordant visceral and liver fat phenotypes, the high LFC-low VAT and high LFC-high VAT groups had a higher prevalence of IGR than the low LFC-low VAT group. However, there was no difference in the prevalence of IGR between the low LFC-low VAT and low LFC-high VAT groups.
Compared with visceral and pancreatic fat content, LFC is a superior risk biomarker for IGR in overweight/obese subjects.
研究超重/肥胖患者腹部脂肪分布，尤其是异位脂肪堆积与葡萄糖代谢的关系。
本研究纳入257名体重指数≥23 kg/m²的超重/肥胖受试者。所有受试者均接受口服葡萄糖耐量试验。采用磁共振成像-质子密度脂肪分数测量肝脏、胰腺和腹部的脂肪堆积情况。糖调节受损（IGR）定义为存在糖尿病前期或糖尿病。
糖尿病超重/肥胖受试者的肝脏脂肪含量（LFC）和内脏脂肪组织（VAT）高于糖耐量正常（NGT）者。NGT和IGR受试者的胰腺脂肪含量和皮下脂肪面积无显著差异。LFC是IGR的独立危险因素（优势比=每标准差单位1.824，95%CI 1.242-2.679，p = 0.002）。与LFC最低三分位数相比，最高三分位数的IGR患病率经多因素调整后的优势比为2.842（95%CI 1.205-6.704）。然而，在调整多个因素后，未观察到VAT每标准差增加量与三分位数之间的关联。对于内脏和肝脏脂肪表型不一致的情况，高LFC-低VAT和高LFC-高VAT组的IGR患病率高于低LFC-低VAT组。然而，低LFC-低VAT组和低LFC-高VAT组的IGR患病率无差异。
与内脏和胰腺脂肪含量相比，LFC是超重/肥胖受试者IGR的更优风险生物标志物。
