Rigsby Ryan K, Barnes Samuel, Sabaté Joan, Oyoyo Udochukwu, Chowdhury Shilpy, Peters Eric M
Department of Radiology, Loma Linda University School of Medicine, 11234 Anderson St., Loma Linda, CA 92354, USA.
Center for Nutrition, Lifestyle and Disease Prevention, Loma Linda University School of Public Health, 24951 Circle Dr., Loma Linda, CA 92354, USA.
Clin Imaging. 2023 Jun;98:61-66. doi: 10.1016/j.clinimag.2023.03.015. Epub 2023 Mar 24.
Spinal epidural lipomatosis is abnormal accumulation of normal fat in the epidural space with weight loss suggested as first-line therapy in select symptomatic patients. However, moderate to large longitudinal studies establishing concordant changes between body mass index and epidural fat are lacking. The purpose of this study was to longitudinally assess this relationship.
We performed an ancillary study of the Habitual Diet and Avocado Trial. Baseline and six-month abdominal MRIs were analyzed for 98 overweight or obese but otherwise healthy subjects. Dorsal epidural fat volumes in the lumbar spine were measured and correlated with changes in body mass index, changes in visceral fat volume, and demographic information.
There was a linear relationship between body mass index changes and epidural fat volume changes with a one-point change in body mass index corresponding to a 45 mm change in dorsal epidural fat volume (p < 0.001, 95% CI 31.87 to 76.77) as well as between visceral fat volume changes and epidural fat volume changes (regression coefficient 0.51, p < 0.001, 95% CI 0.22 to 0.47). Age was inversely related with subjects older than 45.7 years tending to lose epidural fat (regression coefficient -0.22, p = 0.025, 95% CI -10.43 to -0.72).
Changes in spinal dorsal epidural fat volume parallel changes in body mass index and visceral fat, supporting weight loss as initial treatment for uncomplicated obesity-associated spinal epidural lipomatosis.
脊髓硬膜外脂肪增多症是硬膜外间隙正常脂肪的异常蓄积，对于部分有症状的患者，减重被建议作为一线治疗方法。然而，缺乏关于体重指数与硬膜外脂肪之间一致性变化的中大型纵向研究。本研究的目的是纵向评估这种关系。
我们对习惯性饮食与牛油果试验进行了一项辅助研究。对98名超重或肥胖但其他方面健康的受试者的基线和6个月时的腹部MRI进行了分析。测量腰椎的背侧硬膜外脂肪体积，并将其与体重指数变化、内脏脂肪体积变化及人口统计学信息进行关联分析。
体重指数变化与硬膜外脂肪体积变化之间存在线性关系，体重指数每变化1个单位，对应背侧硬膜外脂肪体积变化45mm（p<0.001，95%可信区间31.87至76.77），内脏脂肪体积变化与硬膜外脂肪体积变化之间也存在这种关系（回归系数0.51，p<0.001，95%可信区间0.22至0.47）。年龄与硬膜外脂肪呈负相关，45.7岁以上的受试者倾向于硬膜外脂肪减少（回归系数-0.22，p=0.025，95%可信区间-10.43至-0.72）。
脊髓背侧硬膜外脂肪体积的变化与体重指数和内脏脂肪的变化平行，支持减重作为单纯性肥胖相关脊髓硬膜外脂肪增多症的初始治疗方法。
