Gažarová Martina, Bihari Maroš, Šoltís Jaroslav
Rocz Panstw Zakl Hig. 2023;74(1):59-69. doi: 10.32394/rpzh.2023.0243.
Fat and fat-free/muscle mass and their ratio reflecting the possible presence of obesity or sarcopenic obesity are important in assessing body composition.
The aim of the work was to assess the use of fat and fat-free mass and their ratio in the diagnosis of sarcopenic obesity, as well as correlations with selected anthropometric, somatic and biochemical parameters and indices.
The object of the study was a group of 201 women (20-68 aged) randomly selected from the population without the presence of a serious disease or without the use of medication. Body composition was assessed by the MFBIA method (InBody 720). We used the ratio of fat to fat-free mass (FM/FFM) to define sarcopenic obesity. A Biolis 24i Premium biochemical analyzer was used to determine biochemical parameters.
Using FM and FFM values and their mutual ratio, we identified women with a healthy body weight (28.9%), obese women (58.2%) and women with sarcopenic obesity (12.9%). Values of anthropometric parameters (body weight, BMI, WC, WHR, WHtR, BAI, FM (kg, %), FMI, VFA, FFM (kg), FFMI, SMM (kg), SMMI, ICW, ECW, TBW, CHC, HC), with the exception of FFM (%), SMM (%) and TBW (%), increased significantly with increasing FM/FFM values, so the highest values were found in subjects with sarcopenic obesity. In the case of biochemical parameters, with increasing FM/FFM values, the values of T-CH, LDL, TAG, GLU, hs-CRP, UA, systolic and diastolic blood pressure also increased, so the highest values were again found in women with sarcopenic obesity. HDL values, on the contrary, decreased. FM/FFM had the strongest positive association with the proportion of fat mass on body weight (r=0.989), then with FMI (r=0.980), FM (r=0.965), VFA (r=0.938), WHtR (r=0.937), BMI (r=0.922), WC (r=0.901. We found the strongest negative association with the proportion of FFM on body weight (r=-0.989), the proportion of total body water (r=-0.988) and the proportion of skeletal muscle mass (r=-0.987).
FM/FFM correlates excellently with FM and VFA and can be implemented to diagnose obesity. In order to comprehensively evaluate the state of health and body composition, the proportionality of not only fat, but also fat-free/muscle mass should be analyzed, because it turns out that a negative impact on health and survival is associated not only with an excessive amount of adipose tissue, but also with a lower muscle mass.
脂肪、去脂/肌肉量及其比值反映了肥胖或肌少症性肥胖的可能存在情况，在评估身体成分方面具有重要意义。
本研究旨在评估脂肪和去脂体重及其比值在肌少症性肥胖诊断中的应用，以及与选定的人体测量、躯体和生化参数及指标的相关性。
研究对象为从无严重疾病或未使用药物的人群中随机选取的201名女性（年龄20 - 68岁）。采用多频率生物电阻抗分析法（InBody 720）评估身体成分。我们使用脂肪与去脂体重的比值（FM/FFM）来定义肌少症性肥胖。使用Biolis 24i高级生化分析仪测定生化参数。
利用FM和FFM值及其相互比值，我们识别出体重正常的女性（28.9%）、肥胖女性（58.2%）和肌少症性肥胖女性（12.9%）。除FFM（%）、SMM（%）和TBW（%）外，人体测量参数（体重、BMI、腰围、腰臀比、腰高比、身体脂肪指数、FM（kg，%）、脂肪质量指数、内脏脂肪面积、FFM（kg）、去脂体重指数、骨骼肌质量（kg）、骨骼肌质量指数、细胞内液、细胞外液、总体水、身体细胞质量、身高）的值随FM/FFM值的增加而显著增加，因此在肌少症性肥胖受试者中发现最高值。就生化参数而言，随着FM/FFM值的增加，总胆固醇、低密度脂蛋白、甘油三酯、血糖、超敏C反应蛋白、尿酸、收缩压和舒张压的值也增加，所以在肌少症性肥胖女性中再次发现最高值。相反，高密度脂蛋白值降低。FM/FFM与脂肪量占体重的比例（r = 0.989）、脂肪质量指数（r = 0.980）、FM（r = 0.965）、内脏脂肪面积（r = 0.938）、腰高比（r = 0.937）、BMI（r = 0.922）、腰围（r = 0.901）具有最强的正相关。我们发现与去脂体重占体重的比例（r = -0.989）、总体水的比例（r = -0.988）和骨骼肌质量的比例（r = -0.987）具有最强的负相关。
FM/FFM与FM和内脏脂肪面积具有极佳的相关性，可用于诊断肥胖。为了全面评估健康状况和身体成分，不仅应分析脂肪的比例，还应分析去脂/肌肉量的比例，因为事实证明，对健康和生存的负面影响不仅与过多的脂肪组织有关，还与较低的肌肉量有关。
