Park Min Jeong, Hwang Soon Young, Kim Nam Hoon, Kim Sin Gon, Choi Kyung Mook, Baik Sei Hyun, Yoo Hye Jin
Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
Department of Biostatistics, Korea University College of Medicine, Seoul, Korea.
J Obes Metab Syndr. 2023 Jun 30;32(2):130-140. doi: 10.7570/jomes23005. Epub 2023 May 30.
As the metabolic significance of sarcopenic obesity (SO) is revealed, finding an appropriate index to detect SO is important, especially for type 2 diabetes mellitus (T2DM) patients with accompanying metabolic dysfunction.
Participants (n=515) from the Korea Guro Diabetes Program were included to compare how well waist circumference (WC), waist hip ratio (WHR), waist height ratio (WHtR), and the weight-adjusted waist index (WWI) predict SO in newly diagnosed T2DM patients. Sarcopenia was defined based on guidelines from the 2019 Asian Working Group for Sarcopenia as both low muscle mass (appendicular skeletal muscle [ASM]/height <7.0 kg/m for men, <5.4 kg/m for women) and strength (handgrip strength <28.0 kg for men, <18.0 kg for women) and/or reduced physical performance (gait speed <1.0 m/sec). Obesity was defined as a WC ≥90 cm in men and ≥85 cm in women. The WHR, WHtR, and WWI were calculated by dividing the WC by the hip circumference, height, and √ weight, respectively.
The WC, WHR, and WHtR correlated positively with the fat and muscle mass represented by truncal fat amount (TFA) and ASM, whereas the WWI was proportional to the TFA and inversely related to ASM. Of the four indices, the WWI showed the highest area under the receiver operative characteristic curve for SO. The WWI also exhibited a positive correlation with albuminuria and the mean brachial-ankle pulse wave velocity, especially in patients aged ≥65 years.
The WWI is the preferable anthropometric index for predicting SO in T2DM patients, and it might be a proper index for predicting cardiometabolic risk factors in elderly people.
随着肌肉减少性肥胖（SO）代谢意义的揭示，找到一个合适的指标来检测SO很重要，特别是对于伴有代谢功能障碍的2型糖尿病（T2DM）患者。
纳入韩国九老糖尿病项目的参与者（n = 515），以比较腰围（WC）、腰臀比（WHR）、腰高比（WHtR）和体重校正腰围指数（WWI）在新诊断的T2DM患者中预测SO的效果。根据2019年亚洲肌肉减少症工作组的指南，肌肉减少症的定义为低肌肉量（男性四肢骨骼肌[ASM]/身高<7.0 kg/m，女性<5.4 kg/m）和力量（男性握力<28.0 kg，女性<18.0 kg）和/或身体机能下降（步速<1.0 m/秒）。肥胖定义为男性WC≥90 cm，女性≥85 cm。WHR、WHtR和WWI分别通过WC除以臀围、身高和√体重来计算。
WC、WHR和WHtR与以躯干脂肪量（TFA）和ASM表示的脂肪和肌肉量呈正相关，而WWI与TFA成正比，与ASM成反比。在这四个指标中，WWI在SO的受试者工作特征曲线下面积最高。WWI还与蛋白尿和平均臂踝脉搏波速度呈正相关，尤其是在年龄≥65岁的患者中。
WWI是预测T2DM患者SO的首选人体测量指标，可能是预测老年人心脏代谢危险因素的合适指标。
