内脏脂肪代谢评分（METS-VF）在预测内脏脂肪方面是否比其他肥胖指数是更好的指标？
Is Metabolic Score for Visceral Fat (METS-VF) a Better Index Than Other Adiposity Indices for the Prediction of Visceral Adiposity.
作者信息
Torun Cundullah, Ankaralı Handan, Caştur Lütfullah, Uzunlulu Mehmet, Erbakan Ayşe Naciye, Akbaş Muhammet Mikdat, Gündüz Nesrin, Doğan Mahmut Bilal, Oğuz Aytekin
机构信息
Department of Internal Medicine, Goztepe Training and Research Hospital, Istanbul Medeniyet University, Kadikoy, Istanbul, Türkiye.
Department of Biostatistics and Medical Informatics, Goztepe Training and Research Hospital, Istanbul Medeniyet University, Kadikoy, Istanbul, Türkiye.
出版信息
Diabetes Metab Syndr Obes. 2023 Aug 29;16:2605-2615. doi: 10.2147/DMSO.S421623. eCollection 2023.
BACKGROUND
Visceral adiposity is an important risk factor for cardiometabolic diseases.
OBJECTIVE
To determine whether the Metabolic Score for Visceral Fat (METS-VF) is more effective than other adiposity indices in predicting visceral fat area (VFA).
METHODS
In this single-center and cross-sectional study, we included patients aged 20-50 years, without diabetes and coronary artery disease, who underwent computed tomography (CT) including the third lumbar vertebra. Age, blood pressure, waist circumference (WC), hip circumference, fasting lipids, and glucose were assessed. VFA was measured by cross-sectional examination of CT. The correlation of WC, body mass index (BMI), waist-hip ratio (WHR), lipid accumulation product (LAP), visceral adiposity index (VAI), a body shape index (ABSI), body roundness index (BRI), and METS-VF with VFA was analyzed by correlation analysis. The cut-off values and area under the curve (AUC) for identifying increased VFA (>130 cm) were determined.
RESULTS
We included 185 individuals with mean age 38.2 ± 8 and female predominance (58.4%). There was a significant positive correlation between all indices and VFA (p<0.001). ROC analysis revealed that METS-VF and WC demonstrated the highest predictive value for identifying increased VFA. In both men (p=0.001) and women (p<0.001), METS-VF (AUC 0.922 and 0.939, respectively) showed a significant superiority over ABSI (AUC 0.702 and 0.658, respectively), and VAI (AUC 0.731 and 0.725, respectively). Additionally, in women, its superiority over WHR (AUC 0.807) was also statistically significant (p=0.003). We identified a METS-VF cut-off point >6.4 in males >6.5 in females and WC cut-off point >88 cm in males (AUC 0.922), >90.5 cm in females (AUC 0.938).
CONCLUSION
METS-VF is strongly associated with visceral adiposity and better to predict increased VFA. However, its superiority over WC, BMI, BRI, and LAP was not significant. The results emphasize that WC is more appealing as screening indicator for visceral adiposity considering its easy use.
CLINICAL TRIAL REGISTRY NAME
Clinicaltrials.gov (http://www.clinicaltrials.gov).
CLINICAL TRIAL REGISTRY URL
https://clinicaltrials.gov/ct2/show/NCT05648409.
CLINICAL TRIAL REGISTRY NUMBER
NCT05648409.
背景
内脏脂肪过多是心脏代谢疾病的重要危险因素。
目的
确定内脏脂肪代谢评分（METS-VF）在预测内脏脂肪面积（VFA）方面是否比其他肥胖指数更有效。
方法
在这项单中心横断面研究中，我们纳入了年龄在20至50岁之间、无糖尿病和冠状动脉疾病且接受了包括第三腰椎在内的计算机断层扫描（CT）的患者。评估了年龄、血压、腰围（WC）、臀围、空腹血脂和血糖。通过CT横断面检查测量VFA。通过相关性分析分析WC、体重指数（BMI）、腰臀比（WHR）、脂质蓄积产物（LAP）、内脏肥胖指数（VAI）、体型指数（ABSI）、身体圆润度指数（BRI）和METS-VF与VFA的相关性。确定了用于识别VFA增加（>130 cm²）的临界值和曲线下面积（AUC）。
结果
我们纳入了185名个体，平均年龄为38.2±8岁，女性占多数（58.4%）。所有指数与VFA之间均存在显著正相关（p<0.001）。受试者工作特征（ROC）分析显示，METS-VF和WC在识别VFA增加方面具有最高的预测价值。在男性（p=0.001）和女性（p<0.001）中，METS-VF（AUC分别为0.922和0.939）均显著优于ABSI（AUC分别为0.702和0.658）以及VAI（AUC分别为0.731和0.725）。此外，在女性中，其优于WHR（AUC为0.807）也具有统计学意义（p=0.003）。我们确定男性METS-VF临界值>6.4，女性>6.5，男性WC临界值>88 cm（AUC为0.922），女性>90.5 cm（AUC为0.938）。
结论
METS-VF与内脏脂肪过多密切相关，在预测VFA增加方面表现更佳。然而，其相对于WC、BMI、BRI和LAP的优势并不显著。结果强调，考虑到WC使用简便，它作为内脏脂肪过多的筛查指标更具吸引力。
临床试验注册名称
Clinicaltrials.gov（http://www.clinicaltrials.gov）。
临床试验注册网址
https://clinicaltrials.gov/ct2/show/NCT05648409。
临床试验注册号
NCT05648409。
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