评估传统人体测量学和基于影像学的体脂肪成分测量指标之间的相关性：系统文献回顾和观察性研究的荟萃分析。
Assessment of correlation between conventional anthropometric and imaging-derived measures of body fat composition: a systematic literature review and meta-analysis of observational studies.
机构信息
Cancer Epidemiology Unit, Richard Doll Building, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
MRC Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Big Data Institute, Old Road Campus, Oxford, OX3 7LF, UK.
出版信息
BMC Med Imaging. 2023 Sep 14;23(1):127. doi: 10.1186/s12880-023-01063-w.
BACKGROUND
In studies of the association of adiposity with disease risk, widely used anthropometric measures of adiposity (e.g. body-mass-index [BMI], waist circumference [WC], waist-hip ratio [WHR]) are simple and inexpensive to implement at scale. In contrast, imaging-based techniques (e.g. magnetic resonance imaging [MRI] and dual x-ray absorptiometry [DXA]) are expensive and labour intensive, but can provide more accurate quantification of body fat composition. There is, however, limited evidence about the relationship between conventional and imaging-derived measures of adiposity.
METHODS
We searched Scopus and Web of Science for published reports in English of conventional versus imaging-derived measurements of adiposity. We identified 42 articles (MRI = 22; DXA = 20) that met selection criteria, involving 42,556 (MRI = 15,130; DXA = 27,426) individuals recruited from community or hospital settings. Study-specific correlation coefficients (r) were transformed using Fisher's Z transformation, and meta-analysed to yield weighted average correlations, both overall and by ancestry, sex and age, where feasible. Publication bias was investigated using funnel plots and Egger's test.
RESULTS
Overall, 98% of participants were 18 + years old, 85% male and 95% White. BMI and WC were most strongly correlated with imaging-derived total abdominal (MRI-derived: r = 0.88-; DXA-derived: 0.50-0.86) and subcutaneous abdominal fat (MRI-derived: 0.83-0.85), but were less strongly correlated with visceral abdominal fat (MRI-derived: 0.76-0.79; DXA-derived: 0.80) and with DXA-derived %body fat (0.76). WHR was, at best, strongly correlated with imaging-derived total abdominal (MRI-derived: 0.60; DXA-derived: 0.13), and visceral abdominal fat (MRI-derived: 0.67; DXA-derived: 0.65), and moderately with subcutaneous abdominal (MRI-derived: 0.54), and with DXA-derived %body fat (0.58). All conventional adiposity measures were at best moderately correlated with hepatic fat (MRI-derived: 0.36-0.43). In general, correlations were stronger in women than in men, in Whites than in non-Whites, and in those aged 18 + years.
CONCLUSIONS
In this meta-analysis, BMI and WC, but not WHR, were very strongly correlated with imaging-derived total and subcutaneous abdominal fat. By comparison, all three measures were moderately or strongly correlated with imaging-based visceral abdominal fat, with WC showing the greatest correlation. No anthropometric measure was substantially correlated with hepatic fat. Further larger studies are needed to compare these measures within the same study population, and to assess their relevance for disease risks in diverse populations.
背景
在肥胖与疾病风险相关性的研究中，广泛使用的肥胖体测指标（如身体质量指数[BMI]、腰围[WC]、腰臀比[WHR]）在大规模应用时简单且经济。相比之下，基于成像的技术（如磁共振成像[MRI]和双能 X 射线吸收法[DXA]）昂贵且劳动强度大，但可以更准确地定量身体脂肪成分。然而，关于传统体测指标和基于成像的体测指标之间的关系，证据有限。
方法
我们在 Scopus 和 Web of Science 中搜索了有关传统体测指标和基于成像的体测指标比较的英文文献报告。我们确定了 42 篇符合入选标准的文章（MRI 研究 22 项；DXA 研究 20 项），共涉及 42556 名（MRI 研究 15130 名；DXA 研究 27426 名）来自社区或医院环境的个体。使用 Fisher Z 变换转换研究特异性相关系数（r），并进行荟萃分析，以得出总体和按种族、性别和年龄加权的平均相关系数（如果可行的话）。使用漏斗图和 Egger 检验来研究发表偏倚。
结果
总体而言，98%的参与者年龄在 18 岁及以上，85%为男性，95%为白人。BMI 和 WC 与基于成像的腹部总脂肪（MRI 衍生：r=0.88-；DXA 衍生：0.50-0.86）和腹部皮下脂肪（MRI 衍生：r=0.83-0.85）相关性最强，但与腹部内脏脂肪（MRI 衍生：r=0.76-0.79；DXA 衍生：0.80）和 DXA 衍生的%体脂肪（r=0.76）相关性较弱。WHR 与基于成像的腹部总脂肪（MRI 衍生：r=0.60；DXA 衍生：r=0.13）和内脏腹部脂肪（MRI 衍生：r=0.67；DXA 衍生：r=0.65）相关性最强，与腹部皮下脂肪（MRI 衍生：r=0.54）和 DXA 衍生的%体脂肪（r=0.58）相关性中等。所有传统肥胖指标与肝脂肪（MRI 衍生：r=0.36-0.43）的相关性最强。一般来说，女性的相关性强于男性，白人的相关性强于非白人，18 岁及以上人群的相关性强于其他人群。
结论
在这项荟萃分析中，BMI 和 WC，但不是 WHR，与基于成像的腹部总脂肪和腹部皮下脂肪相关性非常强。相比之下，所有三个指标与基于成像的内脏腹部脂肪相关性均为中度或强，WC 的相关性最强。没有任何人体测量指标与肝脂肪有明显相关性。需要进一步进行更大规模的研究，以在同一研究人群中比较这些指标，并评估它们在不同人群中对疾病风险的相关性。
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