Department of Radiology, Shengjing Hospital of China Medical University, Shenyang 110004, China.
Eur J Radiol. 2024 Jan;170:111205. doi: 10.1016/j.ejrad.2023.111205. Epub 2023 Nov 21.
We aimed to determine if sex differences in abdominal visceral fat composition and metabolism can help predict the prognosis of diffuse large B-cell lymphoma (DLBCL) patients.
This retrospective cohort study included 117 DLBCL patients. The area and metabolic activity of subcutaneous adipose tissue and visceral adipose tissue were measured using CT and PET imaging. Kaplan-Meier survival analysis was employed to evaluate the effect of these parameters on progression-free survival. Multivariate Cox proportional hazard regression models were used to determine the effects of relative visceral fat area (rVFA) on sex-specific survival.
Females with an rVFA greater than the optimal threshold of 35 % and a visceral-to-subcutaneous adipose tissue ratio (V/S) >3.24 had worse progression-free survival (p = 0.01, 0.001, respectively). No rVFA or V/S were identified in significantly stratified males with DLBCL (p = 0.249 and 0.895, respectively). Combining the changes in rVFA and V/S identified a subgroup of females with high rVFA and V/S values and exceptionally poor outcomes. The rVFA was a significant predictor of DLBCL progression in females alone.
Once female DLBCL patients accumulate fat over the tolerable range in the visceral area, they might be at an increased risk of progression (hazard ratio, 3.87; 95 % CI, 1.81-12.69, p = 0.02). Sex differences in visceral fat composition and metabolism may provide a new risk stratification system for patients with DLBCL.
本研究旨在确定腹部内脏脂肪成分和代谢的性别差异是否有助于预测弥漫性大 B 细胞淋巴瘤（DLBCL）患者的预后。
本回顾性队列研究纳入了 117 名 DLBCL 患者。采用 CT 和 PET 成像测量皮下脂肪组织和内脏脂肪组织的面积和代谢活性。采用 Kaplan-Meier 生存分析评估这些参数对无进展生存期的影响。采用多变量 Cox 比例风险回归模型确定相对内脏脂肪面积（rVFA）对性别特异性生存的影响。
rVFA 大于 35%的最佳阈值且内脏-皮下脂肪组织比（V/S）>3.24的女性无进展生存期更差（p=0.01、0.001）。rVFA 或 V/S 在患有 DLBCL 的男性中没有显著分层（p=0.249 和 0.895）。rVFA 和 V/S 的变化结合起来确定了一个具有高 rVFA 和 V/S 值和异常不良结局的女性亚组。rVFA 是女性 DLBCL 进展的一个显著预测因子。
一旦女性 DLBCL 患者的内脏区域脂肪积累超过可耐受范围，她们可能面临更高的进展风险（危险比，3.87；95%CI，1.81-12.69，p=0.02）。内脏脂肪成分和代谢的性别差异可能为 DLBCL 患者提供一种新的风险分层系统。
