不同因素调节成年人内脏脂肪和皮下脂肪堆积：巴西一项单中心研究
Different factors modulate visceral and subcutaneous fat accumulation in adults: a single-center study in Brazil.
作者信息
Chagas Camila Lima, da Silva Nadja Fernandes, Rodrigues Isa Galvão, Arcoverde Gabriela Maria Pereira Floro, Ferraz Victoria Domingues, Sobral Filho Dário Celestino, Diniz Alcides da Silva, Pinho Cláudia Porto Sabino, Cabral Poliana Coelho, de Arruda Ilma Kruze Grande
机构信息
Universidade Federal de Pernambuco - UFPE, Recife, Brazil.
Universidade de Pernambuco - UPE, Recife, Brazil.
出版信息
Front Nutr. 2025 Feb 25;12:1524389. doi: 10.3389/fnut.2025.1524389. eCollection 2025.
BACKGROUND
Abdominal adipose tissue consists of visceral and subcutaneous fat deposits, each with unique metabolic and functional properties. Identifying the characteristics that influence different obesity phenotypes can support targeted prevention and intervention strategies.
OBJECTIVE
To identify predictive factors associated with visceral and subcutaneous adipose tissue accumulation.
METHODS
This is a cross-sectional study including adults of both sexes aged ≥20 years under outpatient care in a public healthcare service in Northeast Brazil. Visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) were measured via ultrasound. Anthropometric, clinical, sociodemographic, and behavioral variables were incorporated into the predictive model.
RESULTS
A total of 347 individuals were included. They were median age of 47.0 years (interquartile range: 39.0 to 56.0). Visceral obesity was found in 79.3% of the sample. Adjusted analysis demonstrated that physical inactivity (OR 2.3; 95% CI 1.1-4.7; = 0.023) and elevated waist circumference (WC) (OR 6.4; 95% CI 2.6-15.8 < 0.001) were associated with VAT accumulation. Alcohol consumption increased the likelihood of SAT accumulation by 2.2 times (95% CI 1.3-3.7; = 0.005), while elevated WC raised this likelihood by 4.5 times (95% CI 2.1-9.8; < 0.001). The VAT/SAT ratio was significantly higher in older adults (OR 5.5; 95%CI 2.0-14.8; = 0.001), among individuals of Mixed Race and Black, those with lower educational levels (OR 2.4; 95%CI 1.1-5.2; = 0.028), and in diabetics (OR 2.4; 95%CI 1.2-4.9; = 0.017).
CONCLUSION
Distinct factors influence visceral and subcutaneous obesity. Sedentary behavior emerged as an independent predictor of visceral obesity, while alcohol consumption was associated with a subcutaneous obesity pattern. Diabetes and sociodemographic factors (older age, non-White race, and lower education) were predictive of an elevated VAT/SAT ratio.
背景
腹部脂肪组织由内脏脂肪和皮下脂肪沉积组成，每种脂肪都有独特的代谢和功能特性。识别影响不同肥胖表型的特征有助于制定有针对性的预防和干预策略。
目的
确定与内脏和皮下脂肪组织堆积相关的预测因素。
方法
这是一项横断面研究，纳入了巴西东北部一家公共医疗服务机构门诊护理下年龄≥20岁的成年男女。通过超声测量内脏脂肪组织（VAT）和皮下脂肪组织（SAT）。将人体测量、临床、社会人口统计学和行为变量纳入预测模型。
结果
共纳入347名个体。他们的年龄中位数为47.0岁（四分位间距：39.0至56.0）。样本中79.3%存在内脏肥胖。校正分析表明，身体活动不足（比值比2.3；95%置信区间1.1 - 4.7；P = 0.023）和腰围（WC）升高（比值比6.4；95%置信区间2.6 - 15.8；P < 0.001）与内脏脂肪堆积有关。饮酒使皮下脂肪堆积的可能性增加2.2倍（95%置信区间1.3 - 3.7；P = 0.005），而腰围升高使这种可能性增加4.5倍（95%置信区间2.1 - 9.8；P < 0.001）。在老年人（比值比5.5；95%置信区间2.0 - 14.8；P = 0.001）、混血和黑人个体、教育水平较低者（比值比2.4；95%置信区间1.1 - 5.2；P = 0.028）以及糖尿病患者（比值比2.4；95%置信区间1.2 - 4.9；P = 0.017）中，内脏脂肪与皮下脂肪的比值显著更高。
结论
不同因素影响内脏肥胖和皮下肥胖。久坐行为是内脏肥胖的独立预测因素，而饮酒与皮下肥胖模式相关。糖尿病和社会人口统计学因素（年龄较大、非白人种族和教育程度较低）可预测内脏脂肪与皮下脂肪比值升高。
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