[超声检查是评估腹内脂肪厚度的合适方法吗？与计算机断层扫描的比较]

Cucchi E, Piatti P M, Orena C, Pontiroli A E, Martino E, Paesano P L, Pozza G, Del Maschio A

Radiologia Diagnostica, Cattedra di Clinica Medica I, IRCCS, Ospedale. S. Raffaele, Milano.

Radiol Med. 1997 Oct;94(4):329-34.

PURPOSE

The methods to measure intraabdominal fat amount and to distinguish visceral from subcutaneous fat are useful and needed because visceral obese people are at risk of developing cardiovascular disorders. We investigated US capabilities in measuring intraabdominal fat thickness and distribution distinguishing visceral from subcutaneous fat. The results were compared with those obtained with CT, the gold standard, and with the waist-hip ratio (W/H).

MATERIAL AND METHODS

Thirty obese women admitted to the Internal Medicine I Department, Ospedale S. Raffaele (Milan, Italy) were examined. The patients, aged 18-60 years and with BMI ranging 29.0-47.3, were submitted to consecutive double blind measurements with US and CT. The following anthropometric values were compared for every patient: W/H, US visceral/subcutaneous thickness, CT visceral/subcutaneous thickness, CT visceral area, CT subcutaneous adipose area and CT visceral/subcutaneous adipose area.

RESULTS

The classification of visceral obesity by W/H (> .85) was confirmed by CT visceral/subcutaneous adipose area (> .491). The W/H correlated significantly with CT visceral/subcutaneous adipose thickness and CT visceral/subcutaneous adipose area (r = .52, p < .004; r = .51, p < .004), but not with US visceral/subcutaneous adipose thickness (r = .42, p < .06). Significant correlations were found between Ct visceral/subcutaneous adipose area and with both US and CT visceral/subcutaneous adipose thickness (r = .59, p < .006; = .71, p < .0001). A high correlation was found between US visceral/subcutaneous adipose thickness and CT visceral/subcutaneous adipose thickness (r = .96, p < .0001).

CONCLUSION

Analyzing the results of the different methods, we conclude that US can always be used to study abdominal fat amount and distribution in obese women because this method exhibits significant correlations with CT, the gold standard. The W/H is not sufficient to distinguish visceral from subcutaneous intraabdominal fat.

目的

测量腹内脂肪量以及区分内脏脂肪与皮下脂肪的方法是有用且必要的，因为内脏型肥胖者有患心血管疾病的风险。我们研究了超声在测量腹内脂肪厚度以及区分内脏脂肪与皮下脂肪分布方面的能力。将结果与采用金标准CT以及腰臀比（W/H）所获得的结果进行比较。

材料与方法

对意大利米兰圣拉斐尔医院内科一部收治的30名肥胖女性进行检查。患者年龄在18至60岁之间，BMI范围为29.0至47.3，接受了超声和CT的连续双盲测量。对每位患者的以下人体测量值进行比较：腰臀比、超声测量的内脏/皮下厚度、CT测量的内脏/皮下厚度、CT测量的内脏面积、CT测量的皮下脂肪面积以及CT测量的内脏/皮下脂肪面积。

结果

通过CT内脏/皮下脂肪面积（>.491）证实了腰臀比（>.85）对内脏型肥胖的分类。腰臀比与CT内脏/皮下脂肪厚度以及CT内脏/皮下脂肪面积显著相关（r = .52，p < .004；r = .51，p < .004），但与超声内脏/皮下脂肪厚度不相关（r = .42，p < .06）。CT内脏/皮下脂肪面积与超声和CT内脏/皮下脂肪厚度均显著相关（r = .59，p < .006；r = .71，p < .0001）。超声内脏/皮下脂肪厚度与CT内脏/皮下脂肪厚度高度相关（r = .96，p < .0001）。