Analysis of the Correlation Between Visceral Fat Area and Insulin Resistance in Patients with Type 2 Diabetes and Abdominal Obesity

Objective: To analyze the correlation between visceral fat area and insulin resistance index (HOMA-IR) in patients with type 2 diabetes mellitus (T2DM) and abdominal obesity and to provide a reference for screening and related research of such patients. Methods: Two hundred patients with T2DM admitted to Guandu People’s Hospital of Kunming were included. The study was carried out from October 2022 to December 2023. The patients were divided into three groups according to different abdominal visceral fat areas (VFA): Group A (n = 65) was less than 75cm2, Group B (n = 75) was 75-100 cm2, and Group C (n = 60) was greater than 100 cm2. The subjects in the three groups were all tested for glycated hemoglobin (HbA1c), fasting insulin (FINS), and fasting blood glucose (FPG). Height and weight were measured to calculate body mass index (BMI). The HOMA-IR and TYG (fasting triglyceride and glycemic index) were also calculated. Changes in the BMI, VFA, HOMA-IR, and TYG levels were observed in the three groups. Results: The VFA, BMI, HbA1c, FPG, FINS, HOMA-IR, and TYG of the patients all increased, with a more significant increase in the BMI, FINS, HOMA-IR, and TYG levels (P < 0.01). Multiple linear stepwise regression analyses used visceral fat area (VFA) as the dependent variable. The results showed that VFA was closely related to BMI, FINS, HOMA-IR, and TYG. Conclusion: Early reduction of VFA to reduce insulin resistance may be a better treatment and effective method for T2DM, providing powerful measures and new strategies for effective blood sugar control and early prevention in the treatment of metabolic diseases.

Impact of Lifestyle Intervention on the Estimated Visceral Fat Area and Skeletal Muscle Mass in Men with Obesity

Background: The lifestyle modification remains the fundamental approach for the obesity treatment. The aim of this study is to demonstrate the effect of the multimodal lifestyle intervention on the estimated visceral fat area versus changes in musculoskeletal mass in a cohort of adult men with obesity. Subjects and Methods: A retrospective cohort study in which the file of eighty-two male subjects, aged 20 - 60 years, was studied for three months. Patients had been instructed to follow a balanced-hypocaloric diet, physical activity plan and general advice for combating the unhealthy lifestyle habits through the study period. Those who succeeded to loss > 5% of their body weight were classified as weight loser (WL) group, while others as weight resistant (WR) group. The results of In Body-720 bioelectric impedance analysis were used to report the fat mass (FM), visceral fat area (VFA), skeletal muscle mass (SMM), SMM/VFA ratio, osseous mass (OM), and basal metabolic rate (BMR) before and after the study period. Anthropometric measures, glucose, and lipid profile were also analyzed. Paired t-test was used to detect the significance of change between before and after measures, independent sample t-test was used to compare WL vs. WR groups. Results: There were significant decreases in weight, FM (p 0.05) and VFA (p 0.001), in addition to a significant rise of SMM/VFA ratio (p 0.05), together with insignificant changes of osseous mass, SMM and BMR after 3 months. Additionally, total cholesterol, low-density lipoprotein, and triglycerides were significantly reduced (P 0.05). The percentages of reduction in weight, FM and VFA in WL vs. WR groups were highly significant (p 0.001), while the percentages of change in SMM, SMM/VFA ratio and BMR were significant (p 0.05). Conclusion: Lifestyle modification might be effective in production of positive changes in the body composition of patients with obesity. These changes were more significant in weight losers.

Relation between serum progranulin, inflammatory markers and visceral fat in childhood obesity

Aim: To study serum progranulin (PGRN) level in children with obesity and its relationship to inflamamatory markers and visceral fat. Methods: Fifty obese children and 50 controls aged 10-18 years were recruited. Demographic, anthropometric and biochemical features were collected according to a standard protocol. Serum progranulin levels, serum IL-6 and hsCRP were measured using ELISA. Insulin resistance was calculated by the homeostasis model (HOMA-IR) using the following formula: HOMA-IR = fasting insulin (mU/L) × fasting glucose (mmoL/L)/ 22.5. The maximum visceral fat thickness (VFT) and the minimum subcutaneous fat thickness (SFT) were measured by ultrasonography. Results: In the obese group, a significant increase was found in serum PGRN (48.87 ± 42.33 ng/mL) compared to control group (30.18 ± 23.82 ng/mL). Progranulin correlated significantly with VFT (r = 0.475), IL6 (r = 0.368), Insulin(r = 0.440) and HOMA-IR (r = 0.379). The mean serum progranulin in the high tertile VFT group was significantly higher than those in the low tertile and middle tertile groups (P = 0.030 and P = 0.039 respectively). VFT was highly positively correlated to progranulin, SFT, IL6, insulin, HOMA-IR and hsCRP (P = 0.001, 0.000, 0.001, 0.001, 0.003 and 0.003). However, the correlation coefficient between SFT and progranulin was insignificant. Summary: we demonstrated for the first time that serum PGRN concentrations increased in Egyptian obese children. The concentrations of serum PGRN correlated closely with visceral fat and IL6. Conclusion: PGRN may contribute to the pathogenesis of chronic inflammation in obesity. It could be a novel marker of visceral fat in obesity. Thus PGRN could be a potential therapeutic target for management of chronic inflammation in obesity.

What is the role of adiponectin in obesity related non-alcoholic fatty liver disease?

Non-alcoholic fatty liver disease (NAFLD) is recognized as the most common type of chronic liver disease in Western countries.Insulin resistance is a key factor in the pathogenesis of NAFLD,the latter being considered as the hepatic component of insulin resistance or obesity.Adiponectin is the most abundant adipose-specific adipokine.There is evidence that adiponectin decreases hepatic and systematic insulin resistance,and attenuates liver inflammation and fibrosis.Adiponectin generally predicts steatosis grade and the severity of NAFLD;however,to what extent this is a direct effect or related to the presence of more severe insulin resistance or obesity remains to be addressed.Although there is no proven pharmacotherapy for the treatment of NAFLD,recent therapeutic strategies have focused on the indirect upregulation of adiponectin through the administration of various therapeutic agents and/or lifestyle modifications.In this adiponectin-focused review,the pathogenetic role and the potential therapeutic benefits of adiponectin in NAFLD are analyzed systematically.

Visceral fat and insulin resistance as predictors of non-alcoholic steatohepatitis

AIM： To examine whether visceral fat is associated with non-alcoholic steatohepatitis （NASH）, to assess for parameters associated with visceral adiposity and to investigate for factors associated with fibrotic severity in NASH. METHODS： Thirty NASH and 30 control subjects underwent biochemical tests, anthropometric assessment, bioelectrical impedance, dual energy X-ray absorptiometry and abdominal fat study by CT scan. Liver biopsies were graded according to the Brunt criteria. RESULTS： NASH subjects had elevated blood pressure, body mass index, waist circumference and waist-to-hip ratio. A greater number of diabetes rnellitus, impaired glucose tolerance test and HOMA-IR 〉 3.5 were found in NASH patients. HOMA-IR 〉 2.8 （OR 20.98, 95% CI 3.22-136.62; P 〈 0.001） and visceral fat area 〉 158 cm^2 （OR 18.55, 95% CI 1.60-214.67; P = 0.019） were independent predictors for NASH. Advanced stage of NASH was found in 15 （50%） patients. HOMA-IR 〉 3.5 （OR 23.12, 95% CI 2.00-266.23; P = 0.012） and grading of portal inflammation （OR 7.15, 95% CI 1.63-31.20; P = 0.009） were determined as independent risk factors for advanced stage of NASH. CONCLUSION： Obesity （especially central obesity） and metabolic syndrome are common in Thai NASH. Insulin resistance and elevated visceral fat are risk factors for the presence of NASH. The advanced stage of thedisease is related to insulin resistance.

Association of visceral obesity and early colorectal neoplasia

AIM:To examine whether visceral adipose tissue(VAT)serves as a risk factor for colorectal adenoma-early colorectal cancer(CRC)sequence.METHODS:A retrospective case-control study was conducted with 153 patients with stageⅠCRC,age/sex-matched 554 patients with colorectal adenoma and557 normal controls.All subjects underwent various laboratory tests,abdominal fat computed tomography(CT),and colonoscopy.VAT was defined as an intraabdominal adipose tissue area measured by CT scan.Adipose tissue area was measured at the level of the umbilicus from CT scan.We used the lowest quartile of VAT and subcutaneous adipose tissue area as a reference group.RESULTS:The body mass index(BMI),total cholesterol,fasting glucose and VAT areas were significantly different among normal,adenoma and CRC groups.The VAT area was 120.6±49.0 cm2in normal controls,130.6±58.4 cm2in adenoma group and 117.6±51.6cm2in CRC group(P=0.002).In univariate analysis,increased BMI was a risk factor for CRC compared to control(P=0.025).However,VAT area was not a risk factor for CRC compared to control.In multivariate analysis that adjusted for smoking,alcohol consumption and subcutaneous adipose tissue area,VAT area was inversely related to CRC,compared to the adenoma(OR=0.53,95%CI:0.31-0.92,highest quartile vs lowest quartile).CONCLUSION:Our study shows that visceral obesity is not a risk factor for early CRC.Visceral obesity might influence the normal-adenoma sequence but not the adenoma-early carcinoma sequence.

Estimation of visceral fat is useful for the diagnosis of significant fibrosis in patients with non-alcoholic fatty liver disease

BACKGROUND Obesity is a risk factor for non-alcoholic fatty liver disease(NAFLD),although obese patients with NAFLD do not always develop significant fibrosis.The distribution of body fat could predict the risk of NAFLD progression.AIM To investigate the role of bioelectrical impedance-estimated visceral fat(VF)in assessing NAFLD severity.METHODS In this cross-sectional study,patients with biopsy-proven NAFLD were prospectively included.All patients underwent anthropometric evaluation,blood tests and bioelectrical impedance analysis.RESULTS Between 2017 and 2020,119 patients were included[66.4%male,56 years(SD 10.7),62.2%obese,61.3%with metabolic syndrome].Sixty of them(50.4%)showed significant fibrosis(≥F2)in liver biopsy.Age,VF and metabolic syndrome were associated with significant fibrosis(61 years vs 52 years,16.4 vs 13.1,73.3%vs 49.2%,respectively;P<0.001 for all).In the multivariate analysis,VF and age were independently associated with significant fibrosis(VF,OR:1.11,95%CI:1.02-1.22,P=0.02;age,OR:1.08,95%CI:1.03-1.12,P<0.01).A model including these variables showed and area under the receiver operating characteristic curve(AUROC)of 0.75,which was not inferior to transient elastography or NAFLD fibrosis score AUROCs.We developed a nomogram including age and VF for assessing significant fibrosis in routine practice.CONCLUSION VF is a surrogate marker of liver fibrosis in patients with NAFLD.Bioelectrical impedance analysis is an inexpensive and simple method that can be combined with age to guide patient referral when other resources may be unavailable.

Visfatin与炎症及胰岛素抵抗研究新进展

内脏脂肪素(visfatin)是新近发现的主要由内脏脂肪组织表达的一种脂肪细胞因子,与内脏脂肪量呈正相关,在内脏脂肪组织丰度极高,在肥胖的发展过程中表达亦升高。而肥胖是一种非感染性、慢性、全身性炎症病理过程,对于visfatin与炎症的关系研究较少。其可能是机体自身平衡而分泌的一个对抗多种致炎(炎症前)细胞因子,如肿瘤坏死因子α、白细胞介素6的细胞因子,其对糖代谢和visfatinmRNA的表达机制研究提供新思路。

训练方式和训练周期对隐性肥胖者内脏和皮下脂肪的影响

背景:研究表明,运动干预比单纯的药物治疗或限制饮食在减脂方面可能更具优势,但同时研究训练方式与训练周期对肥胖人群内脏和皮下脂肪影响的研究较少见。目的:探究训练方式和训练周期对隐性肥胖女大学生内脏和皮下脂肪的影响。方法:招募郑州工商学院隐性肥胖(体质量指数<24 kg/m^(2)且体脂含量百分数≥30%)女大学生63名,采用抽签法随机分为高强度间歇性训练组(n=32)、中等强度持续性训练组(n=31)。两组受试者均在跑台上进行对应强度的运动训练,并保证两组运动量相当,每周3次,每4周为1个训练周期,为期16周。训练前及每个训练周期末,使用对应的测试装置测量被试内脏脂肪、皮下脂肪及整体脂肪情况。结果与结论:(1)重复测量F检验结果显示,内脏脂肪面积、内脏脂肪指数、腹部皮下脂肪厚度、体脂含量和体质量指数的训练周期主效应显著,肱三头肌和肩胛骨部位皮下脂肪厚度的训练方式主效应显著,所有指标训练方式和训练周期的交互效应均显著(P均<0.05);(2)简单效应检验结果显示,训练第4,12周末的内脏脂肪面积和内脏脂肪指数,训练第8,12周末的肱三头肌、肩胛骨和腹部皮下脂肪厚度,以及第8周末体脂含量和体质量指数的训练方式简单效应显著;组内所有指标训练周期的简单效应显著;(3)多重比较结果显示,高强度间歇性训练组训练第4,8,12,16周末的内脏脂肪面积、内脏脂肪指数、体脂含量、体质量指数和腹部皮下脂肪厚度依次下降,训练第8,12,16周末肱三头肌和肩胛骨部位的皮下脂肪厚度依次下降(P均<0.05);中等强度持续性训练组训练第8,12,16周末的内脏脂肪面积、内脏脂肪指数、肱三头肌和肩胛骨部位皮下脂肪厚度以及体脂含量和体质量指数依次下降,训练第4,8,12,16周末的腹部皮下脂肪厚度依次下降(P均<0.05);(4)结果显示,训练方式和训练周期均是影响隐性肥胖女大学生内脏和皮下脂肪的因素,训练方式主要影响肱三头肌和肩胛骨部位皮下脂肪,但在较长训练周期中减脂效果可能趋同;训练周期主要影响内脏脂肪面积、内脏脂肪指数、腹部皮下脂肪、体脂含量和体质量指数。

Fatty liver is an independent risk factor for gallbladder polyps

BACKGROUND Gallbladder polyps(GBPs)are known to be associated with obesity and metabolic diseases.However,to date,the relationship between GBPs and abnormal body fat distribution,such as fatty liver,visceral obesity,or sarcopenia,has not yet been established.AIM To evaluate whether GBPs are associated with fatty liver,visceral obesity,or sarcopenia.METHODS We retrospectively reviewed the medical records of subjects who underwent various laboratory tests,body composition measurement with a non-invasive body composition analyzer,and abdominal ultrasonography during health checkups.A total of 1405 subjects with GBPs were compared with 2810 age-and sex-matched controls.RESULTS The mean age of the subjects was 46.8±11.7 years,and 63.8%were male.According to multiple logistic regression analysis,the presence of fatty liver[odds ratio(OR)1.413;95%confidence interval(CI)1.218-1.638;P<0.001]was an independent risk factor for GBP,together with low levels of alanine aminotransferase(OR 0.993;95%CI 0.989-0.996;P<0.001).Additionally,fatty liver showed both independent(OR 1.629;95%CI,1.335-1.988;P<0.001)and dosedependent(moderate to severe fatty liver;OR 2.137;95%CI,1.662-2.749;P<0.001)relationship with large GBPs(≥5 mm).The presence of sarcopenia and high visceral fat area were not significantly associated with GBPs.CONCLUSION Fatty liver was found to be closely associated with GBPs irrespective of sarcopenia and visceral obesity.

运动处方对老年大鼠和老年肥胖大鼠Resistin和Visfatin mRNA表达及血浆浓度的影响

目的:探讨运动处方对老年大鼠和老年肥胖大鼠内脏脂肪组织Resistin及Visfatin mRNA表达及血浆Resistin和Visfatin浓度的影响。方法:建立老年及老年肥胖模型,选取老年大鼠分对照组(W,5只)和运动组(WE,6只),选取老年肥胖大鼠分对照组(F,6只)和运动组(FE,6只)。运动处方为跑台坡度为0°,速度为15m/min,15min/组,4组/次,组间休息5min,每天1次,每周5次,运动8周。干预后用qRT-PCR测内脏脂肪组织Resistin和Visfatin的mRNA表达,用ELISA测血浆Resistin和Visfatin的浓度。结果:8周运动后,体重WE与W差异无统计学意义(P>0.05)、FE低于F(P<0.01),内脏脂肪量和内脏脂肪率表现为WE低于W、FE低于F(P<0.05,P<0.01);内脏脂肪组织Resistin的mRNA表达WE高于W(P<0.05),F与W和FE差异无统计学意义(P>0.05),血浆Resistin浓度各组间均无统计学意义(P>0.05);内脏脂肪组织Visfatin的mRNA表达与血浆Visfatin浓度WE高于W、FE高于F,但均无统计学意义(P>0.05)。结论:该运动处方减肥效果明显;运动处方仅对老年大鼠内脏脂肪组织Resistin mRNA有影响,对老年肥胖大鼠的内脏脂肪组织Resistin和Visfatin mRNA及血浆Resistin和Visfatin浓度的影响甚微。

腹部肥胖对COPD急性加重的影响

目的探讨腹部肥胖相关指标对慢性阻塞性肺疾病(COPD)患者急性加重的影响。方法对“新疆多民族自然人群队列建设及健康随访研究”招募的和田墨玉县常住居民经肺功能检测诊断为COPD的患者,进行问卷及常规检查测量腰围,体成分检测内脏脂肪等级,计算腰高比、体重调整腰围指数(WWI),随访患者至少1年急性加重住院情况。以急性加重住院为结局分析腹部肥胖相关指标对COPD急性加重的影响,并比较不同腹部肥胖指标对COPD急性加重的预测价值。结果631名COPD患者经过随访,报告了186例COPD急性加重住院病例。整个随访期间,COPD急性加重和无急性加重患者在年龄、肺结核疾病史、吸烟、二手烟、烹饪和取暖燃料、慢阻肺患者评价评分(CAT评分)等方面的比较差异有统计学意义(均P<0.05)。单因素及模型1和2显示,腰围、腰高比、WWI、内脏脂肪等级均对COPD急性加重有影响,指标每增加一个单位急性加重均有增加;腰高比及内脏脂肪等级对COPD急性加重影响的结果较稳定,多重调整后腰高比OR=1.304(1.010~1.683),内脏脂肪等级OR=1.912(1.122~3.257)。腹部肥胖相关指标对COPD急性加重均有预测价值,其中WWI的曲线下面积最大,为0.614。结论腹部肥胖指标腰高比、WWI、内脏脂肪等级是COPD急性加重的危险因素,COPD的防控应考虑减少腹部肥胖的干预策略。

健康体检人群内脏脂肪面积与尿酸/高密度脂蛋白胆固醇比值的相关性研究

目的探讨健康体检人群内脏脂肪面积(VFA)与尿酸(UA)/高密度脂蛋白胆固醇(HDL-C)比值(UHR)的相关性。方法随机选取2020年6月至2022年6月于枣庄市立医院进行健康体检的人群360名。根据VFA值,将人群分为内脏脂肪型肥胖组(VFA≥100 cm^(2))172名和对照组(VFA<100 cm^(2))188名,比较两组一般资料及生化指标。采用Spearman相关分析评估VFA与UHR的相关性,多元线性回归分析UHR的影响因素;采用受试者工作特征(ROC)曲线评估UHR对内脏脂肪型肥胖的预测价值。结果与对照组相比,内脏脂肪型肥胖组体重指数(BMI)、VFA、皮下脂肪面积(SFA)、VFA/SFA(V/S)、甘油三酯(TG)、甘油三酯葡萄糖指数(TyG)、UA、UHR水平升高,HDL-C水平降低,差异有统计学意义(均P<0.05)。Spearman相关分析显示,UHR与BMI、VFA、SFA、V/S、TG、TyG呈正相关(P<0.01)。以UHR为因变量,BMI、VFA、SFA、V/S、TG、TyG为自变量进行多元线性回归分析,结果显示TG、VFA是UHR的影响因素。ROC曲线显示UHR预测内脏脂肪型肥胖的曲线下面积为0.741(P<0.001),最佳截断值为0.35。结论健康体检人群UHR与VFA有关,对内脏脂肪型肥胖有较好的预测价值。

2型糖尿病患者血清铁蛋白水平与体脂分布的相关性分析

目的探讨2型糖尿病(T2DM)患者血清铁蛋白水平与体脂分布的关系。方法收集2020年6-11月在兰州大学第一医院内分泌科住院的151例T2DM患者进行回顾性分析。所有患者根据血清铁蛋白水平分为高血清铁蛋白组(n=50)与正常血清铁蛋白组(n=101)。测量两组患者的血糖、血脂,以及内脏脂肪面积(VFA)、皮下脂肪面积(SFA)、肝脂肪、身高、体重和腰围(WC),计算体重指数(BMI)和内脏肥胖指数(VAI),并进行组间比较;采用Pearson或Spearman相关性分析及多元线性回归分析血清铁蛋白水平与体脂分布的相关性。结果高血清铁蛋白组VAI和WC均明显高于正常血清铁蛋白组[分别为3.13(2.16,4.58)vs.2.66(1.66,3.81),(96.66±7.78)cm vs.(91.96±9.75)cm,P<0.05]。高血清铁蛋白组中心性肥胖和血脂异常的患病率明显高于正常血清铁蛋白组(分别为88.0%vs.68.3%,90.0%vs.75.2%,P<0.05),且血糖控制差、胰岛素抵抗的构成比也高于正常血清铁蛋白组(分别为96.0%vs.78.2%、62.0%vs.40.6%,P<0.05),而两组间BMI、VFA、SFA水平,以及降糖药物使用情况和糖尿病慢性并发症差异无统计学意义(P>0.05)。T2DM患者血清铁蛋白水平与VAI、WC、三酰甘油(TG)、空腹血糖(FPG)、糖化血红蛋白(HbA1c)、血脂异常、血清肌酐(SCr)呈正相关(r=0.171、0.207、0.187、0.243、0.270、0.162、0.162,P<0.05),与年龄、性别和糖尿病病程呈负相关(r=-0.191、-0.434、-0.352,P<0.05)。多元线性回归显示,在男性T2DM患者中,糖尿病病程和FPG是血清铁蛋白水平增高的危险因素,但WC及VAI对血清铁蛋白的影响不明显;而在女性T2DM患者中,糖尿病病程、TG和VAI是血清铁蛋白水平增高的危险因素(P<0.05)。结论女性T2DM患者的血脂紊乱和内脏脂肪增加是血清铁蛋白水平增高的危险因素。

骨骼肌质量指数、握力及肌肉脂肪比与ASCVD相关性研究

目的探讨骨骼肌质量指数(SMI)、握力、肌肉脂肪比(SVR)与中老年住院患者动脉粥样硬化性心血管疾病(ASCVD)风险的相关性。方法纳入2023年1月至2023年7月在南昌大学第一附属医院全科与老年医学科中老年患者469例。根据China-PAR风险预测模型评估10年发生ASCVD风险,分为低、中、高风险3组。测定所有受试者身体成分、握力,并收集相关血液学指标。采用Pearson或Spearman相关性分析探讨SMI、握力、SVR与ASCVD风险相关性。采用多因素Logistic回归分析高风险ASCVD的独立影响因素。结果高风险ASCVD患者更易出现低SMI、低握力和低SVR(P<0.005)。握力和SVR与ASCVD风险呈显著负相关(P<0.001)。在矫正混在因素后,SMI、握力和SVR是65岁以上老年女性人群发生高风险ASCVD的独立危险因素(OR=0.109,95%CI=0.038~0.317,P<0.001;OR=0.899,95%CI=0.824~0.981,P=0.017;OR=0.042,95%CI=0.013~0.140,P<0.001),而握力是65岁以上男性的独立危险因素(OR=0.910,95%CI=0.845~0.980,P=0.013)。结论中老年人群低SMI、低握力和低SVR显著增加10年ASCVD风险,宜早期进行预防和干预。

中老年住院患者同型半胱氨酸与内脏脂肪型肥胖的相关性研究

目的探讨同型半胱氨酸(homocysteine,Hcy)对中老年住院患者内脏脂肪型肥胖的影响。方法连续入选宣武医院老年医学科患者354例,采集临床和实验室资料、估算内脏脂肪面积(estimated visceral fat area,eVFA),根据是否合并内脏脂肪型肥胖(visceral fat obesity,VFO)分为VFO组(252例)和非VFO组(102例),采取横断面研究Hcy对中老年住院患者VFO的影响。结果与非VFO组比较,VFO组的体重指数、Hcy等指标均明显高于非VFO组(P<0.05)。二分类Logistic回归分析显示性别、BMI、Hcy是VFO的危险因素(P<0.05)。Spearman相关性分析显示,Hcy与eVFA呈正相关(r=0.255,P<0.001),调整年龄后仍相关。按照体重指数分层观察Hcy与体重正常组(r=0.356,P=0.001)和超重组(r=0.255,P<0.001)的eVFA均呈正相关,调整年龄后仍相关。ROC曲线得出截断值为11.05,敏感度为86%,特异度为42%(ROC曲线下面积=0.646,95%CI:0.572~0.719,P<0.001)。结论中老年住院患者Hcy与eVFA具有相关性,Hcy为VFO的危险因素,中老年住院患者应该更为严格地控制Hcy水平。

基于腹部CT确定腹部脂肪参数与肠系膜脂膜炎的关系

目的基于CT测量腹部脂肪参数,探讨肠系膜脂膜炎(MP)与肥胖之间的关系。方法对2019年8月—2022年7月在东南大学附属中大医院住院行腹部CT检查的患者进行回顾性匹配对照研究,根据放射学标准诊断为MP的患者为MP组。收集研究对象的基线信息和血脂水平,获取L3椎体水平上的CT图像,基于腹部CT图像,应用Image J软件测量腹部脂肪参数,使用单因素和多因素分析研究体重指数(BMI)、血脂水平及腹部脂肪参数与MP之间的关系。根据患者BMI和内脏脂肪面积(VFA),分为BMI正常组、内脏型肥胖组、非内脏型肥胖组,比较3组间MP患病率及影像学特征的差异。结果在905例CT诊断为MP的患者中,242例被纳入研究。MP组VFA为(172.46±73.74)cm^(2),皮下脂肪面积(SFA)为(149.54±57.59)cm^(2),VFA/SFA为1.25±0.61。MP组BMI、VFA、SFA和VFA/SFA均明显高于对照组(P<0.05),而2组间血脂水平差异无统计学意义,多因素分析发现BMI、VFA是MP的独立危险因素。MP患病率在不同肥胖类型之间有差异,内脏型肥胖、非内脏型肥胖者患MP的风险分别为BMI正常者的3.83、2.08倍。结论肥胖在MP的发病中起到一定作用,其中VFA升高与MP发病有关,内脏型肥胖、非内脏型肥胖均为MP的危险因素。

肥胖测量指标在预测代谢相关脂肪性肝病健康风险中的应用价值

目的评估肥胖测量指标对代谢相关脂肪性肝病(Metabolic-associated fatty liver disease,MAFLD)健康风险的预测价值。方法选取2023年6月1日-12月31日在新疆医科大学第一附属医院健康管理中心体检的49155例体检者,根据诊断标准,将其分为MAFLD组和非MAFLD组,并计算体质指数(BMI)、腰臀比(WHR)、内脏脂肪指数(VAI)、脂质蓄积指数(LAP)。BMI分为正常、超重、肥胖组;腰围(WC)分为正常、中心性肥胖前期和中心性肥胖组。采用Logistic回归模型分析性别亚组中肥胖测量指标及生化指标的差异。绘制受试者工作特征(ROC)曲线评估各指标对MAFLD的预测价值。结果共检出MAFLD 23765例(48.35%),其中男性18030例(75.87%),女性5735例(24.13%)。同一性别中,MAFLD组除高密度脂蛋白胆固醇(HDL-C)水平低于非MAFLD组外,其余指标水平均高于非MAFLD组(P均<0.001);校正混杂因素后Logistic模型显示,MAFLD发生风险随BMI、WC、WHR、VAI、LAP水平增高而增高;ROC分析发现,BMI、WHR、VAI和LAP预测不同性别组MAFLD的曲线下面积(AUC)均大于0.7,其中LAP的AUC值最大,且预测女性的AUC值[0.896(0.891~0.900)]大于男性AUC值[0.831(0.826~0.836)],最佳截断值为25.49、39.26(P均<0.05);BMI×LAP联合模型在不同性别中预测价值最高,AUC值分别为男性0.846(0.841~0.850)、女性0.908(0.904~0.913)(P均<0.05)。结论MAFLD发生风险随BMI、WHR、VAI、LAP水平升高而增高,LAP相较于其他指标预测价值更高,尤其在女性中。BMI×LAP可作为不同性别中MAFLD健康风险评估的有力工具。

腹腔镜袖状胃切除术对重度肥胖症患者人体成分的影响

目的:探讨腹腔镜袖状胃切除术对重度肥胖症患者人体成分的影响。方法:纳入2021年1月至2023年9月收治的54例BMI≥40 kg/m^(2)的重度肥胖症患者,平均(34.9±9.97)岁,男24例,女30例,体重(144.25±22.41)kg, BMI(50.21±5.98)kg/m^(2),均行腹腔镜袖状胃切除术。观察减重手术前后颈围、胸围、腹围、臀围及人体成分分析仪上相关指标的变化。结果:54例患者均完成腹腔镜袖状胃切除术,无中转开腹,术后未出现明显并发症。术后半年颈围、胸围、腹围、臀围、体重、BMI、人体成分细胞内水分、细胞外水分、蛋白质、无机盐、身体细胞量、体脂肪、体脂百分比、内脏脂肪面积、骨骼肌、基础代谢率及右上肢、左上肢、躯干、右下肢、左下肢肌肉量均较术前减少,差异均有统计学意义(P<0.001)。结论:腹腔镜袖状胃切除术是安全、有效的减重手术,可明显减少体重,术后细胞内外水分、肢体肌肉、蛋白质、无机盐、骨骼肌及内脏脂肪等成分均减少。