DXA-measured visceral adipose tissue predicts impaired glucose tolerance and metabolic syndrome in obese Caucasian and African-American women.
DXA-measured visceral adipose tissue predicts impaired glucose tolerance and metabolic syndrome in obese Caucasian and African-American women.
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DOI：
10.1038/ejcn.2014.227
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发表时间：
2015-03
影响因子：
4.7
通讯作者：
Silver HJ
中科院分区：
文献类型：
--
作者：
Bi X;Seabolt L;Shibao C;Buchowski M;Kang H;Keil CD;Tyree R;Silver HJ
通过DEXA测量内脏脂肪组织（VAT）的新方法可能有助于辨别VAT在心脏代谢风险中作用的性别、种族和表型差异。本研究旨在：a)比较心脏代谢危险因素与DEXA-VAT、人体测量和身体成分测量之间的关系；b)按种族确定DEXA-VAT的阈值；c)确定肥胖女性糖耐量受损（IGT）和代谢综合征（MetSx）最可靠的预测因子。采用Lunar iDXA扫描仪测量229例21-69岁欧美裔（EA = 123）和非裔美国人（AA = 106）肥胖女性（BMI 30-49.9）的VAT面积（cm2）。线性回归模型和曲线下面积（AUC）比较了与心脏代谢风险的关系。用LASSO回归模型确定了IGT和MetSx的阈值和预测因子。与人体测量和身体成分变量相比，DEXA-VAT更能解释甘油三酯、血压、血糖和HOMA-IR的差异。DEXA-VAT对IGT（0.767）和MetSx（0.749）的AUC最高。在建模中加入race和interactionXrace术语并没有显著改变结果。在AA女性中，IGT或MetSx概率≥50%的阈值较低（IGT: 2120cm2 AA vs 2550cm2 EA; MetSx: 1320cm2 AA vs 1713cm2 EA）。随着DEXA-VAT的每一个标准差增加，IGT或MetSx的几率增加3倍。DEXA-VAT提供了关于AA和EA女性心脏代谢风险的可靠临床信息，在降低风险方面具有很大的潜力。
New methods to measure visceral adipose tissue (VAT) by DEXA may help discern sex, race and phenotype differences in the role of VAT in cardiometabolic risk. This study was designed to: a) compare relationships between cardiometabolic risk factors and DEXA-VAT, anthropometric and body composition measures; b) determine thresholds for DEXA-VAT by race; and c) determine the most robust predictors of impaired glucose tolerance (IGT) and metabolic syndrome (MetSx) in obese women. VAT area (cm2) was measured using Lunar iDXA scanner in 229 obese (BMI 30-49.9) women age 21–69 years of European American (EA = 123) and African American (AA = 106) descent. Linear regression modeling and areas under the curve (AUC) compared relationships with cardiometabolic risk. Bootstrapping with LASSO regression modeling determined thresholds and predictors of IGT and MetSx. DEXA-VAT explained more of the variance in triglycerides, blood pressure, glucose and HOMA-IR compared to anthropometric and body composition variables. DEXA-VAT had the highest AUC for IGT (0.767) and MetSx (0.749). Including race and interactionXrace terms in modeling did not significantly change results. Thresholds at which probability was ≥ 50% for IGT or MetSx were lower in AA women (IGT: 2120cm2 AA vs 2550cm2 EA; MetSx: 1320cm2 AA vs 1713cm2 EA). The odds for IGT or MetSx was 3-fold greater with each standard deviation increase in DEXA-VAT. DEXA-VAT provides robust clinical information regarding cardiometabolic risk in AA and EA women and has great potential in risk reduction efforts.