Abdominal Fat from Spine Dual-Energy X-Ray Absorptiometry and Risk for Subsequent Diabetes
Abdominal Fat from Spine Dual-Energy X-Ray Absorptiometry and Risk for Subsequent Diabetes
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DOI：
10.1210/jc.2009-2794
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发表时间：
2010-07-01
影响因子：
5.8
通讯作者：
Morin, Suzanne
中科院分区：
文献类型：
--
作者：
Leslie, William D.;Ludwig, Sora M.;Morin, Suzanne
背景：腹型肥胖是糖尿病的主要危险因素。腰椎双能X线骨密度仪(DXA)提供了腹部脂肪的指标。目的：我们的目的是验证这样一种假设，即在接受骨质疏松症调查的女性中，DXA衍生的腹部脂肪测量可以预测随后诊断糖尿病的风险。设计：这项历史队列研究来自马尼托巴省马尼托巴省骨密度计划数据库，地点和患者：1990年1月至2007年3月，30,252名年龄在40岁及以上的非糖尿病女性被纳入DXA基线骨质疏松评估。主要观察指标：在DXA测试后评估每个女性的纵向省级卫生服务记录中是否存在糖尿病诊断代码。结果：在5.2+/-2.6年的观察期间，1252名(4.1%)女性符合糖尿病的病例定义。在根据年龄、体重指数和其他合并症进行调整的模型中，来自脊柱DXA的腹部脂肪的较大比例与随后的糖尿病诊断密切相关。与最低(参考)五分位数的人相比，五分位数最高的人随后诊断为糖尿病的风险是3.56(95%可信区间=2.67-4.75)倍。在调整相同变量(1.00，95%可信区间=0.79-1.26)后，髋部DXA的脂肪不能预测后续的糖尿病。结论：从脊柱DXA扫描中可以获得关于糖尿病风险的预测性信息，以进行骨质疏松风险评估。这与将腹部脂肪与胰岛素抵抗和代谢综合征联系起来的证据是一致的。(临床内分泌代谢酶95：3272-3276,2010)
Context: Abdominal obesity is a major risk factor for diabetes. Dual-energy x-ray absorptiometry (DXA) of the lumbar spine provides an index of abdominal fat.Objective: Our objective was to examine the hypothesis that DXA-derived abdominal fat measurement in women undergoing osteoporosis investigation predicts risk for subsequent diagnosis of diabetes.Design: This historical cohort study was derived from the Manitoba Bone Density Program Database for the Province of Manitoba, Canada.Setting and Patients: 30,252 nondiabetic women aged 40 yr and older were referred for baseline osteoporosis assessment with DXA between January 1990 and March 2007.Main Outcome Measures: Each woman's longitudinal provincial health service record was assessed for the presence of diabetes diagnosis codes after DXA testing.Results: During 5.2 +/- 2.6 yr of observation, 1252 (4.1%) women met the case definition for diabetes. A greater proportion of abdominal fat from spine DXA was strongly related to subsequent diabetes diagnosis in models adjusted for age, body mass index, and other comorbidities. Those in the highest quintile had 3.56 (95% confidence interval = 2.67-4.75) times the risk for subsequent diabetes diagnosis compared with those in the lowest (reference) quintile. Fat from hip DXA was not predictive of subsequent diabetes after adjustment for the same variables (1.00, 95% confidence interval = 0.79-1.26).Conclusions: Predictive information about diabetes risk can be obtained from spine DXA scans performed for osteoporosis risk assessment. This is consistent with evidence linking abdominal fat with insulin resistance and the metabolic syndrome. (J Clin Endocrinol Metab 95: 3272-3276, 2010)