Clinical relevance of dual-energy X-ray absorptiometry (DXA) as a simultaneous evaluation of fatty liver disease and atherosclerosis in patients with type 2 diabetes.
Clinical relevance of dual-energy X-ray absorptiometry (DXA) as a simultaneous evaluation of fatty liver disease and atherosclerosis in patients with type 2 diabetes.
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DOI：
10.1186/s12933-016-0384-7
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发表时间：
2016-04-14
影响因子：
9.3
通讯作者：
Ogawa Y
中科院分区：
文献类型：
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作者：
Bouchi R;Nakano Y;Ohara N;Takeuchi T;Murakami M;Asakawa M;Sasahara Y;Numasawa M;Minami I;Izumiyama H;Hashimoto K;Yoshimoto T;Ogawa Y
全身双能x线吸收仪（DXA）可以同时测量区域脂肪和非脂肪质量。据报道，DXA测量的Android-to-gynoid （A/G）比率与心血管风险和内脏肥胖有关；然而，其与糖尿病患者脂肪肝和动脉粥样硬化的关系尚不清楚。本研究旨在探讨DXA测量的雄性和雌性脂肪量与2型糖尿病患者脂肪肝疾病和动脉粥样硬化的关系。这是一项对259例2型糖尿病患者的横断面研究（平均年龄64±13岁；40.2%为女性）。DXA法测定Android和gynoid脂肪质量（kg）。骨骼肌指数（SMI）计算方法为阑尾非脂肪质量（kg）除以身高（m2）。通过腹部计算机断层扫描评估内脏脂肪面积（VFA, cm2）、皮下脂肪面积（SFA, cm2）和肝脏衰减指数（LAI）。应用颈动脉超声检测颈总动脉内膜中膜厚度（IMT, mm）。A/G比值与VFA （r = 0.72, p < 0.001）、SFA （r = 0.32, p < 0.001）和LAI （r = - 0.26, p < 0.001）显著相关。在单变量模型中，A/G比（标准化β - 0.223, p = 0.002）和VFA（标准化β - 0.226, p = 0.001）与LAI显著相关。在调整了包括体重指数和转氨酶在内的协变量后，A/G比率仍然与LAI显著相关（标准化β - 0.224, p = 0.005）。在低SMI患者（男性SMI < 7.0，女性SMI < 5.4）中，A/G比值与颈动脉IMT在多变量模型中显著相关（标准化β 0.408, p = 0.014）。DXA可用于同时估计2型糖尿病患者脂肪肝和动脉粥样硬化的风险。
Whole body dual-energy X-ray absorptiometry (DXA) can simultaneously measure both regional fat and non-fat mass. Android-to-gynoid (A/G) ratio measured by DXA has been reported to be associated with cardiovascular risks and visceral adiposity; however, little is known regarding its relationship with fatty liver disease and atherosclerosis among patients with diabetes. This study was designed to investigate the association of android and gynoid fat mass measured by DXA with fatty liver disease and atherosclerosis in patients with type 2 diabetes. This is a cross-sectional study of 259 patients with type 2 diabetes (mean age 64 ± 13 years; 40.2 % female). Android and gynoid fat mass (kg) were measured by DXA. Skeletal muscle index (SMI) was calculated as appendicular non-fat mass (kg) divided by height (m2). Visceral fat area (VFA, cm2), subcutaneous fat area (SFA, cm2), and liver attenuation index (LAI) were assessed by abdominal computed tomography. Intima media thickness (IMT, mm) in common carotid arteries was determined by carotid ultrasonography. A/G ratio was significantly correlated with VFA (r = 0.72, p < 0.001), SFA (r = 0.32, p < 0.001) and LAI (r = −0.26, p < 0.001). A/G ratio (standardized β −0.223, p = 0.002) as well as VFA (standardized β −0.226, p = 0.001) were significantly associated with LAI in the univariate model. A/G ratio remained to be significantly associated with LAI (standardized β −0.224, p = 0.005) after adjusting for covariates including body mass index and transaminases. Among patients with low SMI (SMI < 7.0 in male and < 5.4 in female), A/G ratio was significantly associated with carotid IMT in the multivariate model (standardized β 0.408, p = 0.014). DXA can be used to simultaneously estimate the risks for both fatty liver disease and atherosclerosis in patients with type 2 diabetes.