通过 DXA 测量的内脏脂肪组织可预测低收入社区老年人的代谢综合征：圣保罗老龄化与健康（SPAH）研究的启示。

IF 3.5 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

Bone Pub Date : 2024-10-30 DOI:10.1016/j.bone.2024.117308

Gabriel V. Valente , Luana G. Machado , Camille P. Figueiredo , Valéria F. Caparbo , Liliam Takayama , André S. Franco , Alan L. Fernandes , Ricardo M. Oliveira , Rosa M.R. Pereira , Diogo S. Domiciano

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引用次数: 0

摘要

虽然通过双能 X 射线吸收测量法（DXA）测量的内脏脂肪能准确识别出心脏代谢风险增加的中年人，但目前仍缺乏针对老年人的一致数据。我们的目的是研究 DXA 导出的内脏脂肪组织（VAT）与代谢综合征（MetS）之间的关联，并确定 VAT 的最佳临界值，以预测巴西低收入老年人队列中的代谢综合征。这项研究共招募了 449 名女性和 258 名男性（≥65 岁）。参与者接受了临床和实验室评估，并使用 Hologic Discovery A 密度计进行了身体成分分析。在 DXA 扫描的甲状腺区域测量 VAT。MetS 的诊断采用 NCEP-ATPIII 标准。多变量逻辑回归分析了 VAT 与 MetS 之间的关系。接收者工作特征曲线（ROC）分析评估了VAT对MetS的预测准确性，并通过Youden测试确定了平衡敏感性和特异性的最佳临界值。男性的平均年龄为 76.6 ± 4.7 岁，女性为 77.1 ± 4.9 岁。男性的平均体重指数为 26.5 ± 3.8 kg/m2，女性为 29.0 ± 5.2 kg/m2。175名男性（41.5%）和274名女性（61%）患有 MetS。在对混杂因素进行调整后，多变量分析表明，男性（OR 1.41，95%CI 1.15-1.72）和女性（OR 1.33，95%CI 1.16-1.54，每增加 100 克）的 VAT 均与 MetS 无关。预测 MetS 的最佳 VAT 临界值男性为 642.5 克（AUC = 0.740），女性为 600.5 克（AUC = 0.729）。对非超重/非肥胖受试者进行的子分析得出的 VAT 临界值较低。因此，无论体重指数如何，通过 DXA 测量的 VAT 都与老年人的 MetS 显著相关，这强调了 VAT 在预测 MetS 中的关键作用。因此，通过 DXA 测量 VAT 有望评估老年人的 MetS 风险。我们还需要进一步开展纵向研究，以了解 VAT 对这一人群主要心血管事件发生率的影响。

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Visceral adipose tissue measured by DXA predicts metabolic syndrome in low-income community-dwelling elderly: Insights from the São Paulo Aging & Health (SPAH) study

While visceral fat measured by dual-energy X-ray absorptiometry (DXA) is accurate in identifying middle-aged people at increased cardiometabolic risk, consistent data for the elderly are still lacking. We aimed to investigate the association between DXA-derived visceral adipose tissue (VAT) and metabolic syndrome (MetS) and to establish optimal cutoffs for VAT to predict MetS in a low-income elderly Brazilian cohort. A total of 449 women and 258 men (≥65 years) from the community were enrolled in this study. Participants underwent clinical and laboratory evaluations, along with body composition analysis by Hologic Discovery A densitometer. VAT was measured in the android region of the DXA scan. MetS was diagnosed using NCEP-ATPIII criteria. Multivariate logistic regression analyzed the relationship between VAT and MetS. Receiver-operating characteristic (ROC) curve analysis evaluated VAT's predictive accuracy for MetS, with optimal cutoffs determined by Youden's test to balance sensitivity and specificity. Mean ages were 76.6 ± 4.7 years for men and 77.1 ± 4.9 years for women. Mean BMIs were 26.5 ± 3.8 kg/m² for men and 29.0 ± 5.2 kg/m² for women. One hundred and seventy-five (41.5 %) men and 274 (61 %) women had MetS. After adjustments for confounders, multivariate analysis showed that VAT was independently associated with MetS in both men (OR 1.41, 95%CI 1.15–1.72) and women (OR 1.33, 95%CI 1.16–1.54, per each 100 g increase). Optimal VAT cutoffs to predict MetS were 642.5 g for men (AUC = 0.740) and 600.5 g for women (AUC = 0.729). Subanalysis for non-overweight/non-obese subjects yielded lower VAT cutoffs. Thus, VAT measured by DXA was significantly associated with MetS in older adults, regardless of BMI, emphasizing the critical role of VAT in predicting MetS. Therefore, VAT by DXA holds promise for evaluating MetS risk in the elderly. Further longitudinal studies are needed to investigate VAT's impact on major cardiovascular event incidence in this demographic.

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来源期刊

Bone 医学-内分泌学与代谢

CiteScore

8.90

自引率

4.90%

发文量

264

审稿时长

30 days

期刊介绍： BONE is an interdisciplinary forum for the rapid publication of original articles and reviews on basic, translational, and clinical aspects of bone and mineral metabolism. The Journal also encourages submissions related to interactions of bone with other organ systems, including cartilage, endocrine, muscle, fat, neural, vascular, gastrointestinal, hematopoietic, and immune systems. Particular attention is placed on the application of experimental studies to clinical practice.