超越传统的身体组成指标：负荷能力指数作为心脏代谢结果的预测指标-系统回顾和荟萃分析。

IF 8 1区医学 Q1 NUTRITION & DIETETICS

Advances in Nutrition Pub Date : 2025-02-01 DOI:10.1016/j.advnut.2024.100364

Zhongyang Guan , Marianna Minnetti , Steven B Heymsfield , Eleonora Poggiogalle , Carla M Prado , Marc Sim , Blossom CM Stephan , Jonathan CK Wells , Lorenzo M Donini , Mario Siervo

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引用次数: 0

摘要

不同身体成分之间的适应性和独立相互关系已被确定为疾病风险的关键决定因素。基于这一概念，提出了利用双能x射线吸收仪（DXA）等非人体测量技术获得的测量结果的人体成分负荷能力模型。该模型通常被操作为代谢负荷（脂肪质量）与代谢能力（瘦质量）的比率。近年来，一系列的负荷能力指数（LCIs）被用于识别异常的身体组成表型，如肌少性肥胖（SO），并预测代谢、心血管和认知障碍的风险。在这篇综述中，我们全面回顾了以往研究中使用的不同LCIs的特点，并特别关注它们的应用，特别是在识别SO和预测心脏代谢结果方面。使用PubMed、MEDLINE、PsycINFO、Embase和Cochrane图书馆进行系统的文献检索。进行了两项荟萃分析：(1)估计LCIs所映射的SO的总体患病率；(2)评估LCIs与心脏代谢结果的关系。共纳入48项研究（均为观察性研究），包括22个不同的LCIs。10项研究纳入了SO患病率的荟萃分析，得出总患病率为14.5% （95% CI: 9.4%至21.6%）。17项研究纳入了LCI值与不良心脏代谢结局之间关联的荟萃分析，结果显示LCI值较高与风险增加之间存在显著关联(OR = 2.22；95% CI: 1.81 - 2.72)的心血管代谢疾病（如糖尿病和代谢综合征[MetS]）。这些发现表明，身体组成的负荷能力模型在识别SO病例和预测心脏代谢风险方面可能特别有用。未来的纵向研究需要验证LCIs与慢性心脏代谢和神经退行性疾病的关联。该系统评价和荟萃分析已在PROSPERO注册（CRD42024457750）。

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Beyond Traditional Body Composition Metrics: Load-Capacity Indices Emerge as Predictors of Cardiometabolic Outcomes—A Systematic Review and Meta-Analysis

The adaptive and independent interrelationships between different body composition components have been identified as crucial determinants of disease risk. On the basis of this concept, the load-capacity model of body composition, which utilizes measurements obtained through nonanthropometric techniques such as dual-energy X-ray absorptiometry, was proposed. This model is typically operationalized as the ratio of metabolic load (adipose mass) to metabolic capacity (lean mass). In recent years, a series of load-capacity indices (LCIs) have been utilized to identify abnormal body composition phenotypes such as sarcopenic obesity (SO) and to predict the risk of metabolic, cardiovascular, and cognitive disorders. In this review, we comprehensively review the characteristics of different LCIs used in previous studies, with a specific focus on their applications, especially in identifying SO and predicting cardiometabolic outcomes. A systematic literature search was performed using PubMed, MEDLINE, PsycINFO, Embase, and the Cochrane Library. Two meta-analyses were conducted to 1) estimate the overall prevalence of SO mapped by LCIs, and 2) assess the association of LCIs with cardiometabolic outcomes. A total of 48 studies (all observational) were included, comprising 22 different LCIs. Ten studies were included in the meta-analysis of SO prevalence, yielding a pooled prevalence of 14.5% [95% confidence interval (CI): 9.4%, 21.6%]. Seventeen studies were included in the meta-analysis of the association between LCIs and adverse cardiometabolic outcomes, which showed a significant association between higher LCI values and increased risk (odds ratio = 2.22; 95% CI: 1.81, 2.72) of cardiometabolic diseases (e.g. diabetes and metabolic syndrome). These findings suggest that the load-capacity model of body composition could be particularly useful in the identification of SO cases and prediction of cardiometabolic risk. Future longitudinal studies are needed to validate the association of LCIs with chronic cardiometabolic and neurodegenerative diseases.

This systematic review and meta-analysis has been registered with PROSPERO (CRD42024457750).

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来源期刊

Advances in Nutrition 医学-营养学

CiteScore

17.40

自引率

2.20%

发文量

117

审稿时长

56 days

期刊介绍： Advances in Nutrition (AN/Adv Nutr) publishes focused reviews on pivotal findings and recent research across all domains relevant to nutritional scientists and biomedical researchers. This encompasses nutrition-related research spanning biochemical, molecular, and genetic studies using experimental animal models, domestic animals, and human subjects. The journal also emphasizes clinical nutrition, epidemiology and public health, and nutrition education. Review articles concentrate on recent progress rather than broad historical developments. In addition to review articles, AN includes Perspectives, Letters to the Editor, and supplements. Supplement proposals require pre-approval by the editor before submission. The journal features reports and position papers from the American Society for Nutrition, summaries of major government and foundation reports, and Nutrient Information briefs providing crucial details about dietary requirements, food sources, deficiencies, and other essential nutrient information. All submissions with scientific content undergo peer review by the Editors or their designees prior to acceptance for publication.