{"title":"性别差异对日本2型糖尿病患者肝脂肪变性进展的影响","authors":"Ryotaro Bouchi, Tatsuya Fukuda, Takato Takeuchi, Yujiro Nakano, Masanori Murakami, Isao Minami, Hajime Izumiyama, Koshi Hashimoto, Takanobu Yoshimoto, Yoshihiro Ogawa","doi":"10.1186/s40608-017-0163-3","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Increased visceral adiposity is strongly associated with non-alcoholic fatty liver disease (NAFLD). However, little attention has been paid to the association between the change in subcutaneous adipose mass and the progression of non-alcoholic fatty liver disease (NAFLD). We aimed to investigate whether increased subcutaneous adipose tissue (gynoid fat mass) could be protective against the progression of NAFLD in Japanese patients with type 2 diabetes.</p><p><strong>Methods: </strong>This is a retrospective observational study of 294 Japanese patients with type 2 diabetes (65 ± 10 years old, 40% female). Liver attenuation index (LAI) measured by abdominal computed tomography was used for the assessment of hepatic steatosis. Both gynoid (kg) and android (kg) fat masses were measured by the whole body dual-energy X-ray absorptiometry. One-year changes in LAI, gynoid, and android fat masses were evaluated in both male and female patients. Linear regression analysis with a stepwise procedure was used for the statistical analyses to investigate the association of the changes in gynoid and android fat masses with the change in LAI.</p><p><strong>Results: </strong>LAI levels at baseline were 1.15 ± 0.31 and 1.10 ± 0.34 in female and male patients (<i>p</i> = 0.455). The change in gynoid fat mass was significantly and positively associated with the change in LAI in both univariate (standardized β 0.331, <i>p</i> = 0.049) and multivariate (standardized β 0.360, <i>p</i> = 0.016) models in the female patients. However, no significant association was observed in males. In contrast, the increase in android fat mass was significantly associated with the reduced LAI in both genders in the multivariate models (standardized β -0.651, <i>p</i> < 0.001 in females and standardized β -0.519, <i>p</i> = 0.042 in males).</p><p><strong>Conclusions: </strong>This study provides evidence that increased gynoid fat mass may be protective against the progression of NAFLD in female Japanese patients with type 2 diabetes.</p>","PeriodicalId":37440,"journal":{"name":"BMC Obesity","volume":"4 ","pages":"27"},"PeriodicalIF":0.0000,"publicationDate":"2017-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40608-017-0163-3","citationCount":"5","resultStr":"{\"title\":\"Gender difference in the impact of gynoid and android fat masses on the progression of hepatic steatosis in Japanese patients with type 2 diabetes.\",\"authors\":\"Ryotaro Bouchi, Tatsuya Fukuda, Takato Takeuchi, Yujiro Nakano, Masanori Murakami, Isao Minami, Hajime Izumiyama, Koshi Hashimoto, Takanobu Yoshimoto, Yoshihiro Ogawa\",\"doi\":\"10.1186/s40608-017-0163-3\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Increased visceral adiposity is strongly associated with non-alcoholic fatty liver disease (NAFLD). However, little attention has been paid to the association between the change in subcutaneous adipose mass and the progression of non-alcoholic fatty liver disease (NAFLD). We aimed to investigate whether increased subcutaneous adipose tissue (gynoid fat mass) could be protective against the progression of NAFLD in Japanese patients with type 2 diabetes.</p><p><strong>Methods: </strong>This is a retrospective observational study of 294 Japanese patients with type 2 diabetes (65 ± 10 years old, 40% female). Liver attenuation index (LAI) measured by abdominal computed tomography was used for the assessment of hepatic steatosis. Both gynoid (kg) and android (kg) fat masses were measured by the whole body dual-energy X-ray absorptiometry. One-year changes in LAI, gynoid, and android fat masses were evaluated in both male and female patients. Linear regression analysis with a stepwise procedure was used for the statistical analyses to investigate the association of the changes in gynoid and android fat masses with the change in LAI.</p><p><strong>Results: </strong>LAI levels at baseline were 1.15 ± 0.31 and 1.10 ± 0.34 in female and male patients (<i>p</i> = 0.455). The change in gynoid fat mass was significantly and positively associated with the change in LAI in both univariate (standardized β 0.331, <i>p</i> = 0.049) and multivariate (standardized β 0.360, <i>p</i> = 0.016) models in the female patients. However, no significant association was observed in males. In contrast, the increase in android fat mass was significantly associated with the reduced LAI in both genders in the multivariate models (standardized β -0.651, <i>p</i> < 0.001 in females and standardized β -0.519, <i>p</i> = 0.042 in males).</p><p><strong>Conclusions: </strong>This study provides evidence that increased gynoid fat mass may be protective against the progression of NAFLD in female Japanese patients with type 2 diabetes.</p>\",\"PeriodicalId\":37440,\"journal\":{\"name\":\"BMC Obesity\",\"volume\":\"4 \",\"pages\":\"27\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2017-07-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1186/s40608-017-0163-3\",\"citationCount\":\"5\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"BMC Obesity\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1186/s40608-017-0163-3\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2017/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q1\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMC Obesity","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1186/s40608-017-0163-3","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2017/1/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 5
摘要
背景:内脏脂肪增加与非酒精性脂肪性肝病(NAFLD)密切相关。然而，很少有人关注皮下脂肪量的变化与非酒精性脂肪性肝病(NAFLD)进展之间的关系。我们的目的是研究日本2型糖尿病患者皮下脂肪组织(雌性脂肪团)的增加是否可以预防NAFLD的进展。方法:对294例日本2型糖尿病患者(65±10岁，女性40%)进行回顾性观察研究。通过腹部计算机断层扫描测量肝脏衰减指数(LAI)来评估肝脏脂肪变性。采用全身双能x线吸收仪测量雌性体(kg)和雄性体(kg)脂肪量。在男性和女性患者中，评估一年内LAI、gynoid和android脂肪块的变化。采用逐步线性回归分析进行统计分析，探讨雌二醇和android脂肪块的变化与LAI变化的关系。结果:女性和男性患者基线时LAI分别为1.15±0.31和1.10±0.34 (p = 0.455)。在单因素(标准化β 0.331, p = 0.049)和多因素(标准化β 0.360, p = 0.016)模型中，女性患者的雌二醇脂肪量的变化与LAI的变化呈显著正相关。然而，在男性中没有观察到显著的关联。相比之下，在多变量模型中，男性和女性的脂肪量增加与LAI降低显著相关(标准化β -0.651，男性p = 0.042)。结论:本研究提供的证据表明，增加的女性女性2型糖尿病患者的女性脂肪量可能对NAFLD的进展有保护作用。
Gender difference in the impact of gynoid and android fat masses on the progression of hepatic steatosis in Japanese patients with type 2 diabetes.
Background: Increased visceral adiposity is strongly associated with non-alcoholic fatty liver disease (NAFLD). However, little attention has been paid to the association between the change in subcutaneous adipose mass and the progression of non-alcoholic fatty liver disease (NAFLD). We aimed to investigate whether increased subcutaneous adipose tissue (gynoid fat mass) could be protective against the progression of NAFLD in Japanese patients with type 2 diabetes.
Methods: This is a retrospective observational study of 294 Japanese patients with type 2 diabetes (65 ± 10 years old, 40% female). Liver attenuation index (LAI) measured by abdominal computed tomography was used for the assessment of hepatic steatosis. Both gynoid (kg) and android (kg) fat masses were measured by the whole body dual-energy X-ray absorptiometry. One-year changes in LAI, gynoid, and android fat masses were evaluated in both male and female patients. Linear regression analysis with a stepwise procedure was used for the statistical analyses to investigate the association of the changes in gynoid and android fat masses with the change in LAI.
Results: LAI levels at baseline were 1.15 ± 0.31 and 1.10 ± 0.34 in female and male patients (p = 0.455). The change in gynoid fat mass was significantly and positively associated with the change in LAI in both univariate (standardized β 0.331, p = 0.049) and multivariate (standardized β 0.360, p = 0.016) models in the female patients. However, no significant association was observed in males. In contrast, the increase in android fat mass was significantly associated with the reduced LAI in both genders in the multivariate models (standardized β -0.651, p < 0.001 in females and standardized β -0.519, p = 0.042 in males).
Conclusions: This study provides evidence that increased gynoid fat mass may be protective against the progression of NAFLD in female Japanese patients with type 2 diabetes.
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