摘要
目的探讨肥胖人群减重术前定量CT(QCT)体质成分与代谢综合征(MS)组分的关系。方法本研究为横断面研究,回顾性选取2021年1月至2023年3月在皖南医学院第一附属医院行减重手术的97例肥胖患者,记录其体重指数(BMI)、生化指标以及基于QCT测量的体质成分。按照不同性别、肥胖程度、MS组分数进行分组,比较各组之间体质成分的差异,同时分析各体质成分与代谢指标的相关性,采用受试者工作特征(ROC)曲线分析各体质成分对不同MS组分肥胖人群的诊断效能。结果肥胖患者中女性75例(77.3%)。男性肥胖人群较女性有更高的腹部总脂肪面积[(693.23±148.90)比(574.99±114.89)cm^(2),t=-3.958,P<0.001]、腹内脂肪面积(289.65±57.67比195.60±57.37 cm^(2),t=-6.753,P<0.001)、胰头脂肪含量[27.45%(21.65%,45.48%)比21.60%(17.6%,26.9%),Z=-2.675,P=0.007]及骨骼肌指数[73.36(68.74,81.26)比61.52(55.74,66.41)cm^(2)/m^(2),Z=-5.246,P<0.001]。随肥胖程度的增加,腹部脂肪以皮下脂肪增加为主。随MS组分的增加(MS2组、MS3组、MS4组、MS5组),患者腹内脂肪面积、腹内脂肪/皮下脂肪、肝脏脂肪含量、胰头脂肪含量以及骨骼肌指数均随之升高。在诊断合并2项MS组分中,腹内脂肪面积的曲线下面积[AUC(95%CI)=0.706(0.577~0.834)]最大;在诊断合并3项、4项及5项MS组分中,肝脏脂肪含量的曲线下面积[AUC(95%CI):0.712(0.605~0.818);0.652(0.537~0.766);0.706(0.576~0.836)]最大。结论合并不同MS组分数数目的肥胖患者QCT体质成分存在差异,且各体质成分与MS组分间存在相关性,其中腹内脂肪面积及肝脏脂肪含量对评估肥胖患者合并不同MS组分具有重要价值。
Objective To investigate the association between quantified CT(QCT)-measured body composition and metabolic syndrome(MS)components in obese populations before bariatric surgery.Methods A cross-sectional study.A retrospective analysis was conducted on a cohort of 97 obese patients scheduled for weight-loss surgery at the First Affiliated Hospital of Wannan Medical College from January 2021 to March 2023.The patients′body mass index(BMI),biochemical parameters and body composition measurements obtained by QCT were recorded.The patients were stratified into groups based on gender,obesity severity and the number of MS components.Differences in body composition among the groups were compared.Additionally,the correlations between each body composition parameter and metabolic indicators were analyzed.The diagnostic efficacy of each body composition parameter for identifying obese individuals with different MS components was assessed using receiver operating characteristic(ROC)curve analysis.Results There were 75 females(77.3%).Male obese patients had higher total abdominal fat area[(693.23±148.90)vs(574.99±114.89)cm^(2),t=-3.958,P<0.001],visceral fat area[(289.65±57.67)vs(195.60±57.37)cm^(2),t=-6.753,P<0.001],fat content of pancreatic head[27.45%(21.65%,45.48%)vs 21.60%(17.6%,26.9%),Z=-2.675,P=0.007],and skeletal muscle index[73.36(68.74,81.26)vs 61.52(55.74,66.41)cm^(2)/m^(2),Z=-5.246,P<0.001].With the increase of obesity,abdominal fat mainly increases in subcutaneous fat.With the increase of MS components(MS2 group,MS3 group,MS4 group,MS5 group),the abdominal fat area,abdominal fat/subcutaneous fat,liver fat content,pancreatic head fat content,and skeletal muscle index of patients all increased accordingly.In diagnosing the presence of two components of MS,area under the curve of visceral fat area was the largest(AUC=0.706,95%CI=0.577-0.834).For diagnosing the presence of three,four and five components of MS,area under curve of liver fat content were all the largest(MS3=0.712,95%CI=0.605-0.818;MS4=0.652,95%CI=0.537-0.766;MS5=0.706,95%CI=0.576-0.836).Conclusion There are differences in QCT body composition among obese patients with different MS components,and there is a correlation between each body composition and MS component.Among them,intra-abdominal fat area and liver fat content are of great value in evaluating obese patients with different MS components.
作者
洪薇
郝小军
陶超
殷鹏展
夏亚斌
金岩
周运锋
Hong Wei;Hao Xiaojun;Tao Chao;Yin Pengzhan;Xia Yabin;Jin Yan;Zhou Yunfeng(Department of Radiology,the First Affiliated Hospital of Wannan Medical College,Wuhu 241000,China;Department of Gastrointestinal Surgery,the First Affiliated Hospital of Wannan Medical College,Wuhu 241000,China)
出处
《中华健康管理学杂志》
CAS
CSCD
北大核心
2024年第2期127-134,共8页
Chinese Journal of Health Management
