基于MRI评估的胰腺脂肪沉积及腹部脂肪分布与原发性高血压的相关性研究

目的探讨基于MRI评估的胰腺脂肪沉积、内脏脂肪和皮下脂肪与原发性高血压的相关性。材料与方法纳入54例高血压患者和108例对照者。应用半自动分割对全胰腺进行分割,并测量全胰腺脂肪分数值。应用Image J软件测量内脏脂肪(visceral adipose tissue,VAT)和皮下脂肪(subcutaneous adipose tissue,SAT)面积,并记录VAT和SAT脂肪分数值(fat fraction,FF),计算内脏/皮下脂肪组织的面积比(V/S)。数据由SPSS进行统计学分析。P<0.05被认为差异具有统计学意义。结果高血压患者全胰腺脂肪分数值、VAT和SAT面积、V/S、VAT和SAT脂肪分数值均高于对照者。全胰腺脂肪分数值对高血压的诊断价值最高(AUC=0.816)。全胰腺脂肪分数的阈值为10.15%,对高血压诊断的敏感度为75.9%,特异度为81.5%。全胰腺FF与VAT面积和脂肪分数值呈中等相关性(r=0.541、0.561);与SAT面积、脂肪分数值和V/S的相关性较低(r=0.280、0.324、0.266)。结论高血压者与全胰腺脂肪分数、VAT和SAT增多有关。全胰腺脂肪分数与VAT和SAT的增加相关。     

多层螺旋CT及后处理技术评价腹部及血管周围脂肪

背景:目前国内对腹部脂肪的测量多用单一层面的腹部脂肪面积来表示,而受脂肪分布不均一的影响,其并不能准确定量内脏脂肪含量。国内尚未见到使用多层螺旋CT测量血管周围脂肪体积的研究报道。目的:探讨多层螺旋CT及其后处理技术在评价腹部及血管周围脂肪中的价值。方法:采用16排多层螺旋CT对35例腹型肥胖患者进行腹部容积扫描,在GE(General Electric,通用电气公司)AW(Advantage Workstation)4.3工作站上使用容积再现技术观察腹部及血管周围脂肪的影像表现,并用Histogram软件测量腹部脂肪总体积、皮下脂肪体积、内脏脂肪体积、血管周围脂肪总体积,重复测量各项指标,比较2次测量体积值之间的差异。结果与结论:多层螺旋CT及其后处理技术能直观地显示腹部及血管周围脂肪的分布,且可以准确地测量所扫描范围内所含脂肪的体积及分布在不同部位的脂肪体积。比较2次CT后处理所得腹部及血管周围脂肪组织的体积差异,两次处理所得数值间差异无显著性意义(P>0.05)。提示多层螺旋CT及其后处理技术在评价腹部及血管周围脂肪分布与含量中是可行的,且具有可重复性。     

基于磁共振成像的非酒精性脂肪肝患者上腹部脂肪体积与身体质量指数的相关性研究

目的采用磁共振成像脂肪定量技术测量上腹部(L2、L3水平)脂肪体积,探讨其与身体质量指数(body mass index,BMI)的相关性.材料与方法纳入56例非酒精性脂肪肝的患者,所有患者均计算BMI及行上腹部MRI检查.利用MRI脂肪定量技术测量L2、L3椎体水平腹腔内脏脂肪及皮下脂肪的体积,并分析其与BMI的相关性.结果56例患者的BMI为(26.90±3.18)kg/m2.L2椎体水平腹腔内脏及皮下脂肪体积分别为(556.0±165.6)cm3和(448.9±166.7)cm3;L3椎体水平分别为(513.6±163.6)cm3和(517.6±173.5)cm3.20～40岁组和>40岁组在L2、L3椎体水平的腹腔内脏脂肪及皮下脂肪体积差异均无统计学意义(P>0.05).BMI≥28 kg/cm2组的L2、L3椎体水平的腹腔内脏及皮下脂肪体积均高于BMI<24 kg/cm2组(P<0.01);在L2、L3椎体水平腹腔内脏脂肪体积方面,BMI越大,腹腔内脏脂肪体积越高.腹腔内脏脂肪体积与皮下脂肪体积正相关(r=0.347～0.410;P<0.01).BMI与L2、L3椎体水平腹腔内脏及皮下脂肪体积皆增大,呈中等偏强正相关(r=0.568～0.706;P<0.01).结论磁共振成像脂肪定量技术测量的上腹部(L2、L3椎体水平)脂肪体积与BMI具有正相关.     

内脏脂肪/皮下脂肪比值与超重/肥胖患者胰岛β细胞功能相关性

目的:探讨内脏脂肪/皮下脂肪比值与超重/肥胖患者胰岛β细胞功能的相关性。方法:选取2020年6月至2022年1月就诊于上海中医药大学附属普陀医院肥胖专病门诊的96例体重指数(body mass index,BMI)>24 kg/m^(2)的超重/肥胖患者,测量内脏脂肪面积(visceral fat area,VFA)、皮下脂肪面积(subcutaneous fat area,SFA)、身高、体重,计算BMI,测定空腹血糖(fasting blood glucose,FBG)、糖化血红蛋白(glycosylated hemoglobin,HbAl c)、空腹胰岛素(fasting insulin,FINS)、餐后胰岛素、空腹C肽、餐后C肽;测定成纤维细胞生长因子21(fibroblast growth factor 21,FGF-21)、瘦素(leptin,LEP)、脂联素(adiponectin,ADP)等脂肪因子以及胰高血糖素样肽-l(glucagon-like peptide-1,GLP-1)、YY肽重组蛋白(recombinant peptide YY,YY肽)等胃肠激素,并计算内脏脂肪/皮下脂肪比值、稳态模型胰岛素抵抗指数(homeostasis model insulin resistance index,HOMA-IR)、胰岛β细胞功能指数(isletβcell function index,HOMA-β)。根据内脏脂肪/皮下脂肪比值将患者分为低内脏脂肪/皮下脂肪比值组与高内脏脂肪/皮下脂肪比值组,分析其与胰岛β细胞功能及脂肪因子等的相关性。结果:低内脏脂肪/皮下脂肪比值组VFA、FBG、HbAlc、YY肽均低于高内脏脂肪/皮下脂肪比值组,SFA、餐后C肽、HOMA-β、FGF-21、LEP均高于高内脏脂肪/皮下脂肪比值组,差异均有统计学意义(均P<0.05)。VFA/SFA与FBG、HbAlc呈正相关(分别r=0.344、0.434,P<0.05),与餐后C肽、HOMA-β、FGF-21、LEP呈负相关(分别r=-0.406、-0.343、-0.345、-0.344,P<0.05)。结论:研究结果提示内脏脂肪/皮下脂肪比值越大,FBG、HbA1c水平越高,餐后C肽、HOMA-β、FGF-21、LEP越低。不同于传统意义上的内脏脂肪含量,内脏脂肪/皮下脂肪比值还考虑了皮下脂肪含量对胰岛β细胞功能的影响,综合分析脂肪分布情况,有助于全面评估超重、肥胖患者胰岛功能损伤的严重程度和机体的糖代谢情况。     

上海中年人群不同脂肪分布指标与血脂异常的相关性流行病学研究

目的:探讨上海市淞南地区人口不同脂肪分布指标与血脂异常风险的相关性。方法 :采取整群抽样法选取上海市淞南地区40～60岁的550名社区居民进行调查,发放调查问卷收集受检者的既往病史和生活方式等信息,并对进行身高、体重、腰围、血压等体格检查以及血糖、血脂等生化指标检测,采用计算机断层扫描及FATSCAN软件测量其腹部内脏脂肪及腹部皮下脂肪面积。结果:上海市淞南地区550名社区中年居民血脂异常的患病比例为65.1%。血脂异常者的体质量指数(body mass index, BMI)、腰臀比、腰围、皮下脂肪面积、内脏脂肪面积均显著高于血脂正常者(P0.05)。多元Logistic回归分析显示,在校正性别、年龄、目前吸烟、目前饮酒、高中以上学历、收缩压、糖化血红蛋白和胰岛素抵抗、使用降糖药物后,腰臀比每增加一个标准差(standard deviation,SD),患高低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-c)血症的风险增加0.87倍;腰围每增加一个SD,患低高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-c)血症的风险增加0.60倍,患血脂异常的风险增加0.45倍。结论:大多数脂肪分布指标(包括BMI、腰臀比、腰围、皮下脂肪面积、内脏脂肪面积)均与血脂异常相关,但相关程度存在差异。腰臀比增加与高LDL-c血症风险间相关性最大,腰围增加与低HDL-c血症以及血脂异常风险间相关性最大。     

原发性高血压患者内脏脂肪分布与左心室肥厚的相关性

目的通过观察原发性高血压患者腹部CT内脏脂肪/皮下脂肪比值(V/S)及体质量指数(BMI)、腰臀比(WHR)、腰围/身高比值(WHtR )与原发性高血压左心室肥厚（LVH）的关系,探讨原发性高血压患者腹部CT内脏脂肪分布与LVH的相关性。方法对80例入选者行上腹CT检查及心脏超声检查,分别测量上腹CT的V/S及心脏超声左心室质量指数（LVMI）,并记录年龄、收缩压、舒张压、BMI、WHR和WHtR,应用统计学方法观察各参数与LVMI的关系。结果原发性高血压患者LVH组与非LVH组年龄、收缩压和舒张压差异均无统计学意义（P＞0.05）,而原发性高血压患者LVH组V/S、BMI、WHR和WHtR显著高于非LVH组（P＜0.05）;V/S、WHtR、WHR和BMI与LVMI之间有线性回归关系,且V/S回归系数最大。结论肥胖对原发性高血压患者LVH有促进作用,内脏脂肪聚集与LVH关系尤为密切。     

多层螺旋CT及后处理技术评价腹部及血管周围脂肪

背景：目前国内对腹部脂肪的测量多用单一层面的腹部脂肪面积来表示,而受脂肪分布不均一的影响,其并不能准确定量内脏脂肪含量。国内尚未见到使用多层螺旋CT测量血管周围脂肪体积的研究报道。目的：探讨多层螺旋CT及其后处理技术在评价腹部及血管周围脂肪中的价值。方法：采用16排多层螺旋CT对35例腹型肥胖患者进行腹部容积扫描,在GE（General Electric,通用电气公司）AW（Advantage Workstation）4.3工作站上使用容积再现技术观察腹部及血管周围脂肪的影像表现,并用Histogram软件测量腹部脂肪总体积、皮下脂肪体积、内脏脂肪体积、血管周围脂肪总体积,重复测量各项指标,比较2次测量体积值之间的差异。结果与结论：多层螺旋CT及其后处理技术能直观地显示腹部及血管周围脂肪的分布,且可以准确地测量所扫描范围内所含脂肪的体积及分布在不同部位的脂肪体积。比较2次CT后处理所得腹部及血管周围脂肪组织的体积差异,两次处理所得数值间差异无显著性意义（P〉0.05）。提示多层螺旋CT及其后处理技术在评价腹部及血管周围脂肪分布与含量中是可行的,且具有可重复性。     

CT测量2型糖尿病患者内脏脂肪容积和胰岛素抵抗的关系

目的:探讨2型糖尿病患者的内脏脂肪容积和胰岛素抵抗(IR)的关系.方法:对60例2型糖尿病患者,按照内脏脂肪容积,分为非内脏肥胖组和内脏肥胖组,均采用CT在L4-5水平扫描,进行皮下及内脏脂肪容积测定;采用稳态模式评估法(HOMA)计算胰岛素抵抗指数,测定相关的人体指标、空腹血生化检查.结果:肥胖组内脏脂肪容积平均值为132.10 cm2,非肥胖组内脏脂肪容积平均值为72.32 cm2:内脏肥胖组比非肥胖组甘油三酯水平增高;内脏肥胖组IR平均值为2.60,非肥胖组IR平均值为1.22,两组差异有显著意义.内脏脂肪和皮下脂肪与2型糖尿病胰岛素抵抗显著相关,其中内脏脂肪是IR的最大影响因素.结论:内脏脂肪容积是2型糖尿病胰岛素抵抗的独立影响因子.     

腹部脂肪分布与肺通气功能的关系研究

目的 研究内脏脂肪面积(visceral adipose tissue area,VTA)和皮下脂肪面积(subcutaneous adipose tissue area,STA)对肺通气功能的影响,进而评估腹部脂肪分布在肺通气功能中的作用.方法 在四川大学华西医院的电子病历系统中选择2017年1月1日-12月31日既...     

糖代谢异常对中老年人高尿酸血症和腹部脂肪容积及分布的影响

目的分析糖代谢异常对中老年人高尿酸血症、腹部脂肪容积及分布的影响。方法根据北京协和医院保健医疗部2015—2018年间183例年龄50岁以上体检者的腹部CT,计算其腹部脂肪容积与分布,分析高尿酸血症、糖代谢异常的资料分布。结果高尿酸血症人群的体质量[(73.9±13.0) kg]比正常尿酸人群[(69.4±10.2) kg]明显增加(P 0.05),腰围明显较大[(91.7±7.9) cm比(88.8±7.6) cm,P 0.05],腹部内脏脂肪容积明显增多[(75.0±30.2) cm~3比(63.9±28.6) cm~3,P 0.05]。糖代谢正常人群中,有无高尿酸血症,其体质量、体质指数、腰围、腹部内脏脂肪容积、腹部皮下脂肪容积、腹部脂肪总容积、腹部内脏脂肪百分比均差异无统计学意义;糖代谢异常人群中,高尿酸血症的人群较正常尿酸人群腹部内脏脂肪容积明显较多[(80.7±30.9) cm~3比(65.2±27.5) cm~3,P 0.05],腹部脂肪总量明显增多[(169.2±57.8) cm~3比(144.7±53.4) cm~3,P 0.05]。结论在50岁以上有糖代谢异常的人群,如有高尿酸血症往往腹部内脏脂肪容积将明显增多。50岁以上糖代谢正常的人群,高尿酸血症与腹部内脏脂肪容积之间没有相关性。     

Practical approach for estimation of subcutaneous and visceral adipose tissue

OBJECTIVES: The first objective was to investigate the correlations between anthropometrical measurements and visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) in two cohorts differing in age using magnetic resonance imaging (MRI) as reference. A second objective was to investigate the potential usage of abdominal diameters in practical estimation of adipose tissue compartments using these cohorts. METHODS: Measurements of body mass index, waist circumference, sagittal abdominal diameter (sagittal AD) and transverse abdominal diameter (transverse AD) were obtained from 336 volunteers of age 14-70 years. Manual measurements of VAT and SAT from single slice MRI at the L4-L5 level were used as reference. The abdominal diameters were measured from the MR images. Linear correlations between the anthropometrical measurements and the reference were studied. RESULTS: Sagittal AD showed the strongest correlation to VAT (r >or= 0 x 780, P<0 x 0001) and transverse AD was found to give information about the amount of SAT (r >or= 0 x 866, P<0 x 0001). The ellipse spanned by the sagittal AD and the transverse AD was strongly correlated to the total amount of adipose tissue (r >or= 0 x 962, P<0 x 0001). CONCLUSION: Strong correlations were found between sagittal and transverse abdominal diameters, assessed using MRI, and VAT and SAT, respectively. These results suggest the use of abdominal diameters in practical estimations of VAT and SAT depots.     

Patterns of Abdominal Fat Distribution: The Framingham Heart Study

OBJECTIVE—The prevalence of abdominal obesity exceeds that of general obesity. We sought to determine the prevalence of abdominal subcutaneous and visceral obesity and to characterize the different patterns of fat distribution in a community-based sample.RESEARCH DESIGN AND METHODS—Participants from the Framingham Heart Study (n = 3,348, 48% women, mean age 52 years) underwent multidetector computed tomography; subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) volumes were assessed. Sex-specific high SAT and VAT definitions were based on 90th percentile cut points from a healthy referent sample. Metabolic risk factors were examined in subgroups with elevated SAT and VAT.RESULTS—The prevalence of high SAT was 30% (women) and 31% (men) and that for high VAT was 44% (women) and 42% (men). Overall, 27.8% of the sample was discordant for high SAT and high VAT: 19.9% had SAT less than but VAT equal to or greater than the 90th percentile, and 7.9% had SAT greater than but VAT less than the 90th percentile. The prevalence of metabolic syndrome was higher among women and men with SAT less than the 90th percentile and high VAT than in those with high SAT but VAT less than the 90th percentile, despite lower BMI and waist circumference. Findings were similar for hypertension, elevated triglycerides, and low HDL cholesterol.CONCLUSIONS—Nearly one-third of our sample has abdominal subcutaneous obesity, and >40% have visceral obesity. Clinical measures of BMI and waist circumference may misclassify individuals in terms of VAT and metabolic risk.Obesity is associated with an increased risk of multiple cardiometabolic risk factors. The prevalence of obesity in the U.S. has increased over the last two decades, with one-third of adults having a BMI ≥30 kg/m² (1). However, obesity is a heterogeneous condition with individual differences in the pattern of adipose tissue deposition. Accumulation of abdominal fat, particularly in the visceral compartment, may confer the majority of obesity-associated health risks (2).The prevalence of abdominal obesity (defined as waist circumference ≥88 cm in women and ≥102 cm in men) has increased over the last decade and now exceeds the prevalence of overall obesity, with rates of 42.4% in men and 61.3% in women (1,3). Notably, the largest relative increase in the prevalence of abdominal obesity has been among individuals with BMI <30 kg/m² (3). Although waist circumference is an easily obtainable index of abdominal adiposity, it does not distinguish between the subcutaneous and visceral adipose tissue compartments. We and others have previously reported that visceral adipose tissue (VAT) has a stronger association with metabolic risk factors and metabolic syndrome than subcutaneous adipose tissue (SAT) (4–6). These studies are limited, however, by the high correlations between SAT and VAT that make it difficult to distinguish between the contribution of SAT compared with that of VAT with regard to metabolic risk.Thus, the objectives of the present study were twofold. First, we sought to define the prevalence of abdominal obesity in terms of elevated volumes of VAT and SAT, as measured by a volumetric computed tomography (CT) method. To do this, we developed cut points for elevated SAT and VAT based on a healthy referent sample. Second, we examined the occurrence of different patterns of adipose tissue distribution and concomitant metabolic risk factor profiles. We hypothesized that metabolic risk factors would be more likely to track with elevated levels of VAT than with SAT.     

Adipose tissue distribution in relation to insulin sensitivity and inflammation in Pakistani and Norwegian subjects with type 2 diabetes

Abstract

Immigrants from South Asia to Western countries have a high prevalence of type 2 diabetes mellitus (T2DM) associated with obesity. We investigated the relationship between diabetes and adipose tissue distribution in a group of younger T2DM subjects from Norway and Pakistan. Eighteen immigrant Pakistani and 21 Norwegian T2DM subjects (age 29–45, 49% men) were included. They underwent anthropometrical measurements including bioelectrical impedance analysis, CT scans measuring fatty infiltration in liver and adipose and muscle tissue compartments in mid-abdomen and thigh, a euglycemic clamp, and blood samples for serum insulin and plasma glucose, adipokines and inflammation markers. Adipose tissue distribution was similar in Norwegians and Pakistanis. Pakistanis, but not Norwegians, showed a negative correlation between insulin sensitivity and visceral adipose tissue (VAT, r_s = ? 0.704, p = 0.003). Subcutaneous adipose tissue (SAT) correlated to leptin in both Pakistanis and Norwegians (r_s = 0.88, p < 0.001 and 0.67, p = 0.001). SAT also correlated to C-reactive protein (CRP) in the Pakistanis only (r_s = 0.55, p = 0.03), and superficial SAT to Interleukin-1 receptor antagonist (IL-1RA) in Norwegians only (r_s = 0.47, p = 0.04). In conclusion, despite similar adipose tissue distribution in the two groups Pakistanis were more insulin resistant, with a negative correlation of VAT to insulin sensitivity, not present in Norwegians. The correlation of adipose tissue to Leptin, CRP and IL-1RA showed ethnic differences.     

Sagittal Abdominal Diameter Is a Strong Anthropometric Measure of Visceral Adipose Tissue in the Asian General Population

OBJECTIVE

Finding the anthropometric measure of visceral obesity is essential to clinical practice, because it predicts cardiovascular and metabolic risks. Sagittal abdominal diameter (SAD) has been proposed as an estimate of visceral adipose tissue (VAT). The aim of the present study was to evaluate the usefulness of SAD in predicting visceral obesity by comparing SAD to other anthropometric measures.

RESEARCH DESIGN AND METHODS

Estimation of subcutaneous and visceral adipose tissue and measurement of SAD and transverse abdominal diameter using computed tomography at the umbilical level were obtained in 5,257 men and women who were enrolled in a health checkup program in Korea. To compare SAD to other anthropometric measures, linear regression analyses were used to determine correlations between anthropometrics and visceral obesity.

RESULTS

SAD showed a stronger correlation to VAT than waist circumference, BMI, and transverse abdominal diameter in the both sexes (men: r = 0.804, women: r = 0.724). Waist circumference showed generally stronger associations to subcutaneous adipose tissue (SAT) than to VAT (men: r = 0.789 vs. 0.705, women: r = 0.820 vs. 0.636). Even after subdividing according to age or BMI in both sexes and analyzing multiple regressions, SAD showed the strongest correlation to VAT.

CONCLUSIONS

SAD showed the strongest correlation to VAT irrespective of age, sex, and the degree of obesity compared with other anthropometric measures, whereas waist circumference may have a stronger correlation to SAT than to VAT. The clinical use of SAD has advantages over other anthropometric measures in predicting VAT.Although abdominal obesity has been considered a risk factor compromising health in only Western countries, where its presence has been relatively high, the prevalence of abdominal obesity has recently increased in Asian countries because of sedentary lifestyles and westernized diet. Abdominal obesity frequently leads to diabetes or metabolic disorders and can induce cardiovascular diseases with a risk of early death (1,2). Several studies have suggested that, compared with subcutaneous adipose tissue (SAT), visceral adipose tissue (VAT) has a stronger correlation to these obesity-related disorders (3,4). Thus, accurate measurement of VAT is required to predict the risk of obtaining such diseases. Computed tomography (CT) or magnetic resonance imaging is the most accurate method for estimating VAT (5). However, since the high costs of these tests make them clinically impractical, much effort has been made to find inexpensive, easily obtainable anthropometric measures to clinically evaluate the relationship between VAT and metabolic diseases.Waist circumference (WC) has been widely used to measure abdominal obesity (6), and it serves as one of the criteria for the diagnosis of metabolic syndrome (7,8). However, WC does not distinguish visceral from subcutaneous abdominal adipose tissue (9–11). Pou et al. (11) revealed that WC may misclassify individuals in terms of VAT. Their result implies that other anthropometric measures to correlate with VAT are needed.Sagittal abdominal diameter (SAD), which measures the anteroposterior diameter of the abdomen, reflects VAT based on the fact that subcutaneous fat is displaced inferiorly by gravity (12). Since SAD was introduced as a means of estimating visceral obesity (12), a few studies have been conducted on the usefulness of SAD in the evaluation of visceral obesity (13–15) as well as cardiovascular and metabolic risks (16,17) in comparison to other anthropometric measures. However, there were still insufficient evidences to draw any conclusions whether SAD more accurately represents visceral obesity due to the small number of subjects and selection process in the previous studies. Larger population-based studies are still needed to determine it. Moreover, the previous studies on SAD have been carried out in Western countries; there have been little data in the Asian population.Transverse abdominal diameter (TAD) was the largest spanned width, whereas SAD was the largest spanned height of the abdomen (12). TAD has been presented on correlation to SAT (12,13,15). However, TAD has never previously been investigated in terms of its correlation to the amount of adipose tissue in the Asian population.Therefore, the present study was conducted to compare SAD to other anthropometric measures in predicting the amount of CT-measured adipose tissue in a large, apparently healthy population.     

腰椎骨质密度与年龄、性别、体质参数及腹部脂肪的相关性

目的 探讨腰椎骨质密度(BMD)与年龄、性别、体质参数及腹部皮下脂肪(SAT)、内脏脂肪(VAT)的关系。方法 纳入健康志愿者或慢性腰腿痛患者111人(男56人,女55人),测量受检者身高、体质量及腰围,计算体质指数(BMI);采用定量CT(QCT)行腹部扫描,测量L3的BMD及相应层面腹部SAT与VAT含量。将男性与女性分别分为骨质疏松组、骨量减少组和骨量正常组,分别比较3组间年龄、性别、身高、体质量、BMI、腰围、SAT和VAT的差异,对BMD与存在显著性差异的指标进行相关性分析。结果 3组男性间除年龄的差异有统计学意义(P<0.05)外,身高、体质量、BMI、腰围、SAT及VAT的差异均无统计学意义(P均>0.05);男性BMD与年龄呈负相关(r=-0.680,P<0.05)。3组女性年龄、腰围及VAT的差异有统计学意义(P均<0.05),身高、体质量、BMI、SAT差异均无统计学意义(P均>0.05);女性BMD与年龄、腰围、VAT均呈负相关(r= -0.849、-0.412、-0.501,P均<0.05)。结论 男、女性腰椎BMD与年龄均呈明显负相关,与身高、体质量、BMI无明显相关性;男性腰椎BMD与腰围、SAT与VAT均无明显相关性,但女性腰椎BMD与腰围及VAT关系密切。     

双源CT尿路造影中双能量虚拟平扫检查尿路结石

目的 评价双源CT虚拟平扫(VNCT)在检查泌尿系统结石中的价值.方法 对2007年11月至2008年5月间于我院就诊的222例临床怀疑泌尿系统结石患者进行双源CT全腹部常规平扫(CNCT)及增强检查,并行肾脏排泄期双能量扫描(80 kV/400 mA和140 kV/95 mA).利用Liver VNC处理得到VNCT数据,与CNCT检出的阳性结石对照,比较CNCT和VNCT的辐射剂量.结果 222例患者中,有142例结石患者.CNCT检出结石183枚,其中肾实质内结石32枚,肾盂肾盏内结石56枚,腹段输尿管内结石40枚,盆段输尿管内结石22枚,膀胱壁段输尿管内18枚,膀胱内结石15枚;VNCT检出结石181枚,其中肾实质内结石30枚,肾盂肾盏内结石57枚,膀胱壁段输尿管内17枚,其余与普通平扫相同.CNCT与VNCT在检出阳性结石上有很高的一致性.VNCT较CNCT单次辐射剂量高[(10.14±1.83)mGry vs (8.84±1.67)mGry;t=-25.98,P=0.001].结论 VNCT与CNCT在检出泌尿系统结石中具有很高一致性.尽管单次VNCT的辐射剂量高于CNCT,但因减少一次扫描,可降低辐射剂量.     

Sonography of a human jackstone calculus.

Jackstone calculi are urinary tract stones that have a specific appearance resembling toy jacks. They are almost always composed of calcium oxalate dihydrate and may be found in the urinary bladder or rarely in the upper urinary tract. Their appearance on plain radiographs and computed tomography (CT) in human patients has been well described. They have also been imaged in several species of animals. However, our review of the English medical literature revealed no previous report in which a jackstone calculus had been identified on the sonographic examination of a human patient. We report a case in which a large jackstone calculus was incidentally detected during abdominal sonography in a 75-year-old man.     

Effects of dietary treatment alone or diet with voglibose or glyburide on abdominal adipose tissue and metabolic abnormalities in patients with newly diagnosed type 2 diabetes

OBJECTIVE; To examine the effects of diet and diet with voglibose or glyburide on abdominal adiposity and metabolic abnormalities in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS: A total of 36 Japanese patients with newly diagnosed type 2 diabetes (50.8 +/- 8.6 years of age, BMI 24.5 +/- 3.5 kg/m(2)) and 273 normal control subjects were studied. The patients were treated for 3 months with diet alone (30 kcal/kg per day) (n = 15), diet with voglibose (n = 12), or diet with glyburide (n = 9). They underwent 75-g oral glucose tolerance testing, assessment of insulin sensitivity (SI), and acute insulin response (AIR) with intravenous glucose tolerance testing based on the minimal model, and measurement of abdominal visceral adipose tissue area (VAT) and subcutaneous adipose tissue area (SAT) by computed tomography before and after treatment. RESULTS: The diabetic patients had comparable SAT but larger VAT than the control subjects. With a mean weight loss of 2-3 kg, VAT and SAT were decreased similarly in all treatment groups. The VAT-to-SAT ratio was decreased only in the voglibose group. Glycemic control and serum lipid profiles were improved in all groups. Changes in glycemic control after diet were closely correlated with changes in VAT but not with changes in SAT. SI and AIR were unchanged in the diet group but were improved in the voglibose and glyburide groups. CONCLUSIONS: In Japanese patients with newly diagnosed type 2 diabetes who were relatively lean but had excess VAT, diet with or without voglibose or glyburide effectively reduced VAT. Decrease in VAT was closely associated with improvement of glycemic control with diet. Additional use of voglibose or low-dose glyburide had no detrimental effects on abdominal adiposity and had beneficial effects on SI and AIR.