A novel method of measuring intra-abdominal fat volume using helical computed tomography

OBJECTIVES: :We present a novel method of scanning for intra-abdominal fat volume by helical computed tomography (CT), and describe the clinical significance of measuring the volumes of intra-abdominal visceral fat (V(vol)) and subcutaneous fat (S(vol)) vs these respective areas determined by conventional slice-by-slice CT at the umbilical level. METHOD: Subjects with obesity or hyperlipidemia (79 men, 74 women) were recruited for this study. We obtained helical CT scans with a tube current of 150 mA, voltage of 120 kV and 2:1 pitch (table speed in relation to slice thickness), starting at the upper edge of the liver and continuing until the pelvis. The intra-abdominal visceral fat volume was measured by drawing a line within the muscle wall surrounding the abdominal cavity. The abdominal subcutaneous fat volume was calculated by subtracting the visceral fat volume from the total abdominal fat volume. By comparison, the intra-abdominal visceral and subcutaneous fat areas were determined at the umbilical level by the established slice-by-slice CT scanning technique. RESULTS: V(vol) was correlated positively with visceral fat area (V(area)) measured by conventional CT in both genders (in men (n=79) V(vol) vs V(area), r=0.81 P<0.0001; in women (n=74) V(vol) vs V(area), r=0.85, P<0.0001). S(vol) also showed a positive correlation with subcutaneous fat area (S(area)) in both genders (in men (n=78) S(vol) vs S(area), r=0.95, P<0.0001; in women (n=74) S(vol) vs S(area), r=0.92, P<0.0001). CONCLUSION: We have reported a novel method for measuring intra-abdominal fat volume by the use of helical CT.     

Clinical features of a young Japanese woman having marked obesity and abrupt onset of diabetes mellitus with ketoacidosis

The subject was a 26-year-old Japanese woman of 148 cm height, 96.2 kg of body weight (BW) (body mass index (BMI) of 43.8 kg/m(2)). She was referred to our hospital on May 1, 2000 for the evaluation of marked hyperglycemia with clinical symptom of general malaise, polydipsia, and ketonuria (3+). She did not smoke, or drink alcohol. But, she tended to eat lots of sweet food every day before the onset of this symptom. Her father was diagnosed type 2 diabetes mellitus. Her fasting plasma glucose and HbA(1c), and serum C-peptide were 398 mg/dl, 7.8% and less than 0.05 ng/ml [normal range: 0.94-2.8], respectively. She tested negative for anti-glutamic acid decarboxylase (GAD) antibodies and islet-cell antibodies. C-peptide level in her urine was as low as 3.4 microg/day. We immediately started insulin treatment under the diagnosis of abrupt onset of diabetes mellitus with diabetic ketoacidosis on the day of her admission, and the insulin treatment was continued after her being discharged. She showed continuous BW reduction until her BW reached approximately 60 kg, followed by her BW being plateau. During the period, intra-abdominal visceral fat (VF) and subcutaneous fat (SF) volume assessed by helical computerized tomography (CT) showed a substantial reduction [3.9-0.5 l for VF, 19-3.2 l for SF volume]. Pre-heparin plasma lipoprotein lipase (LPL) mass showed a considerably lower value when she had continuous BW reduction than did it when her BW reduction discontinued. These findings suggest that in this subject, continuous BW reduction after the abrupt onset of diabetes is closely associated with intra-abdominal fat mass reduction, which may be related to decreased production of LPL.     

Body fat distribution and cardiovascular risk in normal weight women. Associations with insulin resistance, lipids and plasma leptin

OBJECTIVE: To systematically examine the correlations between insulin resistance, plasma leptin concentration, obesity and the distribution of fat assessed by anthropometry and magnetic resonance imaging in Asian women. DESIGN: A cross sectional study of non-diabetic, normal weight women. SUBJECTS: Twenty-one healthy women aged 38.8 y (s.d. 11.7) and BMI 22.6 kg/m2 (s.d. 2.3). MEASUREMENTS: Intraperitoneal, retroperitoneal and subcutaneous abdominal fat volume was assessed by magnetic resonance imaging. Anthropometric data were collected. Total fat mass was assessed by bioelectric impedance analysis. Fasting serum lipids, insulin and plasma leptin were assayed. RESULTS: Generalized obesity correlated with subcutaneous abdominal fat mass (r=0.83, P<0.001), but not with intra-abdominal fat mass. Both intraperitoneal fat mass and retroperitoneal fat mass increased with age (r=0.58, P=0.005 and r=0. 612, P=0.003, respectively). Abdominal subcutaneous fat mass was the most important determinant of insulin resistance and plasma leptin. Of the serum lipids, only fasting triglyceride correlated significantly with the waist-to-hip ratio. CONCLUSIONS: It is possible that the large size of the subcutaneous depot compared to the intra-abdominal depot overwhelms any metabolic differences between adipose tissue from these two sites, resulting in the stronger correlation between insulin resistance and subcutaneous abdominal fat mass rather than intra-abdominal fat mass. On the other hand, the distribution of fat between subcutaneous fat depots may be important in the metabolic syndrome given the correlation of fasting triglyceride with waist to hip ratio but not with abdominal fat. However, the study population was small, younger and leaner compared to previous studies and we may not be able to generalize these results to all segments of the population. We confirm that subcutaneous fat mass is the major determinant of plasma leptin.     

Hypoadiponectinemia is associated with visceral fat accumulation and insulin resistance in Japanese men with type 2 diabetes mellitus

The aim of the present study was to investigate the association of serum adiponectin concentration with regional adiposity and insulin resistance in subjects with type 2 diabetes mellitus. A total of 73 Japanese men with type 2 diabetes (aged 59 +/- 11 years and body mass index [BMI] 23.8 +/- 3.0 kg/m(2), mean +/- SD) were studied. Fasting serum adiponectin and leptin concentrations were determined by radioimmunoassay. Regional adiposity was measured by abdominal computed tomography (CT) at the umbilical level, and insulin resistance was estimated by homeostasis model assessment (HOMA-R). Univariate regression analysis showed that serum adiponectin levels were negatively correlated with subcutaneous and visceral fat areas. With multivariate regression analysis, visceral fat area was a predominant determinant of serum adiponectin levels. In contrast, subcutaneous fat area was strongly associated with serum leptin concentrations. Among subcutaneous and visceral fat areas, BMI, and serum leptin levels, both subcutaneous and visceral fat areas were independently associated with HOMA-R. In another model incorporating serum adiponectin levels, serum adiponectin levels were selected as an independent determinant of HOMA-R instead of visceral fat area. In conclusion, hypoadiponectinemia was associated with visceral fat accumulation rather than subcutaneous fat depot in Japanese men with type 2 diabetes mellitus. Both subcutaneous and visceral fat accumulation contribute to insulin resistance in these subjects, and the contribution of visceral fat may be mediated, in part, by hypoadiponectinemia.     

Abdominal fat distribution in pre- and postmenopausal women: The impact of physical activity, age, and menopausal status

Age-related increases in total body fat have been reported, but the impact of menopause on abdominal fat distribution is still unclear. The purpose of this study was to determine the impact of menopausal status on abdominal fat distribution using magnetic resonance imaging (MRI). In addition, we investigated the influence of abdominal fat distribution on blood lipid profiles and leptin concentrations. Twenty-three premenopausal (PRE), 27 postmenopausal (POST), and 28 postmenopausal women on estrogen replacement therapy (ERT) had measurements of regional abdominal fat, blood lipids, and serum leptin concentrations. The women were matched for body mass index (BMI) and total body fat mass. Age and menopausal status were not found to be significant predictors of total abdominal fat, visceral fat, or subcutaneous fat, while physical activity was a significant predictor (P <.01) for total abdominal fat (R(2) =.16), visceral fat (R(2) =.32) and percent visceral fat (R(2) =.25). There was a trend for a greater visceral fat content in the POST women compared with the PRE women (2,495.0 +/- 228.4 v 1,770.4 +/- 240.8 cm(2), respectively, P =.06). The percent visceral abdominal fat was significantly lower (P <.05) in the premenopausal women than in either postmenopausal group (PRE, 23.2% +/- 1.7%; POST, 28.9% +/- 1.8%; ERT, 28.9% +/- 1.6%). Menopausal status and age did not influence any of the blood lipid values. Abdominal fat distribution was a significant predictor of cholesterol concentrations and the cholesterol/high-density lipoprotein-cholesterol (HDL-C) ratio, but only accounted for approximately 15% of the variability in these levels. Total body fat and physical activity accounted for 47% of the variability in leptin concentrations, while abdominal fat distribution, age, and menopausal status were not significant predictors. In conclusion, in early postmenopausal women, the level of physical activity accounts for the variability in abdominal fat distribution observed, while menopausal status and age do not play a significant role. ERT was not associated with additional benefits in abdominal fat distribution compared with postmenopausal women not on ERT or in the blood lipid profile in these women.     

Insulin-leptin-visceral fat relation during weight loss

INTRODUCTION: The relation between insulin-leptin-visceral fat axis during weight loss has not been studied previously. AIMS: To evaluate the insulin, leptin, and abdominal adiposity relation during weight loss in patients with upper body obesity. METHODOLOGY: Twenty volunteers (7 men, 13 women) with mean age 50.6+/-6.3 (SD) and upper body obesity (weight 105.4+/-12.3 kg, BMI 35.9+/-2.5 kg/m2) were recruited. Participants were enrolled in a one-arm clinical study using a calorie-deficient diet and an escalating dose regimen of sibutramine, starting with 5 mg daily and increasing in 5-mg increments to 20 mg per day. Body weight, insulin, leptin, glucose, lipids, abdominal computed tomography (CT), and total body electrical conductance (TOBEC) were measured serially at weeks 0, 4, 8, 12, and 24. RESULTS: Eighteen patients completed the 6-month study: one man and one woman discontinued because of adverse events. With diet and sibutramine, body weight was significantly and continuously reduced throughout the 6-month study. There was a 16.0% (p = 0.0001) reduction in body weight (p < 0.001) and 22.5% (p = 0.0001) decrease in total body fat mass. Abdominal CT scans showed a 28.3% (p = 0.0001) reduction in total abdominal fat, a 26.0% (p = 0.0001) reduction in subcutaneous fat (p < 0.001), and a 31.0% (p = 0.0003) reduction in visceral fat (p < 0.001). There was a 32.0% (p = 0.0008) reduction in leptin levels and 37.9% (p = 0.0001) reduction in insulin levels between baseline and week 4, but no further significant reduction in leptin and insulin levels was observed for the duration of the study. There was a significant correlation between insulin and leptin concentrations throughout the study (p = 0.0001). Leptin was presented as a function of insulin measured at the same time. Significant associations between visceral abdominal fat, subcutaneous fat, and leptin were also observed. CONCLUSION: In this study, we found that leptin and insulin were related in weight loss. The data suggest that insulin may act as a strong regulator of leptin secretion during weight loss and that circulating leptin levels can be predicted by insulin level. Using sibutramine in conjunction with hypocaloric diet reduced body weight and decreased fat mass significantly. Visceral and subcutaneous abdominal fat depots were shown to decrease. Whether sibutramine exerts any selective reduction of visceral abdominal fat as opposed to total body fat mass will require further clinical investigation.     

Gender differences in the effect of type 2 diabetes on serum lipids, pre-heparin plasma lipoprotein lipase mass and other metabolic parameters in Japanese population

DESIGN: Cross-sectional study of fasting serum lipid and lipoprotein levels, pre-heparin lipoprotein lipase (LPL) mass, several other metabolic parameters, and intra-abdominal fat areas in 26 Japanese poorly controlled type 2 diabetic men and 23 women when matched for age, body mass index (BMI), and HbA1c between genders. SUBJECTS: Study subjects were Japanese type 2 diabetic patients who were admitted to our hospital between Jun 2001 and Aug 2002 because of their poorly controlled diabetes. A total of 49 subjects [40-79 years of age, average age 61.5 +/- 8.7; mean BMI 23.2 +/- 3.7 kg/m2] with fasting plasma glucose (PG) and HbA1c levels being 251 +/- 76.5 mg/dl and 10.8 +/- 2.2%, respectively, were involved in this study. METHODS: Pre-heparin LPL mass was determined by enzyme linked immunosorbent assay. Remnant like particle cholesterol (RLP-C) level was measured using an immunoaffinity mixed gel containing anti-apolipoprotein (apo) A-I and anti-apo B monoclonal antibodies. Serum leptin level was determined by radioimmunoassay. Intra-abdominal fat area was determined by computerized tomography analysis at the umbilical level. RESULTS: The men group showed a higher serum triglycerides (TG) and RLP-C levels, and lower high density lipoprotein-cholesterol levels and pre-heparin plasma LPL mass than did women. Serum leptin level was higher in women than in men counterparts. The intra-abdominal subcutaneous fat areas were significantly larger in women than in men counterparts, whereas the visceral fat areas did not differ. CONCLUSION: In Japanese population, poorly controlled type 2 diabetic men had more unfavorable lipid profile than did women counterparts, which may be associated with decreased lipolysis of plasma TG-rich lipoproteins by LPL.     

体内脂肪分布与甲状腺功能的相关性

目的分析甲状腺功能与核磁共振测定的腹部皮下脂肪及内脏脂肪面积的相关性,探讨甲状腺功能对腹部脂肪分布的影响。方法随机选取763名沈阳市南站社区40至65岁居民为研究对象,进行问卷调查,测量身高、体重、腰围、臀围、血压、体脂含量,测定空腹血糖（FPG）、总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL－C）、低密度脂蛋白胆固醇（LDL－C）、空腹胰岛素（FINS）、口服葡萄糖耐量试验2h血糖（OGTF2hPG）、促甲状腺激素（TSH）、游离甲状腺素（FT４）、游离三碘甲状腺原氨酸（FT３）及甲状腺过氧化物酶抗体（TPOAb）。应用核磁共振测定腹部皮下脂肪面积及内脏脂肪面积。应用Pearson相关检验及多因素线性回归模型进行数据分析。结果Pearson相关分析显示,lnTSH与皮下脂肪呈正相关（r=0．183,P〈0．05）,而与内脏脂肪无相关性。FT4与皮下脂肪呈负相关（r=－0．164,P〈0．05）,与内脏脂肪呈正相关（r=0．118,P〈0．05）。FＴ３与皮下脂肪呈负相关（r=－0．098,P〈0．05）,与内脏脂肪呈正相关（r=0．261,P〈0．05）。将Pearson相关分析中与皮下脂肪或内脏脂肪有相关的变量代人多因素线性回归模型,结果显示收缩压、lnTSH及兀’,是影响皮下脂肪的危险因素,而BMI、腰围、血尿酸及OGTT2h血糖是影响内脏脂肪的危险因素。结论流行病学的横断面研究结果显示血清TSH增高及正常范围内的FＴ３,降低是预测皮下脂肪面积的危险因素,提示血清TSH及FＴ３可能在体内脂肪的分布上发挥着一定的作用。     

Association between basal serum and leptin levels and changes in abdominal fat distribution during weight loss

The aim of this study was to evaluate the relationship between changes in abdominal fat areas and the baseline serum leptin levels of Japanese obese women during weight reduction. The study was performed on 100 obese female Japanese volunteers. We measured the BMI and abdominal fat areas (visceral, subcutaneous and total) by magnetic resonance imaging and determined the fasting serum leptin levels before and after a 3 month weight reduction program. We examined whether or not a relationship exists between the baseline leptin levels and the subsequent changes in the abdominal fat areas after a weight reduction program. Multiple linear regression analysis was performed to examine the relationship between the baseline leptin levels and changes in abdominal visceral, subcutaneous, and total fat areas, and demonstrated that the baseline leptin level was a significant predictive factor for changes in the abdominal visceral fat area in both pre and postmenopausal Japanese obese women. We thus concluded the relatively higher baseline leptin levels in Japanese obese women to be associated with a relatively smaller reduction in the amount of abdominal visceral fat after undergoing a weight reduction program.     

Visceral fat accumulation measured by magnetic resonance imaging in relation to serum lipids in obese men and women.

In 91 apparently healthy obese subjects (45 premenopausal women and 46 men) the associations between specific fat depots and serum lipids were studied. Magnetic resonance imaging was used to quantify fat depots at abdominal and hip level. In women, an accumulation of visceral fat was associated with a less favourable lipid profile, even after adjustment for age and body fat percentage: higher triglycerides levels (P less than 0.001), lower levels of HDL-cholesterol (P less than 0.01) and a diminished HDL-cholesterol/LDL-cholesterol ratio (P less than 0.01). In men, however, the significant inverse relationship between an abundance of visceral fat and the HDL-cholesterol/LDL-cholesterol ratio and the significant positive correlations with total-, LDL-cholesterol and triglycerides disappeared after adjustment for age and fat percentage. Within each sex, subcutaneous fat neither at abdominal level nor at hip level was significantly related to serum lipids. It is concluded that there are gender differences in the associations between visceral fat accumulation and serum lipids.     

Chemerin levels are positively correlated with abdominal visceral fat accumulation

Objective Chemerin, a recently discovered adipocytokine, may be linked to obesity and obesity‐associated metabolic complications. However, the relationship between visceral fat accumulation and chemerin is still unknown. Therefore, we investigated the relationship between serum chemerin levels and body composition as measured by computed tomography (CT). Patients We recruited 173 men and women without histories of diabetes or cardiovascular disease. Measurements Biomarkers of metabolic risk factors and body composition by computed tomography were assessed. Serum chemerin levels were measured by enzyme‐linked immunosorbent assay. Results Chemerin levels correlated with body mass index (BMI), waist circumference, abdominal visceral fat area, blood pressure, fasting insulin, homoeostasis model of assessment‐insulin resistance, total cholesterol, triglyceride, creatinine, aspartate aminotransferase and alanine aminotransferase. By stepwise multiple regression analysis, abdominal visceral fat area, blood pressure and total cholesterol levels independently affected chemerin levels. Conclusions Abdominal visceral fat accumulation, blood pressure and lipid profile were significantly associated with serum chemerin levels. Our findings suggest that chemerin may be a mediator that links visceral obesity to cardiovascular risk factors.     

Liver fat is not a marker of metabolic risk in lean premenopausal women

We examined the independent associations among abdominal adipose tissue (AT) depots, liver fat, cardiorespiratory fitness (CRF), and metabolic risk factors in 86 lean premenopausal women. We measured abdominal AT and liver fat by computed tomography (CT), and CRF by a maximal treadmill exercise test. Liver fat was not related to any abdominal AT depot, metabolic risk factor, or CRF (P > .10). Visceral AT mass (kilograms) remained a significant (P < .05) predictor of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), TC/high-density lipoprotein cholesterol (HDL-C), and LDL-C/HDL-C after statistical adjustment for CRF. Abdominal subcutaneous AT mass was also a significant (P < .05) correlate of TC/HDL-C and LDL-C/HDL-C after control for CRF. Visceral AT remained a significant predictor (P < .05) of TC and LDL-C after control for abdominal subcutaneous AT. Conversely, subcutaneous AT did not remain a significant correlate after control for visceral AT. However, the deep subcutaneous AT depot remained significantly associated with LDL-C, TC/HDL-C, and LDL-C/HDL-C after control for visceral AT. In contrast, visceral AT remained correlated with triglycerides (TG) alone, after control for the deep subcutaneous AT. These observations suggest that liver fat is not a determinant of metabolic risk in lean women. Conversely, both visceral and the deep subcutaneous depot are determinants of metabolic risk in premenopausal woman despite the absence of obesity.     

Body composition and metabolic factors in obese children and adolescents

OBJECTIVE: Body composition is associated with metablic factors in adults; however, data are limited regarding obese children. This study was undertaken to assess body composition, regional fat distribution, and metabolic factors in obese 6-18-y-old children and adolescents. DESIGN: Cross-sectional assessment. SUBJECTS: Thirty-six obese children and adolescents, (mean+/-s.e.m.) age 11.8+/-0.5 y, BMI 34.1+/-1.2 kg/m(2). MEASUREMENTS: Body composition was assessed by dual energy X-ray absorptiometry and computerized tomography. Fasting insulin, glucose and leptin levels, and the homeostasis model assessment of insulin sensitivity (HOMA-IR) were assessed. RESULTS: The girls had significantly lower glucose levels than the boys. The ethnic group differences (African American children vs white children) in fat mass, total CT fat, subcutaneous CT fat, insulin level, leptin level, and higher HOMA-IR were not significant after adjusting for age or pubertal stage. These differences in abdominal fat and subcutaneous abdominal fat were also not independent of total body fat or BMI. No ethnic group differences in visceral abdominal fat were noted. Insulin level and HOMA IR were associated with leptin level (independent of fat mass) and fat mass. Leptin level was associated with fat mass, total CT fat, and subcutaneous CT fat; however the associations between the CT fat measures and leptin were not independent of total body fat mass. CONCLUSIONS: Neither visceral abdominal fat, subcutaneous abdominal fat, insulin levels, or insulin resistance differed by ethnic group when adjusted for age or pubertal status. This contrasts with findings in adults and non-obese children which suggest lower levels of visceral fat and higher insulin levels and insulin resistance in African American children and adolescents.     

Plasma leptin in non-diabetic Asian Indians: association with abdominal adiposity

Plasma leptin concentrations were measured in 144 non-diabetic men and women (age 21–73 years, BMI 14.8–37.7 kg m⁻²), in fasting samples collected during a population survey for diabetes mellitus. Leptin, fasting and 2-h post-glucose load plasma concentrations of glucose and immunoreactive insulin were measured. In a subset of 50 normoglycaemic individuals, subcutaneous fat (SF) and visceral fat (VF) areas at L4–L5 level were also measured by CT. As in other populations, women had significantly higher plasma leptin concentrations than men (p < 0.001) but the values were similar in normal (NGT) and impaired glucose tolerance (IGT). Geometric mean concentrations of leptin in men and women with NGT were 4.8 and 17.7 ng ml⁻¹, respectively, and the corresponding values in IGT were 6.2 and 19.0 ng ml⁻¹. Multiple regression analysis in the total group showed that the leptin concentration (log-transformed) was strongly dependent on sex (R² = 53.4 %), BMI (R² = 17.4 %), and to a lesser degree on the 2-h plasma insulin (R² = 2.4 %) and the WHR (R² = 0.8 %). In men, the total abdominal fat showed a strong association with leptin (R² = 49.3 %) and in women the subcutaneous fat area showed a similar effect (R² = 39.5 %). It is likely that subcutaneous and not visceral fat may be a determinant of plasma leptin in Asian Indians, and the correlation between leptin and insulin resistance may be less strong than in other ethnic groups. © 1997 John Wiley & Sons, Ltd.     

局部体脂及内分泌脂肪调节激素对瘦素水平的影响

目的　研究中国人非超重、超重及肥胖者瘦素水平与局部体脂、内分泌脂肪调节激素之间的关系。方法　用核磁共振 (MRI)测量 15 0例正常糖耐量的非超重、超重及肥胖者的局部体脂。同时测定瘦素、空腹胰岛素、皮质醇、生长激素、总睾酮、游离睾酮、硫酸去氢表雄酮等内分泌脂肪调节激素。结果　 (1)超重或肥胖者瘦素水平升高 ,女性瘦素水平显著高于男性 ;(2 )体脂对瘦素的影响有性别差异 ,在男性 ,瘦素与腹部皮下脂肪显著相关 (r =0 .75 ,P <0 .0 0 1) ;在女性 ,瘦素与体重指数相关 (r =0 .6 5 ,P <0 .0 0 1) ;(3)胰岛素是独立于体脂之外的调节瘦素的因素 ;(4 )游离睾酮参与瘦素的调节 ,但对瘦素的影响因性别而不同。结论　皮下脂肪是影响瘦素的局部体脂因素 ,胰岛素及雄性激素参与瘦素水平的调节     

血浆瘦素与体重指数和脂肪分布的关系

目的探讨血浆瘦素水平与体重指数和脂肪分布的关系。方法对100例肥胖者(男性52例,女性48例)和71非肥胖者(男性38例,女性33例)用免疫放射法测定血浆瘦素水平,测量身高、体重,计算体重指数(BMI)。对其中19例肥胖者(男12例,女7例),15例非肥胖者(男6例,女9例)经CT扫描测量腹部内脏和皮下脂肪面积,分析瘦素与肥胖程度和脂肪分布的关系。结果血浆瘦素水平性别差异显著(P<0.001),女性是男性的2～3倍;瘦素与体重指数呈正相关(男r=0.6772,P<0.01;女r=0.7191,P<0.01)。经CT扫描测量皮下和内脏脂肪面积,瘦素水平与皮下脂肪面积的正相关(r=0.8238,P<0.01),与腹部内脏脂肪面积无明显相关性(r=0.2118,P>0.05)。结论肥胖者血浆瘦素升高,瘦素水平不仅与肥胖程度有关,还与脂肪分布有关。     

肥胖者内脏脂肪蓄积与脂代谢的关系

目的:研究内脏脂肪蓄积与脂代谢的相关性。方法:选择首次就诊的163名单纯性肥胖病人。采用CT测定腹腔内脂肪面积,依据腹腔内脂肪面积分为内脏型肥胖组(腹腔内脂肪面积≥100cm2,115例)及皮下型肥胖组(腹腔内脂肪面积<100cm2,48例),并进行人体指标、脂代谢指标测定。结果:与皮下型肥胖组比较,内脏型肥胖组甘油三酯[TG,(1.69±1.51)mmol/L比(2.67±2.61)mmol/L]、总胆固醇[TC,(5.07±1.03)mmol/L比(5.65±1.19)mmol/L]水平显著升高(P<0.01),高密度脂蛋白胆固醇[HDL-C,(1.17±0.48)mmol/L比(1.02±0.22)mmol/L]水平显著降低(P<0.05)。直线相关分析显示,腹腔内脂肪面积与TG呈正相关(r=0.235,P=0.003),与HDL-C负相关(r=-0.162,P=0.039)。结论:内脏脂肪蓄积与脂代谢紊乱密切相关。     

男性体脂肪含量及其分布与血脂关系的研究

目的探讨男性体脂肪含量及脂肪分布与血脂代谢的关系。方法采用临床横断面研究,对194例青岛港男职工行体脂肪测定仪检查和血脂的测定,将所有入选对象分为血脂异常组和血脂正常组,两组之间比较。结果两组间脂肪量和肥胖度差异没有统计学意义(P>0.05);血脂异常组脂肪率、腹部总脂肪面积、腰围(WC)、腰臀比(WHR)和体重高于对照组(P<0.05);脂肪量和肥胖度与甘油三酯(TG)成正相关;腹部总脂肪面积、WC和WHR均与总胆固醇(TC)、低密度脂蛋白-胆固醇(LDL-C)和TG成正相关,与高密度脂蛋白-胆固醇(HDL-C)成负相关;脂肪率与TC、LDL-C成正相关,与HDL-C成负相关。结论男性脂肪量、尤其是脂肪分布与血脂代谢有关,腹部总脂肪面积是预测心血管危险因素的一个指标。     

A technique for the measurement of visceral fat by ultrasonography: comparison of measurements by ultrasonography and computed tomography

OBJECTIVE: This study aims to create a method of calculating intra-abdominal visceral fat volume by using ultrasound (US). The visceral fat volume measured by US was evaluated by comparison with the volume measured by computed tomography (CT). METHODS: Eighty-seven patients (52 males and 35 females) were enrolled in this study. Both US and CT were performed, and the visceral fat volume was measured. Both the distance and thickness of the parameters in US were measured as follows: 1) the distance between the internal surface of the abdominal muscle and the splenic vein, 2) the distance between the internal surface of the abdominal muscle and the posterior wall of aorta on the umbilicus, and 3) the thickness of the fat layer of the posterior right renal wall. RESULTS: The equation was calculated as follows: [visceral fat volume]=-9.008+1.191x[distance between the internal surface of the abdominal muscle and the splenic vein (mm)]+0.987x[distance between the internal surface of the abdominal muscle and the posterior wall of the aorta on the umbilicus (mm)]+3.644x[thickness of the fat layer of the posterior right renal wall (mm)]. There was a good correlation between the visceral fat volume calculated by the above equation and the volume by CT described (r=0.860, p<0.0001). CONCLUSION: The measurement of the visceral fat volume using US provided results as effectively as CT, and it was proven to be a useful method.     

Improvement of glucose and lipid metabolism associated with selective reduction of intra-abdominal visceral fat in premenopausal women with visceral fat obesity.

Visceral fat obesity (VFO) with predominant intra-abdominal fat accumulation has been shown to be more often associated with metabolic disorders than subcutaneous fat obesity (SFO). In the present study, changes in fat distribution and their effects on metabolic complications were investigated in forty premenopausal female obese patients in whom substantial weight reduction was obtained by means of a low calorie diet. Analysis of fat distribution by CT scanning demonstrated that visceral fat decreased to a greater extent than abdominal subcutaneous fat, which was particularly evident in VFO patients. On the other hand, change of fat distribution was small in SFO patients. That is, visceral to subcutaneous abdominal fat ratio (V/S ratio) decreased from 0.62 +/- 0.36 to 0.46 +/- 0.33 in VFO, whereas from 0.23 +/- 0.07 to 0.20 +/- 0.09 in SFO after weight reduction. Although obese patients, especially those with VFO, were frequently associated with glucose intolerance and hyperlipidemia, marked diminution was observed in the elevated levels of plasma glucose area on 75g OGTT, serum total cholesterol and triglyceride after weight reduction. By the examination of interrelationship between the changes in body weight, BMI, total and regional fat volume and changes in glucose and lipid metabolism, we found that the decrease in the V/S ratio and visceral fat volume were more strongly correlated with the improvement in plasma glucose and lipid metabolism compared to the decrease in body weight, BMI, total fat volume and abdominal subcutaneous fat volume. Furthermore, partial correlation analyses demonstrated that the metabolic improvements were associated with changes in visceral abdominal fat after control for changes in total adipose tissue volume.(ABSTRACT TRUNCATED AT 250 WORDS)