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Hao X, He H, Tao L, Zhao W, Wang P. Waistline to thigh circumference ratio as a predictor of MAFLD: a health care worker study with 2-year follow-up. BMC Gastroenterol 2024; 24:144. [PMID: 38658820 PMCID: PMC11044289 DOI: 10.1186/s12876-024-03229-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 04/15/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND This study aimed to determine whether the waist-to-thigh ratio (WTTR) is associated with the incidence of metabolic-associated fatty liver disease (MAFLD) in health care workers. METHODS There were 4517 health care workers with baseline data and results from 2 follow-up examinations. We divided the subjects into 3 groups according to baseline WTTR and used the Cox hazard regression model to estimate MAFLD risk. RESULTS The WTTRs were categorized by tertiles at baseline using the values 1.58 and 1.66. Patients with higher WTTR tended to have significantly greater values for the following factors, body mass index (BMI), fasting blood glucose (FPG), systolic blood pressure, diastolic blood pressure, total cholesterol (TC), triglycerides (TG), low-density lipoprotein-cholesterol (LDL-C) and neck circumference. The incidence of MAFLD significantly increased with increasing WTTR tertiles (5.74%, 12.75% and 22.25% for the first, second and third tertiles, respectively, P < 0.05 for trend). Kaplan-Meier(K-M) survival analysis revealed a significant tendency towards increased MAFLD risk with increasing WTTR tertile. In the fully adjusted model, the hazard ratios (95% CIs) for MAFLD in the second, third WTTR tertiles compared with the first quartile were 2.17(1.58,2.98), 3.63(2.70,4.89), respectively, third neck circumference tertiles compared with the first quartile were 2.84(1.89,4.25), 8.95(6.00,13.35), respectively. Compared with those of individuals with a BMI > 23 kg/m2, the associations between WTTR and MAFLD incidence were more pronounced in subjects with a BMI < 23 kg/m2. Similarly, the difference in neck circumference was more pronounced in these patients with a BMI < 23 kg/m2. CONCLUSIONS Our results revealed that the WTTR is an independent risk factor for MAFLD, and there was a dose‒response relationship between the WTTR and MAFLD risk. The neck circumference was significantly different in subjects with a BMI < 23 kg/m2. This approach provides a new way to predict the incidence rate of MAFLD.
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Affiliation(s)
- Xiaoyan Hao
- Medical examination center, Peking University, Third Hospital, North Garden Road & 49, Beijing, China
| | - Honghai He
- Medical examination center, Peking University, Third Hospital, North Garden Road & 49, Beijing, China
| | - Liyuan Tao
- Medical examination center, Peking University, Third Hospital, North Garden Road & 49, Beijing, China
| | - Wei Zhao
- Medical examination center, Peking University, Third Hospital, North Garden Road & 49, Beijing, China.
| | - Peng Wang
- Medical examination center, Peking University, Third Hospital, North Garden Road & 49, Beijing, China.
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2
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Cao YT, Zhang WH, Lou Y, Yan QH, Zhang YJ, Qi F, Xiang LL, Lv TS, Fang ZY, Yu JY, Zhou XQ. Sex- and reproductive status-specific relationships between body composition and non-alcoholic fatty liver disease. BMC Gastroenterol 2023; 23:364. [PMID: 37875811 PMCID: PMC10598923 DOI: 10.1186/s12876-023-02997-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 10/13/2023] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND Sex and reproductive status differences exist in both non-alcoholic fatty liver disease (NAFLD) and body composition. Our purpose was to investigate the relationship between body composition and the severity of liver steatosis and fibrosis in NAFLD in different sex and reproductive status populations. METHODS This cross-sectional study included 880 patients (355 men, 417 pre-menopausal women, 108 post-menopausal women). Liver steatosis and fibrosis and body composition data were measured using FibroScan and a bioelectrical impedance body composition analyzer (BIA), respectively, and the following parameters were obtained: liver stiffness measurement (LSM), controlled attenuation parameter (CAP), waist circumference (WC), body mass index (BMI), percent body fat (PBF), visceral fat area (VFA), appendicular skeletal muscle mass (ASM), appendicular skeletal muscle mass index (ASMI), fat mass (FM), fat free mass (FFM), and FFM to FM ratio (FFM/FM). Multiple ordinal logistic regression (MOLR) was used to analyze the independent correlation between body composition indicators and liver steatosis grade and fibrosis stage in different sex and menopausal status populations. RESULTS Men had higher WC, ASM, ASMI, FFM, and FFM/FM than pre- or post-menopausal women, while pre-menopausal women had higher PBF, VFA, and FM than the other two groups (p < 0.001). Besides, men had greater CAP and LSM values (p < 0.001). For MOLR, after adjusting for confounding factors, WC (OR, 1.07; 95% CI, 1.02-1.12; P = 0.011) and FFM/FM (OR, 0.52; 95% CI, 0.31-0.89; P = 0.017) in men and visceral obesity (OR, 4.16; 95% CI, 1.09-15.90; P = 0.037) in post-menopausal women were independently associated with liver steatosis grade. WC and visceral obesity were independently associated with liver fibrosis stage in men (OR, 1.05; 95% CI, 1.01-1.09, P = 0.013; OR, 3.92; 95% CI, 1.97-7.81; P < 0.001, respectively). CONCLUSIONS Increased WC and low FFM/FM in men and visceral obesity in post-menopausal women were independent correlates of more severe liver steatosis. In addition, increased WC and visceral obesity were independent correlates of worse liver fibrosis in men. These data support the sex- and reproductive status-specific management of NAFLD.
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Affiliation(s)
- Yu-Tian Cao
- Department of Endocrinology, Affiliated Hospital of Nanjing, Jiangsu Province Hospital of Chinese Medicine, University of Chinese Medicine, Nanjing, China
- The First School of Clinical Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Wen-Hui Zhang
- Department of Endocrinology, Affiliated Hospital of Nanjing, Jiangsu Province Hospital of Chinese Medicine, University of Chinese Medicine, Nanjing, China
- The First School of Clinical Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Yan Lou
- Department of Endocrinology, Affiliated Hospital of Nanjing, Jiangsu Province Hospital of Chinese Medicine, University of Chinese Medicine, Nanjing, China
| | - Qian-Hua Yan
- Department of Endocrinology, Affiliated Hospital of Nanjing, Jiangsu Province Hospital of Chinese Medicine, University of Chinese Medicine, Nanjing, China
| | - Yu-Juan Zhang
- Department of Endocrinology, Affiliated Hospital of Nanjing, Jiangsu Province Hospital of Chinese Medicine, University of Chinese Medicine, Nanjing, China
- The First School of Clinical Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Fang Qi
- Department of Endocrinology, Affiliated Hospital of Nanjing, Jiangsu Province Hospital of Chinese Medicine, University of Chinese Medicine, Nanjing, China
- The First School of Clinical Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Liu-Lan Xiang
- Department of Endocrinology, Affiliated Hospital of Nanjing, Jiangsu Province Hospital of Chinese Medicine, University of Chinese Medicine, Nanjing, China
- The First School of Clinical Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Tian-Su Lv
- The First School of Clinical Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Zhu-Yuan Fang
- Institute of Hypertension, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Jiang-Yi Yu
- Department of Endocrinology, Affiliated Hospital of Nanjing, Jiangsu Province Hospital of Chinese Medicine, University of Chinese Medicine, Nanjing, China
| | - Xi-Qiao Zhou
- Department of Endocrinology, Affiliated Hospital of Nanjing, Jiangsu Province Hospital of Chinese Medicine, University of Chinese Medicine, Nanjing, China.
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3
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Zou X, Zhou X, Li Y, Huang Q, Ni Y, Zhang R, Zhang F, Wen X, Cheng J, Yuan Y, Yu Y, Guo C, Xie G, Ji L. Gender-specific data-driven adiposity subtypes using deep-learning-based abdominal CT segmentation. Obesity (Silver Spring) 2023; 31:1600-1609. [PMID: 37157112 DOI: 10.1002/oby.23741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 01/11/2023] [Accepted: 01/11/2023] [Indexed: 05/10/2023]
Abstract
OBJECTIVE The aim of this study was to quantify abdominal adiposity and generate data-driven adiposity subtypes with different diabetes risks. METHODS A total of 3817 participants from the Pinggu Metabolic Disease Study were recruited. A deep-learning-based recognition model on abdominal computed tomography (CT) images (A-CT model) was developed and validated in 100 randomly selected cases. The volumes and proportions of subcutaneous fat, visceral fat, liver fat, and muscle fat were automatically recognized in all cases. K-means clustering was used to identify subgroups using the proportions of the four fat components. RESULTS The Dice indices among the measurements assessed by the A-CT model and manual evaluation to detect liver fat, muscle fat, and subcutaneous fat areas were 0.96, 0.95, and 0.92, respectively. Three subtypes were generated separately in men and women: visceral fat dominant type (VFD); subcutaneous fat dominant type (SFD); and intermuscular fat dominant type (MFD). Compared with the SFD group, the MFD group had similar diabetes risk, and the VFD group had a 60% higher diabetes risk when age and BMI were adjusted for in men. The adjusted odds ratio for diabetes was 1.92 (95% CI: 1.32-2.78) in the MFD group and 6.14 (95% CI: 4.18-9.03) in the VFD group in women. CONCLUSIONS This study identified gender-specific abdominal adiposity subgroups, which may help clinicians to distinguish diabetes risk quickly and automatically.
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Affiliation(s)
- Xiantong Zou
- Department of Endocrinology and Metabolism, Peking University People's Hospital, Beijing, China
| | - Xianghai Zhou
- Department of Endocrinology and Metabolism, Peking University People's Hospital, Beijing, China
| | - Yufeng Li
- Department of Endocrinology, Beijing Friendship Hospital Pinggu Campus, Capital Medical University, Beijing, China
| | - Qi Huang
- Department of Endocrinology and Metabolism, Peking University People's Hospital, Beijing, China
| | - Yuan Ni
- Ping An Technology (Shenzhen) Co., Ltd., Shanghai, China
| | - Ruiming Zhang
- Ping An Technology (Shenzhen) Co., Ltd., Shanghai, China
| | - Fang Zhang
- Department of Endocrinology and Metabolism, Peking University People's Hospital, Beijing, China
| | - Xin Wen
- Department of Endocrinology and Metabolism, Peking University People's Hospital, Beijing, China
| | - Jiayu Cheng
- Department of Endocrinology and Metabolism, Peking University People's Hospital, Beijing, China
| | - Yanping Yuan
- Department of Endocrinology and Metabolism, Peking University People's Hospital, Beijing, China
| | - Yue Yu
- Department of Endocrinology and Metabolism, Peking University People's Hospital, Beijing, China
| | - Chengcheng Guo
- Department of Endocrinology and Metabolism, Peking University People's Hospital, Beijing, China
| | - Guotong Xie
- Ping An Technology (Shenzhen) Co., Ltd., Shanghai, China
| | - Linong Ji
- Department of Endocrinology and Metabolism, Peking University People's Hospital, Beijing, China
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4
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Hao X, He H, Tao L, Wang P. Using hyperhomocysteinemia and body composition to predict the risk of non-alcoholic fatty liver disease in healthcare workers. Front Endocrinol (Lausanne) 2023; 13:1063860. [PMID: 36686421 PMCID: PMC9852987 DOI: 10.3389/fendo.2022.1063860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 12/19/2022] [Indexed: 01/09/2023] Open
Abstract
Purpose This study investigated associations between serum homocysteine levels, body composition, and the probability of having nonalcoholic fatty liver disease (NAFLD) in Chinese healthcare workers. Patients and Methods A total of 4028 healthcare workers were enrolled in this study, and all underwent a physical examination. Body composition was measured using multifrequency bioelectrical impedance analysis. Results There were 1507 NAFLD patients (72.26% male, 27.74% female) and 2521 controls (39.83% male, 60.17% female). Body mass index (BMI), waistline, neck-circumference (NC), abdominal visceral fat area (AVFA), total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), glucose (Glu), homocysteinemia (hcy) were higher in the NAFLD group than controls. Additionally, the skeletal-muscle was associated with a lower risk of NAFLD, whereas BMI, waistline, NC, hyperhomocysteinemia (HHcy) were associated with a higher risk of NAFLD. The best NC cut-off point for NAFLD was 34.45 cm (sensitivity 83.3% and specificity 83.9%) in women with HHcy, and the best skeletal-muscle content cut-off point for NAFLD was 41.335% (sensitivity 74.2% and specificity 65.6%) in men with HHcy. Conclusion Interactions between skeletal-muscle content, NC, and HHcy may affect the incidence of NAFLD in healthcare workers. This may provide a novel approach for diagnosing NAFLD.
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Affiliation(s)
| | | | | | - Peng Wang
- Medical examination center, Peking University, Third Hospital, Beijing, China
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5
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Liu D, Zhong J, Ruan Y, Zhang Z, Sun J, Chen H. The association between fat-to-muscle ratio and metabolic disorders in type 2 diabetes. Diabetol Metab Syndr 2021; 13:129. [PMID: 34758864 PMCID: PMC8579541 DOI: 10.1186/s13098-021-00748-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Accepted: 10/27/2021] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Altered body composition is known to be related to abnormal metabolism. The aim of this study was to determine the association between the fat-to-muscle ratio (FMR) and metabolic disorders in type 2 diabetes (T2DM) population. METHOD In total, 361 T2DM participants aged ≥ 18 years were included in our research. A bioelectrical impedance analyzer was applied to measure fat mass and muscle mass. FMR was calculated as body fat mass (kg) divided by muscle mass (kg). The performance of FMR to assess metabolic disorders in T2DM was conducted using ROC curves. The independent association between FMR and metabolic syndrome (MS) was tested by logistic regression analysis. RESULTS The FMR was significantly higher in patients with MS than in those without MS (p < 0.001). The optimal FMR cutoff point for identifying MS was higher in females than in males (0.465 vs. 0.296, respectively). In addition, the areas under the ROC curve (AUCs) for the evaluation of MS by FMR, fat mass, muscle mass, BMI and waist circumference were further compared, indicating that the AUC of FMR (0.843) was the largest among the five variables in females, but the AUC of waist circumference (0.837) was still the largest among other variables in males. Based on the derived FMR cutoff point, patients with a high FMR exhibited more cardiometabolic risk indicators (all p < 0.05). Using a low FMR as a reference, the relative risk of a high FMR for MS was 2.861 (95% CI 1.111-7.368, p = 0.029) in males and 9.518 (95% CI 2.615-34.638, p = 0.001) in females following adjustment for confounding factors. CONCLUSIONS The fat-to-muscle ratio is independently and positively associated with metabolic disorders in T2DM. FMR may serve as an optimal method for screening T2DM patients coupled with a high risk of abnormal metabolism, especially in females, providing a new perspective for the prevention and treatment of cardiovascular complications in Chinese type 2 diabetes.
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Affiliation(s)
- Dixing Liu
- Department of Endocrinology, Zhujiang Hospital, Southern Medical University, 253 industrial avenue, Guangzhou, 510282, Guangdong, China
| | - Jiana Zhong
- Department of Endocrinology, Zhujiang Hospital, Southern Medical University, 253 industrial avenue, Guangzhou, 510282, Guangdong, China
| | - Yuting Ruan
- Department of Endocrinology, Zhujiang Hospital, Southern Medical University, 253 industrial avenue, Guangzhou, 510282, Guangdong, China
| | - Zhen Zhang
- Department of Endocrinology, Zhujiang Hospital, Southern Medical University, 253 industrial avenue, Guangzhou, 510282, Guangdong, China
| | - Jia Sun
- Department of Endocrinology, Zhujiang Hospital, Southern Medical University, 253 industrial avenue, Guangzhou, 510282, Guangdong, China.
| | - Hong Chen
- Department of Endocrinology, Zhujiang Hospital, Southern Medical University, 253 industrial avenue, Guangzhou, 510282, Guangdong, China.
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6
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The Possibility of Using Bioelectrical Impedance Analysis in Pregnant and Postpartum Women. Diagnostics (Basel) 2021; 11:diagnostics11081370. [PMID: 34441305 PMCID: PMC8391189 DOI: 10.3390/diagnostics11081370] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 07/22/2021] [Accepted: 07/29/2021] [Indexed: 12/14/2022] Open
Abstract
Pregnancy is a time of significant changes occurring in the composition of a woman’s body in order to provide support for the growth and development of the foetus. Bioelectrical impedance analysis (BIA) is used to assess the body composition and hydration status. This technique represents a non-invasive, reliable, and fast clinical approach, which is well tolerated by patients. A segmental impedance measurement might be advantageous in pregnant women, particularly in late pregnancy. The purpose of this paper is to provide a review of different applications of BIA in pregnant and postpartum women. It seems that BIA has a better prognostic potential for gestational and post-partum outcomes than body mass index. The BIA method can be successfully used to study the effect of excessive gestational weight gain in pregnancy on the development of obstetric complications. Studying the mother’s body composition and correlating it with her energy balance could facilitate the development of dietary recommendations for women. Evaluation of the body composition can provide important clues for diagnosis of gestational diabetes mellitus in pregnant women with a low risk of this disease. BIA is also used as one of the additional tests in assessing the risk of developing gestational hypertension and preeclampsia.
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7
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Kurinami N, Sugiyama S, Yoshida A, Hieshima K, Miyamoto F, Kajiwara K, Jinnouch K, Jinnouchi T, Nomura M, Jinnouchi H. Body Muscle-to-Fat Ratio, Rather Than Fat-to-Muscle Ratio, Significantly Correlates With Measured Insulin Resistance in Patients With Type 2 Diabetes Mellitus. J Clin Med Res 2021; 13:387-391. [PMID: 34394781 PMCID: PMC8336940 DOI: 10.14740/jocmr4401] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 07/07/2021] [Indexed: 12/13/2022] Open
Abstract
Background Insulin resistance (IR) assessment is important in treating type 2 diabetes mellitus (T2DM). We thus compared body muscle-to-fat ratio (BMFR) and fat-to-muscle ratio (FMR) values against M/I values as clinical index of IR. Methods Subject included 118 untreated T2DM patients. Hyperinsulinemic-euglycemic clamp examination was performed to calculate the M/I as index of IR. Body composition was measured by impedance analysis using InBody770. Results Simple linear regression analyses confirmed correlations between M/I and BMFR (B: 0.756 (P < 0.01), coefficients of determination (R2): 0.572, mean absolute error (MAE): 3.19, and root mean squared error (RMSE): 4.14), and between M/I and FMR (B: -0.601 (P < 0.01), R2: 0.362, MAE: 3.97, and RMSE: 5.05). Against the M/I values, BMFR also showed better goodness-of-fit than did FMR. In comparing correlation coefficients, the BMFR absolute B value was significantly larger than that of FMR (P = 0.027). Conclusions BMFR is more useful than FMR in quantifying IR in patients with T2DM because the correlation between BMFR and the insulin sensitivity index M/I is significantly greater than that between FMR and M/I.
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Affiliation(s)
- Noboru Kurinami
- Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan.,Division of Endocrinology and Metabolism, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan.,Noboru Kurinami and Seigo Sugiyama contributed equally to the present study
| | - Seigo Sugiyama
- Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan.,Division of Cardiovascular Medicine, Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan.,Noboru Kurinami and Seigo Sugiyama contributed equally to the present study
| | - Akira Yoshida
- Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan
| | - Kunio Hieshima
- Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan
| | - Fumio Miyamoto
- Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan
| | - Keizo Kajiwara
- Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan
| | | | | | - Masatoshi Nomura
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Hideaki Jinnouchi
- Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan.,Division of Preventive Cardiology, Department of Cardiovascular Medicine, Kumamoto University Hospital, Kumamoto, Japan
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8
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Dai H, Xiang J, Hou Y, Xuan L, Wang T, Li M, Zhao Z, Xu Y, Lu J, Chen Y, Wang W, Ning G, Bi Y, Xu M. Fat mass to fat-free mass ratio and the risk of non-alcoholic fatty liver disease and fibrosis in non-obese and obese individuals. Nutr Metab (Lond) 2021; 18:21. [PMID: 33608033 PMCID: PMC7893940 DOI: 10.1186/s12986-021-00551-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 02/11/2021] [Indexed: 01/04/2023] Open
Abstract
Context Body composition may explain partially why non-obese individuals still at the risk of developing non-alcoholic fatty liver disease (NAFLD). The ratio of fat mass to fat-free mass (FM/FFM) has been proposed to assess the combined effect of different body compositions. Objective We aimed to investigate the associations of FM/FFM ratio with the risk of developing NAFLD and fibrosis and to identify the potential mediators according to obesity status. Methods This cohort study comprised 3419 adults age ≥ 40 years and free of NAFLD at baseline. Body composition was measured by bioelectrical impedance analysis. NAFLD was ascertained by ultrasonography and fibrosis was assessed by non-invasive score systems. Results For each 1 standard deviation increment in FM/FFM ratio, the odds ratio for the risk of NAFLD was 1.55 (95% confidence interval [CI] 1.23–1.95) in non-obese men, 1.33 (95% CI 1.08–1.65) in obese men, 1.42 (95% CI 1.44–1.67) in non-obese women, and 1.29 (95% CI 1.12–1.50) in obese women. Similar associations were also found between FM/FFM ratio and NAFLD with fibrosis. Mediation analysis showed that insulin resistance, triglycerides, high-density lipoprotein cholesterol, white blood cells, and total cholesterol mediated the association of FM/FFM ratio with NAFLD risk in specific sex and obesity subgroups. Conclusions The FM/FFM ratio significantly associated with the NAFLD and fibrosis risk in both non-obese and obese individuals. Different factors may mediate the association between body composition and NAFLD risk according to different obesity status.
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Affiliation(s)
- Huajie Dai
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, China.,Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiali Xiang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, China.,Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yanan Hou
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, China.,Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Liping Xuan
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, China.,Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tiange Wang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, China.,Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Mian Li
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, China.,Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhiyun Zhao
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, China.,Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yu Xu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, China.,Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jieli Lu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, China.,Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuhong Chen
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, China.,Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Weiqing Wang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, China.,Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Guang Ning
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, China.,Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yufang Bi
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, China.,Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Min Xu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, China. .,Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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9
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Ruan Y, Zhong J, Chen R, Zhang Z, Liu D, Sun J, Chen H. Association of Body Fat Percentage with Time in Range Generated by Continuous Glucose Monitoring during Continuous Subcutaneous Insulin Infusion Therapy in Type 2 Diabetes. J Diabetes Res 2021; 2021:5551216. [PMID: 34136580 PMCID: PMC8177984 DOI: 10.1155/2021/5551216] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 05/08/2021] [Accepted: 05/15/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Obesity is a crucial risk factor associated with type 2 diabetes mellitus (T2DM). Excessive accumulation of body fat may affect the glycemia control in T2DM. This study investigated the relationship between body fat percentage and time in range (TIR) assessed by continuous glucose monitoring (CGM) during short-term continuous subcutaneous insulin infusion (CSII) therapy in T2DM patients. METHOD A total of 85 T2DM patients were recruited in this cross-sectional study. All participants underwent 72 h CGM period during short-term CSII therapy. TIR was defined as the percentage of time spent within the target glucose range of 3.9-10.0 mmol/L. Body composition was measured using bioelectrical impedance analysis (BIA) and overfat was defined as an amount of body fat of at least 25% of total body mass for men or at least 30% for women. Multiple linear regression models were used to evaluate the independent association of body fat percentage with TIR after adjusting for confounding factors. RESULTS Compared with normal fat T2DM patients, individual with a higher body fat percentage exhibited lower levels of TIR (P = 0.004) and higher 72 h mean blood glucose (72 h MBG) (P = 0.001) during short-term CSII treatment. The prevalence of overfat assessed by body fat percentage decreased with the ascending TIR tertiles (P < 0.05). Multiple linear regression analysis indicated that body fat percentage was significantly associated with TIR independent of age, gender, diabetes duration, HbA1c, and BMI (P = 0.043). CONCLUSIONS Body fat percentage was significantly associated with TIR in T2DM during short-term CSII therapy. Reduction of body fat may be an important therapeutic target to improve glycemic control in high body fat T2DM patients, who may benefit less from intensive insulin treatment.
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Affiliation(s)
- Yuting Ruan
- Department of Endocrinology, Zhujiang Hospital, Southern Medical University, Guangzhou, 510282 Guangdong, China
| | - Jiana Zhong
- Department of Endocrinology, Zhujiang Hospital, Southern Medical University, Guangzhou, 510282 Guangdong, China
| | - Rongping Chen
- Department of Endocrinology, Zhujiang Hospital, Southern Medical University, Guangzhou, 510282 Guangdong, China
| | - Zhen Zhang
- Department of Endocrinology, Zhujiang Hospital, Southern Medical University, Guangzhou, 510282 Guangdong, China
| | - Dixing Liu
- Department of Endocrinology, Zhujiang Hospital, Southern Medical University, Guangzhou, 510282 Guangdong, China
| | - Jia Sun
- Department of Endocrinology, Zhujiang Hospital, Southern Medical University, Guangzhou, 510282 Guangdong, China
| | - Hong Chen
- Department of Endocrinology, Zhujiang Hospital, Southern Medical University, Guangzhou, 510282 Guangdong, China
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Chao YP, Chen WL, Peng TC, Wu LW, Liaw FY, Kao TW. Examining the association between muscle mass, muscle function, and fat indexes in an elderly population. Nutrition 2020; 83:111071. [PMID: 33360504 DOI: 10.1016/j.nut.2020.111071] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 07/05/2020] [Accepted: 11/11/2020] [Indexed: 12/25/2022]
Abstract
OBJECTIVES Skeletal muscle mass with function decline indicated as sarcopenia, which may cause disability in elderly adults. Studies regarding fat composition in sarcopenia have gained attraction recently; however, different fat indexes have yielded different findings. It is necessary to explore the association between muscle mass, muscle function, and fat indexes among elderly adults. METHODS Community-dwelling elderly adults ages 65 and older who received annual health examination or outpatient services were enrolled. Hand grip strength and gait speed were measured. Muscle and fat mass were estimated by bioelectrical impedance analyzer. Presarcopenia was defined as loss of muscle mass only; sarcopenia was loss of muscle mass accompanied by low grip strength or/and slow gait speed. The relationships between sarcopenia parameters and different fat indexes among elderly adults were analyzed. RESULTS There were 295 participants recruited. The presarcopenia group showed lower fat indexes compared to the sarcopenia group. Negative correlations existed between sarcopenia parameters (skeletal muscle mass index, grip strength, gait speed) and fat indexes (body-fat percentage, fat-to-muscle ratio). In the multiple hierarchical regression model, gait speed was negatively associated with body-fat percentage (β = -0.255, P = 0.009) and fat-to-muscle ratio (β = -0.272, P = 0.005) in the male group. In the female group, grip strength was inversely associated with body-fat percentage (β = -0.232, P = 0.009) and fat-to-muscle ratio (β = -0.195, P = 0.031). CONCLUSIONS Individuals in the presarcopenia group had lower fat indexes than those in the sarcopenia group. Gait speed in men and hand grip strength in women-but not muscle mass for either- were negatively associated with body-fat percentage and fat-to-muscle ratio.
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Affiliation(s)
- Yuan-Ping Chao
- Division of Family Medicine and Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital; and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Wei-Liang Chen
- Division of Family Medicine and Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital; and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China; Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Tao-Chun Peng
- Division of Family Medicine and Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital; and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Li-Wei Wu
- Division of Family Medicine and Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital; and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Fang-Yih Liaw
- Division of Family Medicine and Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital; and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Tung-Wei Kao
- Division of Family Medicine and Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital; and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China.
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11
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Seo Y, Song HJ, Song YR. Fat-to-muscle ratio as a predictor of insulin resistance and metabolic syndrome in Korean adults. J Cachexia Sarcopenia Muscle 2020; 11:710-725. [PMID: 32030917 PMCID: PMC7296262 DOI: 10.1002/jcsm.12548] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 07/31/2019] [Accepted: 01/07/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The present study evaluated the associations of the fat-to-muscle ratio (FMR) with metabolic syndrome (MetS) and insulin resistance (IR) in Korean adults using nationally representative survey data. METHODS A two-stage stratified sampling method was reflected in a cross-sectional study involving a total of 13 032 participants aged ≥ 19 years who participated in the fourth and fifth Korea National Health and Nutrition Examination Surveys. The homeostasis model assessment for IR (HOMA-IR) was used to evaluate IR and was calculated as follows: [fasting plasma glucose level (mg/dL) × fasting plasma insulin level (uIU/mL)]/405. MetS was defined using the 2006 International Diabetes Federation criteria, and FMR was measured using whole-body dual-energy X-ray absorptiometry and calculated as follows: total fat mass (kg) divided by total lean mass (kg). In addition, the optimal FMR cut-off values for detecting MetS and the odds ratios (ORs) for MetS risk were determined according to the FMR quartile and sex. RESULTS Among all participants, the proportion of women was 58.4%, and the mean age was 44.22 ± 0.26 years. The FMR significantly differed between men and women (0.30 ± 0.002 vs. 0.53 ± 0.003, respectively, P < 0.001), and the prevalence of MetS and IR gradually increased as FMR increased (P for trend: <0.001). The optimal FMR cut-off value for detecting MetS was higher in women than in men (0.555 vs. 0.336, respectively). The negative predictive value was the highest in normal-weight participants (0.9992 in women and 0.9986 in men), while the positive predictive value was the highest in obese participants (0.5994 in women and 0.5428 in men). Based on the derived cut-off FMR, a high FMR was associated with poor outcomes in terms of cardiometabolic risk markers (P < 0.001). The multivariable-adjusted ORs for MetS, abdominal obesity, and IR (HOMA-IR ≥ 3) were 5.35 [95% confidence interval (CI): 4.39-6.52], 7.67 (95% CI: 6.33-9.30), and 3.25 (95% CI: 2.70-3.92), respectively, in men and 5.59 (95% CI: 4.66-6.72), 7.48 (95% CI: 6.35-8.82), and 2.55 (95% CI: 2.17-3.00), respectively, in women. CONCLUSIONS In the present study, a high FMR was significantly associated with the prevalence of MetS and IR. The present findings also showed that FMR can be a novel indicator for detecting the absence or presence of MetS, particularly in metabolically healthy normal-weight individuals and metabolically obese obese-weight individuals.
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Affiliation(s)
- Young‐Gyun Seo
- Department of Family MedicineHallym University Sacred Heart HospitalAnyangGyeonggi‐doRepublic of Korea
| | - Hong Ji Song
- Department of Family MedicineHallym University Sacred Heart HospitalAnyangGyeonggi‐doRepublic of Korea
| | - Young Rim Song
- Department of Internal MedicineHallym University Sacred Heart HospitalDongan‐guAnyangGyeonggi‐doRepublic of Korea
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Liang J, Zhang H, Sun X, Liao L, Li X, Hu X, Du J, Zhuang X, Liao X. Association between calf girth and peripheral artery disease in the Atherosclerosis Risk in Communities Study. J Cardiol 2020; 76:273-279. [PMID: 32439339 DOI: 10.1016/j.jjcc.2020.04.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 01/20/2020] [Accepted: 03/16/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND The pathogenesis of peripheral artery disease (PAD) is associated with impaired calf muscle. We sought to investigate the association between gender-specific calf girth and the prevalence of PAD among participants from a community-based cohort study. METHODS A total 13,808 participants in the Atherosclerosis Risk in Communities (ARIC) study without prior PAD were included in the final analysis. Calf girth was measured at baseline (1985-1987). A hospital diagnosis with an ICD-9 code defined incident PAD during follow up. Cox regression analysis adjusted for demographic variables and other covariates was used to estimate hazard ratios (HR) and 95% confidence interval (CI) for the association between calf girth and PAD. RESULTS After a medium follow-up of 25.2 years, the overall prevalence of PAD in our study was 5.2% (721/13,808), 335 patients were women and 386 were men. The adjusted HR for PAD with calf girth as continuous variables was 0.99 (95% CI 0.95-1.04) in females and 0.93 (95% CI 0.88-0.99) in males, respectively. Moreover, interaction for gender was statistically significant between calf girth and PAD in overall population (p=0.001). CONCLUSIONS Our findings revealed a linear association of calf girth with the prevalence of PAD among male participants in ARIC.
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Affiliation(s)
- Jianwen Liang
- Cardiology Department, the Eighth Affiliated Hospital of Sun Yat-Sen University, Shenzhen, Guangdong, China
| | - Huanji Zhang
- Cardiology Department, the Eighth Affiliated Hospital of Sun Yat-Sen University, Shenzhen, Guangdong, China
| | - Xiuting Sun
- Cardiology Department, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China; Key Laboratory on Assisted Circulation, Ministry of Health, Guangzhou, Guangdong, China
| | - Lizhen Liao
- Department of Health, Guangdong Pharmaceutical University, Guangzhou Higher Education Mega Center, China
| | - Xiaoling Li
- Cardiology Department, the Eighth Affiliated Hospital of Sun Yat-Sen University, Shenzhen, Guangdong, China
| | - Xun Hu
- Cardiology Department, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China; Key Laboratory on Assisted Circulation, Ministry of Health, Guangzhou, Guangdong, China
| | - Jianhang Du
- Cardiology Department, the Eighth Affiliated Hospital of Sun Yat-Sen University, Shenzhen, Guangdong, China
| | - Xiaodong Zhuang
- Cardiology Department, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China; Key Laboratory on Assisted Circulation, Ministry of Health, Guangzhou, Guangdong, China; Center for Information Technology & Statistics, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China.
| | - Xinxue Liao
- Cardiology Department, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China; Key Laboratory on Assisted Circulation, Ministry of Health, Guangzhou, Guangdong, China.
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Kurinami N, Sugiyama S, Yoshida A, Hieshima K, Miyamoto F, Kajiwara K, Jinnouch K, Jinnouchi T, Jinnouchi H. Body muscle-to-fat ratio gender-specific cut-off values for impaired insulin sensitivity in patients with treatment-naïve type 2 diabetes mellitus. Endocrine 2019; 66:503-508. [PMID: 31630321 DOI: 10.1007/s12020-019-02092-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 09/13/2019] [Indexed: 01/20/2023]
Abstract
PURPOSE We previously reported that the body muscle-to-fat ratio (BMFR), measured using bioelectrical impedance, significantly correlated with whole-body insulin sensitivity. We examined BMFR gender-specific cut-off values for impaired insulin sensitivity in treatment-naïve type 2 diabetes mellitus (T2DM) patients. METHODS Subjects included 101 untreated T2DM patients (male, 66; female, 35). We performed a hyperinsulinemic-euglycemic clamp examination to measure the steady-state glucose infusion rate (M value) as an indicator of whole-body insulin resistance. We defined the M value divided by the steady-state serum insulin value as the M/I value. We defined the existence of insulin resistance using an M/I ratio <9.0. The optimal cut-off value for BMFR was calculated by receiver operating characteristics (ROC) analysis. RESULTS The cut-off value of the BMFR for insulin resistance was 2.75 (area under the curve [AUC] = 0.83, sensitivity 75%, and specificity 76%, P < 0.001) for males and 1.65 (AUC = 0.87, sensitivity 84%, and specificity 81%, P < 0.001) for females. Simple linear regression analysis showed that BMFR was significantly correlated with the M/I value in both genders (males, B = 0.77, P< 0.01; females, B = 0.83, P< 0.01). CONCLUSIONS BMFR cut-off values for impaired insulin sensitivity in treatment-naïve T2DM patients were 2.75 for males and 1.65 for females.
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Affiliation(s)
| | - Seigo Sugiyama
- Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan
- Division of Cardiovascular Medicine, Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan
| | - Akira Yoshida
- Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan
| | - Kunio Hieshima
- Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan
| | - Fumio Miyamoto
- Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan
| | - Keizo Kajiwara
- Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan
| | | | | | - Hideaki Jinnouchi
- Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan.
- Division of Preventive Cardiology, Department of Cardiovascular Medicine, Kumamoto University Hospital, Kumamoto, Japan.
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Kurinami N, Sugiyama S, Ijima H, Yoshida A, Hieshima K, Miyamoto F, Kajiwara K, Jinnouch K, Jinnouchi T, Jinnouchi H. Clinical usefulness of the body muscle-to-fat ratio for screening obstructive sleep apnea syndrome in patients with inadequately controlled type 2 diabetes mellitus. Diabetes Res Clin Pract 2018; 143:134-139. [PMID: 29990564 DOI: 10.1016/j.diabres.2018.07.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2018] [Revised: 06/22/2018] [Accepted: 07/03/2018] [Indexed: 01/11/2023]
Abstract
AIMS To investigate whether body composition measures can be used for screening obstructive sleep apnea syndrome (OSAS) in patients with type 2 diabetes mellitus (T2DM) suspected of having OSAS. METHODS Subjects were 186 hospital inpatients with inadequately controlled T2DM. We measured the respiratory disturbance index (RDI) as an indicator of OSAS using a sheet-type breath detection monitor, defining OSAS as an RDI ≥ 19 events/hour. Elementary body composition was measured by bioelectrical impedance analysis using InBody770. RESULTS Simple logistic regression analysis identified body weight, body mass index (BMI), waist circumference, total body fat mass, body fat percentage, and body muscle-to-fat ratio (BMFR) as significantly associated with OSAS. The Nagelkerke R2 test showed that the BMFR was the most suitable measure for screening OSAS. Multivariate logistic regression analysis demonstrated that BMFR was significantly and independently associated with OSAS. In receiver operating characteristic curve analysis, the area under the BMFR curve was 0.70 (P < 0.001), indicating that BMFR was significantly predictive of OSAS. Furthermore, BMFR was the most suitable measure for screening OSAS in a sub-group analysis of non-obese patients with relatively low BMI (<27.5 kg/m2). CONCLUSIONS In patients with T2DM, the BMFR is useful for screening OSAS in daily clinical practice.
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Affiliation(s)
| | - Seigo Sugiyama
- Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan; Division of Cardiovascular Medicine, Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan
| | - Hiroko Ijima
- Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan
| | - Akira Yoshida
- Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan
| | - Kunio Hieshima
- Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan
| | - Fumio Miyamoto
- Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan
| | - Keizo Kajiwara
- Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan
| | | | | | - Hideaki Jinnouchi
- Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan; Division of Preventive Cardiology, Department of Cardiovascular Medicine, Kumamoto University Hospital, Kumamoto, Japan.
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15
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Kurinami N, Sugiyama S, Yoshida A, Hieshima K, Miyamoto F, Kajiwara K, Jinnouch K, Jinnouchi T, Jinnouchi H. Dapagliflozin significantly reduced liver fat accumulation associated with a decrease in abdominal subcutaneous fat in patients with inadequately controlled type 2 diabetes mellitus. Diabetes Res Clin Pract 2018; 142:254-263. [PMID: 29859912 DOI: 10.1016/j.diabres.2018.05.017] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 04/23/2018] [Accepted: 05/09/2018] [Indexed: 12/25/2022]
Abstract
AIMS We examined dapagliflozin-induced changes in liver fat accumulation. METHODS We prospectively recruited Japanese patients with inadequately controlled type 2 diabetes mellitus (T2DM) [hemoglobin A1c (HbA1c) >7.0%]. Dapagliflozin (5 mg/day) or non-sodium glucose cotransporter 2 inhibitors (SGLT2i) was added to the patients' treatment regimen for 6 months. Changes in liver fat accumulation were assessed by the liver-to-spleen (L/S) attenuation ratio using abdominal computed tomography (CT). RESULTS This study enrolled 55 Japanese T2DM patients. The L/S ratio significantly increased in the dapagliflozin group compared with the non-SGLT2i group. Abdominal subcutaneous fat area (SFA), visceral fat area, total fat area assessed by abdominal CT, aspartate aminotransferase, alanine aminotransferase (ALT), and γ-glutamyl transpeptidase decreased significantly only in the dapagliflozin group. Changes in the L/S ratio showed a significant negative relationship with changes in abdominal SFA, ALT, and non-esterified fatty acid. In sub-group analyses of non-insulin users, hepatic insulin extraction was assessed by the plasma C-peptide-to-insulin ratio, which was significantly increased in the dapagliflozin group but not in the non-SGLT2i group. CONCLUSION In patients with inadequately controlled T2DM, additional dapagliflozin-treatment significantly reduced the liver fat accumulation associated with a decrease in abdominal SFA.
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Affiliation(s)
| | - Seigo Sugiyama
- Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan; Division of Cardiovascular Medicine, Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan
| | - Akira Yoshida
- Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan
| | - Kunio Hieshima
- Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan
| | - Fumio Miyamoto
- Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan
| | - Keizo Kajiwara
- Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan
| | - Katsunori Jinnouch
- Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan; Division of Preventive Cardiology, Department of Cardiovascular Medicine, Kumamoto University Hospital, Kumamoto, Japan
| | | | - Hideaki Jinnouchi
- Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan; Division of Preventive Cardiology, Department of Cardiovascular Medicine, Kumamoto University Hospital, Kumamoto, Japan.
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