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动脉粥样硬化性血脂异常与肌内脂肪浸润定义的肌肉质量之间的关系。

Association between atherogenic dyslipidemia and muscle quality defined by myosteatosis.

机构信息

Department of Internal Medicine, Chung-Ang University Gwangmyeong Hospital, Chung-Ang University College of Medicine, Gwangmyeong, Republic of Korea.

Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.

出版信息

Front Endocrinol (Lausanne). 2024 Aug 7;15:1327522. doi: 10.3389/fendo.2024.1327522. eCollection 2024.

Abstract

BACKGROUND

Myosteatosis, ectopic fat accumulation in skeletal muscle, is a crucial component of sarcopenia, linked to various cardiometabolic diseases. This study aimed to analyze the association between dyslipidemia and myosteatosis using abdominal computed tomography (CT) in a large population.

METHODS

This study included 11,823 patients not taking lipid-lowering medications with abdominal CT taken between 2012 and 2013. Total abdominal muscle area (TAMA), measured at the L3 level, was segmented into skeletal muscle area (SMA) and intramuscular adipose tissue. SMA was further classified into normal attenuation muscle area (NAMA: good quality muscle) and low attenuation muscle area (poor quality muscle). NAMA divided by TAMA (NAMA/TAMA) represents good quality muscle. Atherosclerotic dyslipidemia was defined as high-density lipoprotein cholesterol (HDL-C) less than 40 mg/dL in men and 50 mg/dL in women, low-density lipoprotein cholesterol (LDL-C) greater than 160 mg/dL, triglycerides (TG) greater than 150 mg/dL, small dense LDL-C (sdLDL-C) greater than 50.0 mg/dL, or apolipoprotein B/A1 (apoB/A1) greater than 0.08.

RESULTS

The adjusted odds ratios (ORs) of dyslipidemia according to the HDL-C and sdLDL definitions were greater in both sexes in the lower quartiles (Q1~3) of NAMA/TAMA compared with Q4. As per other definitions, the ORs were significantly increased in only women for LDL-C and only men for TG and ApoB/A1. In men, all lipid parameters were significantly associated with NAMA/TAMA, while TG and ApoB/A1 did not show significant association in women.

CONCLUSION

Myosteatosis measured in abdominal CT was significantly associated with a higher risk of dyslipidemia. Myosteatosis may be an important risk factor for dyslipidemia and ensuing cardiometabolic diseases.

摘要

背景

肌肉脂肪变性,即骨骼肌内的异位脂肪堆积,是肌肉减少症的重要组成部分,与各种心血管代谢疾病有关。本研究旨在利用腹部计算机断层扫描(CT)分析在大量人群中血脂异常与肌肉脂肪变性之间的关联。

方法

本研究纳入了 11823 名未服用降脂药物且于 2012 年至 2013 年间进行过腹部 CT 检查的患者。在 L3 水平测量总腹部肌肉面积(TAMA),并将其分为骨骼肌面积(SMA)和肌内脂肪组织。SMA 进一步分为正常衰减肌肉面积(NAMA:优质肌肉)和低衰减肌肉面积(低质量肌肉)。NAMA 除以 TAMA(NAMA/TAMA)表示优质肌肉的比例。动脉粥样硬化性血脂异常定义为男性高密度脂蛋白胆固醇(HDL-C)<40mg/dL,女性<50mg/dL,低密度脂蛋白胆固醇(LDL-C)>160mg/dL,三酰甘油(TG)>150mg/dL,小而密 LDL-C(sdLDL-C)>50.0mg/dL,或载脂蛋白 B/A1(apoB/A1)>0.08。

结果

根据 HDL-C 和 sdLDL-C 的定义,与 Q4 相比,NAMA/TAMA 较低四分位(Q1~3)的男女患者血脂异常的调整比值比(OR)均较高。其他定义中,仅女性的 LDL-C 和仅男性的 TG 和 apoB/A1 的 OR 显著升高。在男性中,所有血脂参数均与 NAMA/TAMA 显著相关,而在女性中,TG 和 apoB/A1 与 NAMA/TAMA 无显著相关性。

结论

腹部 CT 测量的肌肉脂肪变性与血脂异常的风险显著相关。肌肉脂肪变性可能是血脂异常和随后发生心血管代谢疾病的重要危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b6d/11335673/e36da6e145aa/fendo-15-1327522-g001.jpg

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