组织弥散定量分析技术评估女性医护隐性肥胖者肝脏弹性特征的价值探讨
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摘要
目的探讨组织弹性成像弥散定量分析技术评估女性医护隐性肥胖(invisible obesity,IO)者肝脏弹性的应用价值。方法选取正常女性医护体检人员,利用Inbody770体成分分析仪检测体质指数(BMI)、体脂率(F%)、内脏脂肪面积(VFA)等身体成分,筛选出43例BMI正常范围内(18.5～23.9 kg/m2),F%>28%的隐性肥胖成年女性作为隐性肥胖组(IO组),35例BMI和F%在正常范围内的人群作为对照组。进行肝脏常规超声检查及实时组织弹性成像检查,采用组织弥散定量分析软件,得到肝纤维化指数(LFI)、蓝色区域面积百分比(%AREA)、应变均值(MEAN)、标准差(SD)、复杂度(COMP)、对比度(CONT)、峰度(KURT)、偏度(SKEW)、均等性(ENT)、相关性(CORR)以及杂乱度(ASM),比较两组受检者各弹性参数的差异情况,并分析其与F%、内脏脂肪面积(visceral fat area,VFA)的关系。结果 IO组与对照组比较,LFI、SD、AREA%、COMP、CONT、KURT、SKEW多个弹性参数差异均具有显著统计学意义(P<0.01)。两组间MEAN、ENT、IDM、ASM、CORR比较差异无统计学意义(P>0.05);IO肝脏回声异常与对照组比较差异无统计学意义(P>0.05);LFI、SD、AREA%与F%、VFA呈正相关。结论女性医护IO者肝脏弹性功能减低;组织弥散定量分析技术能够早期、定量评估女性医护IO者肝脏弹性功能的改变。
Objective To investigate the application value of tissue elastography diffusion quantitative analysis technique in evaluating the liver elasticity of female medical staff with invisible obesity(IO). Methods Normal female medical staff who underwent physical examine were selected.The body composition index(BMI), body fat percentage(F%),visceral fat area(VFA) and other body components were measured using the Inbody 770 body composition analyzer. 43 adult women with invisible obesity within the normal range of BMI(18.5-23.9 kg/m2) and F%>28% were screened as the invisible obesity group(IO group), and 35 people with BMI and F% in the normal range were used as the control group. The patients underwent liver routine ultrasound examination and real-time tissue elastography. The LFI, %AREA, MEAN, SD, COMP, CONT, KURT, SKEW, ENT, CORR, and ASM were obtained by tissue diffusion quantitative analysis software. The difference in the elastic parameters of the two groups was compared. And its relationship with F% and visceral fat area(VFA) was analyzed. Results There were significant differences in LFI, SD, AREA%,COMP, CONT KURT and SKEW between the IO group and the control group(P<0.01). There was no significant difference in MEAN, SKEW, ENT, IDM, ASM and CORR between two groups(P>0.05). There was no significant difference in liver echo abnormality between the IO group and the control group(P>0.05). LFI, SD and AREA% were positively correlated with F% and VFA. Conclusion The hepatic elasticity function of female medical staff with recessive obesity is reduced. The tissue diffusion quantitative analysis technology can early and quantitatively evaluate the changes of liver elasticity in female medical staff with invisible obesity.
Objective To investigate the application value of tissue elastography diffusion quantitative analysis technique in evaluating the liver elasticity of female medical staff with invisible obesity(IO). Methods Normal female medical staff who underwent physical examine were selected.The body composition index(BMI), body fat percentage(F%),visceral fat area(VFA) and other body components were measured using the Inbody 770 body composition analyzer. 43 adult women with invisible obesity within the normal range of BMI(18.5-23.9 kg/m2) and F%>28% were screened as the invisible obesity group(IO group), and 35 people with BMI and F% in the normal range were used as the control group. The patients underwent liver routine ultrasound examination and real-time tissue elastography. The LFI, %AREA, MEAN, SD, COMP, CONT, KURT, SKEW, ENT, CORR, and ASM were obtained by tissue diffusion quantitative analysis software. The difference in the elastic parameters of the two groups was compared. And its relationship with F% and visceral fat area(VFA) was analyzed. Results There were significant differences in LFI, SD, AREA%,COMP, CONT KURT and SKEW between the IO group and the control group(P<0.01). There was no significant difference in MEAN, SKEW, ENT, IDM, ASM and CORR between two groups(P>0.05). There was no significant difference in liver echo abnormality between the IO group and the control group(P>0.05). LFI, SD and AREA% were positively correlated with F% and VFA. Conclusion The hepatic elasticity function of female medical staff with recessive obesity is reduced. The tissue diffusion quantitative analysis technology can early and quantitatively evaluate the changes of liver elasticity in female medical staff with invisible obesity.
引文
[1]芦晓磊.隐性肥胖与正常初中生血压及血液生化指标比较[J].中国学校卫生,2018,39(3):429-431,435.
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[13]Booth A,Magnuson A,Foster M.Detrimental and protective fat:body fat distribution and its relation to metabolic disease[J].Hormone Molecular Biology and Clinical Investigation,2014,17(1):13-27.
[14]Faria G,Goncalves A,Cunha R,et al.Beyond central adiposity:liver fat and visceral fat area are associated with metabolic syndrome in morbidly obese patients[J].International Journal of Surgery,2015,14:75-79.
[15]Dhyani M,Anvari A,Samir AE.Ultrasound elastography:Liver[J].Abdominal Imaging,2015,40(4):698-708.
[16]于慧娟.脂肪肝超声弹性成像评分与其严重度的危险因素分析[J].肝脏,2018(3):273-275.
[17]张晓彤.超声组织弥散定量分析技术评估乳腺癌TAC联合化疗患者肝脏损伤的价值研究[D].遵义医学院,2017.
[18]Kurinami N,Sugiyama S,Morita A,et al.Ratio of muscle mass to fat mass assessed by bioelectrical impedance analysis is significantly correlated with liver fat accumulation in patients with type 2 diabetes mellitus[J].Diabetes Research and Clinical Practice,2018,139:122-30.
[2]Pietrobelli A,Malavolti M,Fuiano N,Faith MS.The invisible fat[J].Acta paediatrica(Oslo,Norway:1992),2007,96(454):35-38.
[3]王姗,宋桂花,贺圣文,等.基于体成分分析仪检测的隐性肥胖与慢性病指标相关性研究[J].中国医学装备,2015,12(12):17-20.
[4]Byrne CD.Ectopic fat,insulin resistance and non-alcoholic fatty liver disease[J].The Proceedings of the Nutrition Society,2013,72(4):412-419.
[5]中国肥胖问题工作组数据汇总分析协作组.我国成人体重指数和腰围对相关疾病危险因素异常的预测价值:适宜体重指数和腰围切点的研究[J].中华流行病学杂志,2002,23(1):5-10.
[6]张国盛,王天懿,徐有青,等.实时组织弹性成像技术对慢性乙型肝炎肝纤维化的诊断价值[J].临床肝胆病杂志,2014,30(7):616-619.
[7]Wu T,Ren J,Cong SZ,et al.Accuracy of real-time tissue elastography for the evaluation of hepatic fibrosis in patients with chronic hepatitis B:A prospective multicenter study[J].Digestive diseases(Basel,Switzerland),2014,32(6):791-799.
[8]包云,张舒,邹蓓蓓,等.男性非酒精性脂肪性肝病相关危险因素及人体成分分析的应用价值[J].临床荟萃,2017,32(10):869-872.
[9]Koda M,Kawakami M,Murawaki Y,et al.The impact of visceral fat in nonalcoholic fatty liver disease:Cross-sectional and longitudinal studies[J].Journal of gastroenterology,2007,42(11):897-903.
[10]Stefan N,Kantartzis K,Haring HU.Causes and metabolic consequences of Fatty liver[J].Endocrine Reviews,2008,29(7):939-960.
[11]Habib SS.Body mass index and body fat percentage in assessment of obesity prevalence in saudi adults[J].Biomedical and Environmental Sciences:BES,2013,26(2):94-99.
[12]Milic S,Lulic D,Stimac D.Non-alcoholic fatty liver disease and obesity:Biochemical,metabolic and clinical presentations[J].World Journal of Gastroenterology,2014,20(28):9330-9337.
[13]Booth A,Magnuson A,Foster M.Detrimental and protective fat:body fat distribution and its relation to metabolic disease[J].Hormone Molecular Biology and Clinical Investigation,2014,17(1):13-27.
[14]Faria G,Goncalves A,Cunha R,et al.Beyond central adiposity:liver fat and visceral fat area are associated with metabolic syndrome in morbidly obese patients[J].International Journal of Surgery,2015,14:75-79.
[15]Dhyani M,Anvari A,Samir AE.Ultrasound elastography:Liver[J].Abdominal Imaging,2015,40(4):698-708.
[16]于慧娟.脂肪肝超声弹性成像评分与其严重度的危险因素分析[J].肝脏,2018(3):273-275.
[17]张晓彤.超声组织弥散定量分析技术评估乳腺癌TAC联合化疗患者肝脏损伤的价值研究[D].遵义医学院,2017.
[18]Kurinami N,Sugiyama S,Morita A,et al.Ratio of muscle mass to fat mass assessed by bioelectrical impedance analysis is significantly correlated with liver fat accumulation in patients with type 2 diabetes mellitus[J].Diabetes Research and Clinical Practice,2018,139:122-30.