Risk stratification using magnetic resonance imaging-derived, personalized z-scores of visceral adipose tissue, subcutaneous adipose tissue, and liver fat in persons with obesity.

Autor:	Linge J; AMRA Medical AB, Linköping, Sweden; Division of Diagnostics and Specialist Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden. Electronic address: jennifer.linge@amramedical.com., Widholm P; AMRA Medical AB, Linköping, Sweden; Department of Radiology and Division of Diagnostics and Specialist Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden; Center for Medical Image Science and Visualization, Linköping University, Linköping, Sweden., Nilsson D; AMRA Medical AB, Linköping, Sweden., Kugelberg A; Department of Surgery, Vrinnevi Hospital, Norrköping, Sweden., Olbers T; Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden; Wallenberg Center for Molecular Medicine, Linköping University, Linköping, Sweden., Dahlqvist Leinhard O; AMRA Medical AB, Linköping, Sweden; Division of Diagnostics and Specialist Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden; Center for Medical Image Science and Visualization, Linköping University, Linköping, Sweden.
Jazyk:	angličtina
Zdroj:	Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery [Surg Obes Relat Dis] 2024 May; Vol. 20 (5), pp. 419-424. Date of Electronic Publication: 2024 Jan 24.
DOI:	10.1016/j.soard.2024.01.009
Abstrakt:	Background: Individual patterns of fat accumulation (visceral, subcutaneous, and/or liver fat) can determine cardiometabolic risk profile. Objective: To investigate risk stratification using personalized fat z-scores in persons with a body mass index (BMI) of 30-40 kg/m 2 from the UK Biobank imaging study. Setting: Population-based study. Methods: Whole-body magnetic resonance (MR) images of 40,174 participants from the UK Biobank imaging study were analyzed for visceral adipose tissue (VAT), abdominal subcutaneous adipose tissue (aSAT), and liver fat (LF) and used to calculate sex- and body size-invariant fat z-scores (VATz, aSATz, LFz). Associations between z-scores and later incident cardiovascular disease (CVD) and type 2 diabetes (T2D) were investigated using Cox proportional hazards modeling and Kaplan-Meier curves in participants with BMI 30-40 kg/m 2 . Results: A total of 6716 participants had BMI 30-40 kg/m 2 and within this group, CVD was positively associated with VATz (crude hazard ratio (cHR) [95% CI]: 1.30 [1.20-1.40], P < .001) and negatively associated with aSATz and LFz (cHR: 0.91 [0.85-0.99], P = .028, and 0.88 [0.82-0.95], P = .002). All z-scores remained significant after adjustment for sex, BMI, and age, but only VATz was significant when previous CVD was added. T2D was positively associated with VATz and LFz (cHR: 1.53 [1.40-1.67], P < .001, and 1.35 [1.23-148], P < .001) and negatively associated with aSATz (cHR: 0.90 [0.81-0.99], P = .026). All z-scores remained significant after adjustment for sex, BMI, and age. Conclusions: Personalized MR-derived fat z-scores can identify phenotypes of obesity with specific cardiometabolic risk profiles regardless of BMI. Current guidelines for bariatric surgery based on BMI exclude some of these high-risk patients. (Copyright © 2024 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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