To Investigate The Characteristic Of Abdominal Fat Distribution By Computed Tomography And Relationship With Metabolic Syndrome In The Elderly

Objective: To investigate the characteristic of abdominal fat distribution by computedtomography and the relationship with metabolic syndrome in the elderly throughretrospective analysis.Method: This study included2parts：1. Chinese old subjects (aged≥65years old) who underwent a abdominal CT scanningin the Department of Radiology of Chinese PLA General Hospital from January2009toDecember2010were collected through retrospective analysis.67healthy normalweighted subjects and gender-specific BMI-matching middle-aged adults were selected(38men and29women) to compare the difference of abdominal fat at the same period.2. Chinese old subjects (aged≥65years old) who underwent a abdominal CT scanningin the Department of Radiology of Chinese PLA General Hospital from January2009toDecember2011were collected to analyze the relationship between metabolic syndromeand abdominal fat distribution in the elderly. Visceral fat area(VFA) and subcutaneousfat area(SFA) were measured in the abdomen at the cross-sectional image of L4and L5intervertebral space.Results:1.390subjects were enrolled in this study (252men and138women). Totalabdominal fat(TAF) was not significantly different in both genders(women：（322.81±122.49cm2）vs men：（302.83±141.24cm2），P=0.146), but the old womenhad higher TAF than the men after a height correction(128.57±49.23cm2/m2vs105.12±49.03cm2/m2，P=0.000). VFA/H and SFA/H were higher with higher BMIvalues across the lean, normal weight, overweight and obese groups in both men andwomen. VFA/H and SFA/H were not significantly different in both men and women inthe3different age groups(＞65~75years,＞75~85years,＞85years; P＞0.05). Compared with healthy normal weighted old adults and BMI-matched middle-agedadults, VFA/H and SFA/H increased with more components of MS except in only onecomponent group. When the patients were excluded suffering from2or morecomponents of MS, VFA/H was not significantly different between normal weightedold adults and the individuals who had only one component of MS (diabetes, orhyperlipidemia, or hypertension). Logistic regression analysis showed VFA/H was arisk factor for older adults with MS(male：OR=1.03，95%CI：1.012~1.047；female：OR=1.06，95%CI：1.026~1.088), and SFA/H was also a risk factor in men(OR=1.03,95%CI：1.012~1.051).2. The old women had higher TAF and SFA than the men after a height correction（TAF/H:144.64±52.26cm2/m2vs124.64±49.50cm2/m2, P=0.000; SFA/H:92.44±37.62cm2/m2vs66.30±24.39cm2/m2, P=0.000）, but VFA/H was lower in women（VFA/H:58.34±29.69cm2/m2vs52.20±19.69cm2/m2；P=0.013）. The obese had higherVFA/H and SFA/H than the overweight and normal-weight. The prevalence of MS wasgreater in the obese than the visceral obesity in the overweight and normal-weight. Inboth elderly men and women, the numbers of components of MS increase with VFA/Hand SFA/H. Logistic regression analysis showed VFA/H was a risk factor for olderadults with MS（male：OR=1.53，95%CI：1.113~2.102，P=0.009；female：OR=2.28，95%CI：1.475~3.511，P=0.000）. Besides, SFA/H was also a risk factor in men, but notin women.Conclusion:1.The old men have more visceral fat and less subcutaneous fat than theold women;2. The abdominal fat did not increase with aging in old adults;3. VFA andSFA had a highly positively correlation with BMI and increase with the increment ofmore than2components of MS;4. Visceral fat is a risk factor for older adults with MSin both men and women, and the subcutaneous fat should also be paid attention to in oldmen.