Association Between Skeletal Muscle Mass To Visceral Fat Area Ratio And Metabolic Phenotype Of Obesity

Background:Over the past 50 years,the incidence of obesity has increased globally and has reached epidemic proportions.Obesity is associated with many metabolic diseases,and the risk of obesity-related complications is proportional to the degree of obesity.However,these obesity-related metabolic disorders differ significantly among obese individuals.Individuals presenting with metabolic healthy obesity(Metabolically healthy obesity,MHO)are more resistant to the development of metabolic abnormalities associated with obesity,and the risk of complications such as dyslipidemia,diabetes,hypertension,and cardiovascular disease may not increase.Despite containing too much body fat,it shows good metabolic characteristics.The main controversy over the current concept of MHO is that MHO is a state of transition,which is temporary.Over time,individuals presenting as MHO have the potential to shift to unhealthy phenotypes at later life stages.This conversion will lead to an increased risk of cardiovascular disease.Despite growing evidence that MHO are not static disease states,little attention is paid to variables that predict metabolic deterioration in MHO patients.Therefore,the purpose of this study was to investigate the effect of myolipid ratio on the transformation of metabolically healthy obese individuals into metabolic unhealthy states.At the same time,we further compared the predictive value of skeletal muscle mass(ASM),visceral fat area(VFA)and skeletal muscle mass to visceral fat area ratio(SVR)of three indexes on metabolic abnormalities in metabolically healthy obese individuals,and provided a reference for early identification of metabolic abnormalities in obese individuals.Methods:We retrospect the consecutive medical files of patients recorded during Aapril 2019 to December 2019 in outpatient or inpatient department of our hospital.184 obese patients(58 males and 126 females)were collected.BMI index>28 kg/m2 defined as obesity.Refer to the diagnostic criteria(NCEP-ATPIII criteria)for the third report of the american national cholesterol education program adult treatment group modified according to asian characteristics to assess whether there is a metabolic syndrome score MHO with metabolic aberrant obesity(Metabolically unhealthy obesity,MUO).A body composition analyzer ioi353 made in Korea was used to determine human body composition.pearson correlation analysis was used to analyze the correlation between appendicular skeletal muscle(ASM),visceral fat area(VFA),skeletal muscle mass to visceral fat area ratio(SVR)and other variables in skeletal muscle of the extremities.Logistic regression analysis was used to analyze the association strength(0R values)between appendicular skeletal muscle(ASM),visceral fat area(VFA),skeletal muscle mass to visceral fat area ratio(SVR)and the occurrence of metabolic aberrant obesity in the extremities.Comparative SVR,ASM,VFA ROC curve analysis of metabolic aberrant obesity.Results:Of the 126 women,63 were in the MHO group,50%,and 63 in the MUO group,50%.Of the 58 men,19 were in the MHO group,representing 32.8 per cent and 39 in the MUO group,representing 67.2 per cent.MHO and MUO groups had significant differences in baseline data such as body weight,BMI、WC、ASM、VFA、SVR、FBG、fasting insulin,HOMA-IR、TG、HDL-C and SBP(both values<0.05).compared with MHO group,MUO group had increased ASM、VFA and decreased SVR.VFA are positively correlated with age、BMI、WC、TG、HOMA-IR、UA,ASM with BMI、WC、HOMA-IR,and negatively correlated with age and BMI、WC、FPG、HOMA-IR.VFA were positively correlated with BMI、WC、HOMA-IR,ASM negatively correlated with age,HDL-C、BMI、WC、HOMA-IR and age.The obese population was divided into 3 equal parts according to SVR level,Q1<Q2<Q3.Multivariate logistic regression analysis showed that the odds ratio of metabolic abnormalities in male and female SVR Q1 group compared with Q3 group was 1.866(95%CI 0.480-7.255)and 4.015(95%CI 1.618-9.966).The male and female groups have the largest AUC curve area of SVR(respectively 0.685 and 0.721).Conclusions:As a new anthropometric index,skeletal muscle mass to visceral fat area ratio(SVR)is closely related to the occurrence of metabolic abnormalities in obese patients,and can be used as an important reference index to predict the occurrence of metabolic abnormalities in obesity.