체성분 분석기 InBody 720로 측정한 내장지방 면적과 다양한 복부비만 측정법 간의 연관성
Association of Visceral Fat Area Measured by InBody 720 with the Results Measured by CT, DEXA and Anthropometric Measurement
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연구배경: 복부비만, 특히 내장비만 과다는 심혈관 질환, 대사증후군, 당뇨병, 이상지혈증 및 사망률과 관련이 있다. 이연구는 임상에서 널리 사용되고 있는 생체전기저항측정법(bioelectrical impedance analysis, BIA)으로 측정한 내장지방면적의 정확도를 평가하고 다른 복부비만 측정값과 비교해보았다. 방법: 2005년 10월부터 2007년 12월까지 대학병원 비만 클리닉을 방문한 체질량지수 23 kg/m2 이상인 폐경 전 성인 여성 71명을 대상으로 허리둘레, CT로 복부 총지방면적, 내장지방면적, 피하지방면적을 측정하였고, dual-energy X-ray absorptiometry (DEXA)로 몸통지방량 및 비율을 측정하였다. InBody 720에서 제공하는 내장지방면적과 복부비만 측정변수 간에 편상관분석과 Bland-Altman plot 분석을 시행하고, CT 로 측정한 내장지방면적을 절대표준으로 하여 BIA로 진단한내장형비만의 정확도를 평가하였다. 결과: BIA로 측정한 내장 지방면적은 체질량지수 30 kg/m2 미만 군에서 CT의 내장지방면적과 유의한 차이를 보였으나 체질량지수 30 kg/m2 이상 군에서는 차이를 보이지 않았다. 나이를 보정한 뒤 BIA에 의한 내장지방면적과 CT로 측정한 내장비만면적간의 상관분석 결과 BMI 30 kg/m2 미만 군에서는 유의하였으나(r=0.495, P<0.01), BMI 30 kg/m2 이상 군에서는 유의하지 않았다(r=0.206, P=0.38). 또 BIA로 측정한 내장지방면적은 그 값이 적을 때는 CT로 측정한 값보다 과대평가, 많을때는 과소평가하는 경향을 보였다. BIA 로 평가한 내장형비만진단의 민감도와 특이도는 BMI 30 kg/m2 미만 군에서 50.0%,81.8%였고 BMI 30 kg/m2 이상 군에서 100.0%, 25.0%이었다. 결론: BIA 측정방법으로 구한 복부내장비만 추정치는 비만의정도에 따라 정확도가 변화하므로 이 값을 이용하여 내장 비만을 평가하는 것은 문제가 있다.
Abstract
Background: Obesity is associated with various chronic diseases, especially abdominal fat affect cardiovascular disease,metabolic disease, diabetes mellitus and mortality. The aim of this study was to estimate the accuracy of the visceral fat area measured by bioelectric impedence analysis (BIA) that easily used in many clinical settings, and to compare with the visceral fat area measured by CT and other abdominal obesity measures. Methods: Participants were 71 premenopausal adult women whose BMI was over 23 kg/m2. BMI, waist circumference, total abdominal fat area, visceral fat area, subcutaneous fat area by CT and truncal fat by dual-energy X-ray absorptiometry (DEXA) were measured. Visceral fat area measured by Inbody 720 were compared with variables examining abdominal obesity using partial correlation analysis and Bland-Altman analysis. The accuracy of the visceral obesity by BIA was compared with that diagnosed by CT as gold standard. Results: There was significant difference between visceral fat area measured by CT and BIA in women below BMI 30kg/m2, whereas the difference was not significant in women with BMI ≥ kg/m2. Visceral fat area measured by BIA was significantly correlated with visceral fat area measured by CT only in subjects with BMI less than 30 kg/m2 after adjusting for age (r = 0.495, P < 0.01). Bland-Altman plot analysis showed a tendency regardless of BMI status; the more visceral fat area increased, the less the difference between two measures. The sensitivity and the specificity to diagnose visceral obesity by BIA was 50.0%, 81.8% respectively among women with BMI less than 30 kg/m2, and 100.0%, 25.0% respectively among women with BMI ≥ 30 kg/m2. Conclusion: BIA is not appropriate for evaluation of abdominal visceral obesity.
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