Yıl: 2020 Cilt: 24 Sayı: 3 Sayfa Aralığı: 214 - 220 Metin Dili: İngilizce DOI: 10.25179/tjem.2020-74562 İndeks Tarihi: 20-10-2020

The Effect of Falsely Highlighted Intestinal Intraluminal Areas and the Fat in Paraspinal Muscles on Abdominal Adipose Tissue Measurements Using Computed Tomography

Öz:
Objective: The measurement of abdominal fat using computed tomography(CT) is a reliable method for evaluating metabolic disorders.However, some limitations exist with the current CTmeasurement methods. One of them is falsely highlighted intestinalintraluminal areas and the other one is fat in paraspinal muscles. Weaimed to investigate the effects of highlighted intestinal intraluminalareas and fat in paraspinal muscles on the measured values of abdominalfat. Material and Methods: Measurements were performedon 246 abdominal CT scans of 129 patients using dedicated quantitativeCT software. Visceral and subcutaneous fats were measured atthe level of L1-L2 disc space using two different methods. Method 1included the highlighted intestinal intraluminal areas and fat in paraspinalmuscles for measurements, whereas method 2 excludedthem. The values measured using two methods were compared for astatistically significant difference. In addition, the correlation betweenanthropometric data and subcutaneous adipose tissue measurementmethods was analyzed. Results: The mean age of patients was 53years, and the mean body mass index was 29.73 kg/m2. The waistcircumference data were available of 91 patients, and the mean waistcircumference was 94 cm. The Wilcoxon signed-rank sum test showeda statistically significant difference between methods 1 and 2(p<0.0001). Although the measurements performed using methods1 and 2 were strongly correlated (r>0.9), the Passing-Bablok regressionanalysis indicated a systematic and proportional error betweenmeasurements. Conclusion: Falsely highlighted intestinalintraluminal areas should be excluded for accurate visceral adiposetissue measurements, and the fat in paraspinal muscles affects subcutaneousfat measurement results.
Anahtar Kelime:

İntestinal Lümen İçerisinde Hatalı Olarak Boyanan Alanların ve Paraspinal Kaslar İçerisindeki Yağ Alanlarının Bilgisayarlı Tomografi ile Abdominal Yağ Ölçümü Üzerindeki Etkisi

Öz:
Amaç: Bilgisayarlı tomografi (BT) ile abdominal yağ ölçümü, metabolik hastalık değerlendirmesi açısından oldukça güvenilir bir metottur. Mevcut BT ölçüm metotlarının bazı kısıtlılıkları vardır. Bu kısıtlılıklardan biri, intestinal lümen içerisinde yanıltıcı olarak boyanan alanlardır. Bir diğeri ise paraspinal kaslar içerisindeki yağ doku alanlarıdır. Çalışmamızın amacı, intestinal lümen içerisinde yanıltıcı olarak boyanan alanların ve paraspinal kaslar arasındaki yağ alanlarının abdominal yağ ölçümleri üzerindeki etkisinin araştırılmasıdır. Gereç ve Yöntemler: Yağ ölçümüne yönelik geliştirilmiş kantitatif BT yazılımı kullanılarak 129 hastanın 246 abdomen BT tetkikinde yağ ölçümleri gerçekleştirilmiştir. Viseral ve subkütan yağ ölçümleri, L1- L2 disk düzeyinden iki farklı yöntem kullanılarak gerçekleştirilmiştir. Metot 1’de, intestinal lümen içerisinde yanıltıcı olarak boyanan alanlar ve paraspinal kaslar arasındaki yağ alanları, abdominal yağ ölçümüne dâhil edilmiş, Metot 2’de ise edilmemiştir. İki metot ile ölçülen değerler istatistiksel anlamlı fark açısından karşılaştırılmıştır. Ayrıca antropometrik ölçümler ile subkütanöz yağ dokusu ölçüm metodu arasındaki korelasyon da değerlendirilmiştir. Bulgular: Ortalama hasta yaşı 53 yıl ve ortalama beden kitle indeksi 29,73 kg/m2 olarak bulunmuştur. Bel çevresi ölçümleri 91 hastada mevcut olup, ortalama bel çevresi 94 cm’dir. Wilcoxon işaretli sıralar testi uygulandığında, Metot 1 ve Metot 2 arasında istatistiksel olarak anlamlı fark saptanmıştır (p<0,0001). İki metot ölçümleri arasında güçlü bir korelasyon bulunmakla birlikte (r>0,9), Passing-Bablok analizi ile iki metot arasında sistematik ve orantılı hata saptanmıştır. Sonuç: İntestinal lümen içerisinde yanıltıcı olarak boyanan alanlar viseral yağ ölçümü uygulanırken çıkartılmalıdır. Paraspinal kaslar içerisindeki yağ ise subkütan yağ ölçüm sonuçlarını etkileyecek düzeydedir.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Shuster A, Patlas M, Pinthus JH, Mourstzakis M. The Clinical importance of visceral adiposity: a critical review of methods for visceral adipose tissue analysis. Br J Radiol. 2012;85:1-10. [Crossref] [PubMed] [PMC]
  • 2. Yoshizumi T, Nakamura T, Yamane M, Islam AHMW, Menju M, Yamasaki K, Arai T, Kotani K, Funahashi T, Yamashita S, Matsuzawa Y. Abdominal fat: standardized technique for measurement at CT. Radiology. 1999;211:283-286. [Crossref] [PubMed]
  • 3. Abraham TM, Pedley A, Massaro JM, Hoffmann U, Fox CS. Association between visceral and subcutaneous adipose depots and incident cardiovascular disease risk factors. Circulation 2015;132:1639- 1647. [Crossref] [PubMed] [PMC]
  • 4. Nicklas BJ, Penninx BWJH, Cesari M, Kritchevsky SB, Newman AB, Kanaya AM, Pahor M, Jingzhong D, Harris TB, Health, Aging and Body Composition Study. Association of visceral adipose tissue with incident myocardial infarction in older men and women: the health, aging and body composition study. Am J Epidemiol. 2004;160:741-749. [Crossref] [PubMed]
  • 5. Kuk JL, Katzmarzyk PT, Nichaman MZ, Church TS, Blair SN, Ross R. Visceral fat is an independent predictor of all-cause mortality in men. Obesity (Silver Spring) 2006;14:336-341. [Crossref] [PubMed]
  • 6. Greenfield JR, Samaras K, Chisholm DJ, Campbell LV. Regional intra-subject variability in abdominal adiposity limits usefulness of computed tomography. Obes Res. 2002;10:260-265. [Crossref] [PubMed]
  • 7. Debono M, Prema A, Hughes TJB, Bull M, Ross RJ, Newell-Price J. Visceral fat accumulation and postdexamethasone serum cortisol levels in patients with adrenal incidentaloma. J Clin Endocrinol Metab. 2013, 98:2383-2391. [Crossref] [PubMed]
  • 8. Mazonakis M, Damilakis J. Computed tomography: what and how does it measure? Eur J Radiol. 2016;85:1499-1504. [Crossref] [PubMed]
  • 9. Hung CS, Lee JK, Yang CY, Hsieh HR, Ma WY, Lin MS, Liu PH, Shih SR, Liou JM, Chuang LM, Chen MF, Lin JW, Wei JN, Li HY. Measurement of visceral fat: should we include retroperitoneal fat? PLoS One. 2014; 9:e112355. [Crossref] [PubMed] [PMC]
  • 10.Delivanis DA, Iñguez-Ariza NM, Zeb MH, Moynagh MR, Takahashi N, McKenzie TJ, Thomas MA, Gogos C, Young WF, Bancos I, Kyriazopoulou V. Impact of hypercortisolism on skeletal muscle mass and adipose tissue mass in patients with adrenal adenomas. Clinical Endocrinology (Oxf). 2018;88: 209-216. [Crossref] [PubMed]
  • 11.Akay S, Urkan, M, Balyemez U, Erşen M, Taşar M. Is visceral obesity associated with colorectal cancer? The first volumetric study using all CT slices. Diagn Interv Radiol. 2019;25:338-345. [Crossref] [PubMed] [PMC]
  • 12. Sottier D, Petit JM, Guiu S, Hamza S, Benhamiche H, Hillon P, Cercueil JP, Krausé D, Guiu B. Quantification of the visceral and subcutaneous fat by computed tomography: interobserver correlation of a single slice technique. Diagn Interv Imaging. 2013;94:879-884. [Crossref] [PubMed]
  • 13.Maurovich-Horvat P, Massaro J, Fox CS, Moselewski F, O’Donnell CJ, Hoffmann U. Comparison of anthropometric, area- and volume-based assessment of abdominal subcutaneous and visceral adipose tissue volumes using multi-detector computed tomography. Int J Obes (Lond). 2007;31:500-506. [Crossref] [PubMed]
  • 14.Yener S, Baris M, Secil M, Akinci B, Comlekci A, Yesil S. Is there an association between non-functioning adrenal adenoma and endothelial dysfunction? J Endocrinol Invest. 2011;34:265-270. [Crossref] [PubMed]
  • 15.Rosenquist KJ, Pedley A, Massaro JM, Therkelsen KE, Murabito JM, Hoffman U, Fox CS. Visceral and subcutaneous fat quality and cardiometabolic risk. JACC Cardiovasc Imaging logy. 2013;6:762-771. [Crossref] [PubMed] [PMC]
  • 16.Kuk JL, Church TS, Blais SN, Ross R. Does measurement site for visceral and abdominal subcutaneous adipose tissue alter associations with the metabolic syndrome? Diabetes Care. 2006; 29:679- 684. [Crossref] [PubMed]
  • 17.Kuk JL, Nichaman MZ, Church TS, Blair SN, Ross R. Liver fat is not a marker of metabolic risk in lean premenopausal women. Metabolism. 2004;53: 1066-1071. [Crossref] [PubMed]
  • 18. Sjöstrom L, Kvist H, Cederblad A, Tylén U. Determination of total adipose tissue and body fat in women by computed tomography, 40K, and tritium. Am J Physiol. 1986; 250:E736-745. [Crossref] [PubMed]
  • 19.Kvist H, Chowdhury B, Sjöström L, Tylén U, Cederblad A. Adipose tissue volüme determination in males by computed tomography and 40K. Int J Obes. 1988;12:249-266. [PubMed]
  • 20.Shen W, Punyanitya M, Wang Z, Gallagher D, St- Onge MP, Albu J, Heymsfield SB, Heshka S. Visceral adipose tissue: relations between single-slice areas and total volume. Am J Clin Nutr. 2004;80: 271- 278. [Crossref] [PubMed] [PMC]
  • 21.Yener S, Baris M, Peker A, Demir O, Ozgen B, Secil M. Autonomous cortisol secretion in adrenal incidentalomas and increased visceral fat accumulation during follow-up. Clin Endocrinol (Oxf). 2017;87: 425-432. [Crossref] [PubMed]
APA Baris M, PEKER A, Yener S, Gezer N, SEÇIL M (2020). The Effect of Falsely Highlighted Intestinal Intraluminal Areas and the Fat in Paraspinal Muscles on Abdominal Adipose Tissue Measurements Using Computed Tomography. , 214 - 220. 10.25179/tjem.2020-74562
Chicago Baris Mustafa Mahmut,PEKER AHMET,Yener Serkan,Gezer Naciye Sinem,SEÇIL MUSTAFA The Effect of Falsely Highlighted Intestinal Intraluminal Areas and the Fat in Paraspinal Muscles on Abdominal Adipose Tissue Measurements Using Computed Tomography. (2020): 214 - 220. 10.25179/tjem.2020-74562
MLA Baris Mustafa Mahmut,PEKER AHMET,Yener Serkan,Gezer Naciye Sinem,SEÇIL MUSTAFA The Effect of Falsely Highlighted Intestinal Intraluminal Areas and the Fat in Paraspinal Muscles on Abdominal Adipose Tissue Measurements Using Computed Tomography. , 2020, ss.214 - 220. 10.25179/tjem.2020-74562
AMA Baris M,PEKER A,Yener S,Gezer N,SEÇIL M The Effect of Falsely Highlighted Intestinal Intraluminal Areas and the Fat in Paraspinal Muscles on Abdominal Adipose Tissue Measurements Using Computed Tomography. . 2020; 214 - 220. 10.25179/tjem.2020-74562
Vancouver Baris M,PEKER A,Yener S,Gezer N,SEÇIL M The Effect of Falsely Highlighted Intestinal Intraluminal Areas and the Fat in Paraspinal Muscles on Abdominal Adipose Tissue Measurements Using Computed Tomography. . 2020; 214 - 220. 10.25179/tjem.2020-74562
IEEE Baris M,PEKER A,Yener S,Gezer N,SEÇIL M "The Effect of Falsely Highlighted Intestinal Intraluminal Areas and the Fat in Paraspinal Muscles on Abdominal Adipose Tissue Measurements Using Computed Tomography." , ss.214 - 220, 2020. 10.25179/tjem.2020-74562
ISNAD Baris, Mustafa Mahmut vd. "The Effect of Falsely Highlighted Intestinal Intraluminal Areas and the Fat in Paraspinal Muscles on Abdominal Adipose Tissue Measurements Using Computed Tomography". (2020), 214-220. https://doi.org/10.25179/tjem.2020-74562
APA Baris M, PEKER A, Yener S, Gezer N, SEÇIL M (2020). The Effect of Falsely Highlighted Intestinal Intraluminal Areas and the Fat in Paraspinal Muscles on Abdominal Adipose Tissue Measurements Using Computed Tomography. Turkish Journal of Endocrinology and Metabolism, 24(3), 214 - 220. 10.25179/tjem.2020-74562
Chicago Baris Mustafa Mahmut,PEKER AHMET,Yener Serkan,Gezer Naciye Sinem,SEÇIL MUSTAFA The Effect of Falsely Highlighted Intestinal Intraluminal Areas and the Fat in Paraspinal Muscles on Abdominal Adipose Tissue Measurements Using Computed Tomography. Turkish Journal of Endocrinology and Metabolism 24, no.3 (2020): 214 - 220. 10.25179/tjem.2020-74562
MLA Baris Mustafa Mahmut,PEKER AHMET,Yener Serkan,Gezer Naciye Sinem,SEÇIL MUSTAFA The Effect of Falsely Highlighted Intestinal Intraluminal Areas and the Fat in Paraspinal Muscles on Abdominal Adipose Tissue Measurements Using Computed Tomography. Turkish Journal of Endocrinology and Metabolism, vol.24, no.3, 2020, ss.214 - 220. 10.25179/tjem.2020-74562
AMA Baris M,PEKER A,Yener S,Gezer N,SEÇIL M The Effect of Falsely Highlighted Intestinal Intraluminal Areas and the Fat in Paraspinal Muscles on Abdominal Adipose Tissue Measurements Using Computed Tomography. Turkish Journal of Endocrinology and Metabolism. 2020; 24(3): 214 - 220. 10.25179/tjem.2020-74562
Vancouver Baris M,PEKER A,Yener S,Gezer N,SEÇIL M The Effect of Falsely Highlighted Intestinal Intraluminal Areas and the Fat in Paraspinal Muscles on Abdominal Adipose Tissue Measurements Using Computed Tomography. Turkish Journal of Endocrinology and Metabolism. 2020; 24(3): 214 - 220. 10.25179/tjem.2020-74562
IEEE Baris M,PEKER A,Yener S,Gezer N,SEÇIL M "The Effect of Falsely Highlighted Intestinal Intraluminal Areas and the Fat in Paraspinal Muscles on Abdominal Adipose Tissue Measurements Using Computed Tomography." Turkish Journal of Endocrinology and Metabolism, 24, ss.214 - 220, 2020. 10.25179/tjem.2020-74562
ISNAD Baris, Mustafa Mahmut vd. "The Effect of Falsely Highlighted Intestinal Intraluminal Areas and the Fat in Paraspinal Muscles on Abdominal Adipose Tissue Measurements Using Computed Tomography". Turkish Journal of Endocrinology and Metabolism 24/3 (2020), 214-220. https://doi.org/10.25179/tjem.2020-74562