Faculty of Medicine

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Author: search.filters.author.Janicevic Ivanovska, DanijelaSubject: search.filters.subject.DXA

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    ESTIMATED CENTRAL OBESITY INDEX –WORTHWHILE SCREENING TEST PROCEDURE OF ABDOMINAL OBESITY
    (Institute of Knowledge Management, 2019)
    ;
    Janicevic Ivanovska, Danijela
    Central obesity index (COI) is an indicator of central, abdominal obesity, which is the main characteristic of the metabolic syndrome. Dual-energy x-ray absorptiometric (DXA) assessment of the body fat distribution was performed through the COI values determined with a scan of the entire body in comparison toestimated COI values (eCOI) on spine and hip performed scans. COI was determined as a ratio of android (A) tissue percent fat (A-Tf%) and gynoid (G)-Tf% (COI=A/G-Tf%) as well as eCOI=eA/eG-Tf% in 3 groups of women: 1st group of women with Cushing’s syndrome(CS) (n=14), 2nd group of obese (O) women(n=21), 3rd group of non obese healthy women (C) (n=22). The examinees were not different according to their age, which was 44.32±13.83 years in the 1stgroup, 43.33±12.58 years in the 2ndgroup and 42.56±14.67 years in the 3rdgroup, as well as according to their BMI, which was 30.02±5.02 kg/m2in CS, 29.66±4.88 kg/m2 in O, but it was in normal range 21.76±1.43 kg/m2in non obese control group of healthy women.The values of eA, eG and eA/еG were not significantly different compared to the correspondent values A-Tf%, G-Tf% and A/G-Tf% in all examined groups (p>0.05). The values of eA and A-Tf% in CS were significantly higher compared to O (P<0.05), as well as compared to C and O+C and in O compared to C (p<0.0001). COI value (1.05±0.15) and eCOI (1.04±0.1) in CS were significantly higher compared to O (p<0.006 and p<0.008) and highly significantly higher compared to C, O+C and in O compared to C (p<0.0001). Estimated values eA, eG and eA/eG correlated highly significantly positively with the correspondent values A-Tf%, G-Tf% and A/G-Tf% (p<0.0001) and COI values correlated highly significantly with eCOI, eA and A-Tf% (p<0.0001) and not significantly with G-Tf% and eG (p>0.05) in O confirming COI positive association with central, abdominal fat distribution.Conclusion: DXA indexes COI and eCOI discovered extreme central body fat distribution in CS women,differentiated them significantly and precisely from C and CO, and could be used as diagnostic DXA indexes of extreme central, abdominal obesity in CS and non CS abdominal obese women in DXA body composition and fat distribution assessment. Determination of eCOI is reliable, more practical and faster, with lower radiation and is more acceptable compared to COI, and it can be a routine screening procedure forbody composition and body fat distribution assessment, during regular spine and hip scans for osteoporotic risk assessment instead of COI body fat distribution determination with total body composition measured scans which are used in scientific studies and are not necessary to be performed in clinical body fat distribution examinations.
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    Lipid profile changes relations to body fat distribution changes determined with dual-energy x-ray absorptiometry during the weight loss
    (Institute of Knowledge Management, 2019)
    ;
    Janicevic Ivanovska, Danijela
    ;
    Obesity and central body fat distribution are known risk factors for cardiovascular and metabolic diseases. Dual-energy x-ray absorptiometry (DXA) enables precise, accurate body composition and body fat distribution assessment and it measures and monitors body composition changes in obese patients undergoing weight loss. Obesity is associated with dyslipidemic profile. Low HDL-C levels are frequently associated with raised levels of plasma triglycerides and increased risk of cardiovascular disease and TG/HDL-C ratio may be a better predictor of insulin resistance and cardiovascular disease. LDL-C is one of the major culprits in the development of atherosclerotic heart disease and reduction of LDL-C levels is the primary target of therapy. The effect of weight loss on body fat distribution was examined through android, legs and ndroid/legs tissue and fat mass ratios indexes of central, abdominal obesity determined by DXA and their relationship with lipid profile hanges. The following parameters were determined before and after weight loss: body mass index (BMI), body weight (BW), android (A) and legs (L) tissue mass (TM) and fat mass (FM), their % with DXA, their ratios, indexes of abdominal fat distribution A/L-TM and TM% and A/L-FM and FM%, as well as lipid profile: total cholesterol (C), triglycerides (TG), HDL-C, LDL-C, LDL/HDL-C, C/HDL-C and TG/HDL-C. BW of 62.96±1.2 kg and BMI value of 28.98±0.78 kg/m2 before the weight loss lowered to 49.96±1.3 kg (p<0.012), and normal BMI 22.81±0.62 kg/m2 (p<0.012). A-TMf% value decrease from 50.41±1.7% to 29.55±1.34% after weight loss was significant (p<0.006) and A-FM% 49.92±1.2% decrease to 29.25±1.34% was also highly significant (p<0.005). A-TM 5.43±0.71 kg and A-FM 2.74±0.71 kg lowered to 3.76±0.25 kg and 1.11±0.12 kg after weight loss (p<0.05). L-TMf% 50.31±1.7% lowered to 35.2±2.12% (p<0.018) and L-TM 19.69±0.71 kg lowered to 16.15±0.55 kg (p<0.033). L-FM% 48.51±1.14% lowered to 33.8±1.98% (p<0.009) and L-FM 9.89±0.64 kg lowered to 5.68±0.16 kg (p<0.0002). A/L-TMf% value decrease from 1.01±0.07% to 0.84±0.014% and A/L-FM% value decrease from 1.03±0.04 to 0.87±0.07 were also significant (p<0.05). TG values decrease from 1.21±0.01 mmol/l to 0.83±0.07 mmol/l was significant (p<0.002) and C values decrease from 6.5±0.01 mmol/l to 5.43±0.37 mmol/l was also significant (p<0.05). LDL-C values 4.3±0.1 mmol/l lowered to 3.39±0.34 mmol/l (p<0.026) and TG/HDL-C ratio 0.73±0.01 lowered to 0.52±0.03 (p<0.011). This study showed that A-TMf% and A-FM% lowered highly significantly, indicating significant FM% reduction in android, abdominal TM. Atherogenic lipids TG, C and LDL-C and atherogenic index TG/HDL-C ratio lowered significantly. Also, it was confirmed that DXA indexes of central, abdominal obesity A/L-TM% and A/L-FM% were increased in overweight subjects before the weight loss and lowered highly significantly after the weight loss and increased A/L TM and A/L FM values lowered to normal values, indicating that normal BMI and BW reached after the weight loss were associated with normalized body fat distribution, and significant reduction of the atherogenic lipid profile indicating reduced atherogenic risk.