医学
内科学
比例危险模型
脂肪组织
危险系数
回顾性队列研究
弥漫性大B细胞淋巴瘤
腹内脂肪
队列
肿瘤科
胃肠病学
内分泌学
淋巴瘤
内脏脂肪
肥胖
置信区间
胰岛素抵抗
作者
Lu Wang,Shixiong Zhang,Jun Xin
标识
DOI:10.1016/j.ejrad.2023.111205
摘要
PurposeWe aimed to determine if sex differences in abdominal visceral fat composition and metabolism can help predict the prognosis of diffuse large B-cell lymphoma (DLBCL) patients.MethodsThis retrospective cohort study included 117 DLBCL patients. The area and metabolic activity of subcutaneous adipose tissue and visceral adipose tissue were measured using CT and PET imaging. Kaplan–Meier survival analysis was employed to evaluate the effect of these parameters on progression-free survival. Multivariate Cox proportional hazard regression models were used to determine the effects of relative visceral fat area (rVFA) on sex-specific survival.ResultsFemales with an rVFA greater than the optimal threshold of 35 % and a visceral-to-subcutaneous adipose tissue ratio (V/S) >3.24 had worse progression-free survival (p = 0.01, 0.001, respectively). No rVFA or V/S were identified in significantly stratified males with DLBCL (p = 0.249 and 0.895, respectively). Combining the changes in rVFA and V/S identified a subgroup of females with high rVFA and V/S values and exceptionally poor outcomes. The rVFA was a significant predictor of DLBCL progression in females alone.ConclusionOnce female DLBCL patients accumulate fat over the tolerable range in the visceral area, they might be at an increased risk of progression (hazard ratio, 3.87; 95 % CI, 1.81–12.69, p = 0.02).Sex differences in visceral fat composition and metabolism may provide a new risk stratification system for patients with DLBCL.
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