1.江门市新会区中医院放射科,广东 江门 529100
2.中山大学附属第一医院放射诊断专科,广东 广州 510080
3.深圳市中医院放射影像科,广东 深圳 518033
梁伟强,副主任医师,研究方向:放射诊断学,E-mail:liang233233@126.com
纸质出版日期:2021-03-20,
收稿日期:2020-06-01,
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梁伟强,彭振鹏,高进云等.磁共振胰腺脂肪定量测定预测糖耐量异常及2型糖尿病[J].中山大学学报(医学科学版),2021,42(02):250-256.
LIANG Wei-qiang,PENG Zhen-peng,GAO Jin-yun,et al.Pancreatic Fat Quantification by MRI: Potential Biomarker of Impaired Glucose Tolerance and Type 2 Diabetes[J].Journal of Sun Yat-sen University(Medical Sciences),2021,42(02):250-256.
梁伟强,彭振鹏,高进云等.磁共振胰腺脂肪定量测定预测糖耐量异常及2型糖尿病[J].中山大学学报(医学科学版),2021,42(02):250-256. DOI:
LIANG Wei-qiang,PENG Zhen-peng,GAO Jin-yun,et al.Pancreatic Fat Quantification by MRI: Potential Biomarker of Impaired Glucose Tolerance and Type 2 Diabetes[J].Journal of Sun Yat-sen University(Medical Sciences),2021,42(02):250-256. DOI:
目的
2
探讨磁共振胰腺的脂肪含量测定预测糖耐量异常(IGT)及2型糖尿病(T2DM)的可行性。
方法
2
108名受试者(43男,65女;年龄47.9±12.1岁),包括T2DM(
n
=27),IGT(
n
=29)和葡萄糖耐量正常者(NGT;
n
=53)。NGT组进一步分为
<
40岁的NGT-年轻组和 ≥40岁的NGT-年长组。所有受试者均进行针对胰岛素抵抗和β细胞功能障碍的标准实验室检测。利用MRI非对称回波三点法水脂分离-定量(IDEAL-IQ)技术测定胰腺脂肪含量。分析胰腺脂肪体积分数(PFVF)与实验室检测参数之间的相关性,并分析PFVF预测IGT和T2DM的可行性。
结果
2
T2DM患者的PFVF显著高于其余各组, IGT患者PFVF次之,NGT组PFVF最低。Logistic回归分析提示PFVF是血糖异常(IGT及T2DM)的独立危险因素。ROC曲线分析显示PFVF预测血糖异常(IGT及T2DM)的临界值为5.68%(
P
<
0.001, AUC:0.871, 敏感度92.7%,特异度71.7%)。
结论
2
MRI脂肪定量测定技术可以测定胰腺的脂肪含量,为血糖异常(IGT和T2DM)的预测提供无创性的生物指标。
Objective
2
To investigate whether the quantitative magnetic resonance imaging (MRI) measurement of pancreatic fat content may indicate impaired glucose tolerance (IGT) or type 2 diabetes mellitus (T2DM).
Methods
2
A total of 108 subjects (43 men, 65 women; aged 47.9±12.1 years) were enrolled in this study, including 27 with T2DM, 29 with IGT and 53 with normal glucose tolerant (NGT). NGT individuals were subdivided into younger group (<40 years old) and elder group (≥40 years old). All the participants underwent standard laboratory tests for insulin resistance and β-cell dysfunction. MRI scanning with the iterative decomposition of water and fat with echo asymmetry and least square estimation image quantification (IDEAL-IQ) technique was used to determine fat distribution in the pancreas. The correlation between pancreatic fat volume fractions (PFVF) and laboratory parameters was analyzed. The feasibility of using PFVF to predict IGT and T2DM was evaluated.
Results
2
PFVF was significantly higher in T2DM patients than that in both IGT and NGT patients, with lowest PFVF in NGT patients. Logistic regression indicated that PFVF was an independent risk factor of glucose abnormality (IGT and T2DM). ROC curve analysis showed that the cut-off value for PFVF to predict glucose abnormality (IGT and T2DM) was 5.68% (
P
<
0.001; AUC: 0.871; sensitivity: 92.7%; specificity: 71.7%).
Conclusion
2
MRI fat quantitative assay can quantitatively determine fat content in the pancreas, providing a non-invasive biomarker for the prediction of glucose abnormality (IGT and T2DM).
脂肪体积分数胰腺2型糖尿病磁共振成像
fat volume fractionpancreastype 2 diabetes mellitusmagnetic resonance imaging
Chng MH, Alonso MN, Barnes SE, et al. Adaptive immunity and antigen-specific activation in obesity-associated insulin resistance[J]. Mediators Inflamm, 2015, 20(15): 593075.
Bianchini JA, da Silva DF, Nardo CC, et al. Multidisciplinary therapy reduces risk factors for metabolic syndrome in obese adolescents[J]. Eur J Pediatr, 2013, 172(2): 215-221.
Heiskanen MA, Motiani KK, Mari A, et al. Exercise training decreases pancreatic fat content and improves beta cell function regardless of baseline glucose tolerance: a randomised controlled trial[J]. Diabetologia, 2018, 61(8): 1817-1828.
Nasr P, Fredrikson M, Ekstedt M, et al. The amount of liver fat predicts mortality and development of type 2 diabetes in non-alcoholic fatty liver disease[J]. Liver Int, 2020, 40(5): 1069-1078.
蔡华崧,翟凤仪,杨君,等.糖耐量正常试验者及糖耐量异常患者的全肝脂肪MRI定量研究[J].中山大学学报(医学科学版), 2015, 36(3): 396-402.
Cai HS, Zhai FY, Yang J, et al. MR quantification of total liver fat in patients with impaired glucose tolerance and with normal tolerance[J]. J Sun Yat-sen Univ (Med Sci), 2015, 36(3): 396-402.
王踉碕,彭屹峰. 3.0T MRI IDEAL-IQ序列评价成人肝铁浓度与脂肪分数的相关性[J].中国医学影像技术, 2015, 31(12): 1844-1847.
Wang LQ Peng YF. Correlation study of adult fat fraction and iron concentration with 3.0T MRI IdealIQ sequence[J]. Chin J Med Imag Technol, 2015, 31(12): 1844-1847.
American Diabetes Association. Improving Care and Promoting Health in Populations: Standards of Medical Care in Diabetes-2018[J]. Diabetes Care 2018, 41(Suppl 1): S7-12.
贾宏茹,李畅,刘畅,等. MR扩散峰度成像对非酒精性脂肪性肝病诊断价值[J]. 影像诊断与介入放射学, 2020, 29(1): 3-8.
Jia HR, Li C, Liu C, et al. Diagnostic value of non-alcoholic fatty liver disease with MR diffusion kurtosis imaging[J]. Diagn Imag & Intervent Radiol, 2020, 29(1): 3-8.
Patel NS, Peterson MR, Brenner DA, et al. Association between novel MRI-estimated pancreatic fat and liver histology-determined steatosis and fibrosis in non-alcoholic fatty liver disease[J]. Aliment Pharm Ther, 2013, 37(6): 630-639.
Livingstone RS, Begovatz P, Kahl S, et al. Initial clinical application of modified Dixon with flexible echo times: hepatic and pancreatic fat assessments in comparison with 1H MRS[J]. MAGMA, 2014, 27(5): 397-405.
Ramkissoon R, Gardner TB. Pancreatic steatosis: An emerging clinical entity[J]. Am J Gastroenterol, 2019, 11(4): 1726-1734.
Cohen JC, Horton JD, Hobbs HH. Human fatty liver disease: Old questions and new insights[J]. Science, 2011, 332(6037): 1519-1523.
Tushuizen ME, Bunck MC, Pouwels PJ, et al. Pancreatic fat content and beta-cell function in men with and without type 2 diabetes[J]. Diabetes Care, 2007, 30(11): 2916-2921.
Kahn SE, Hull RL, Utzschneider KM. Mechanisms linking obesity to insulin resistance and type 2 diabetes[J]. Nature, 2006, 444(7121): 840-846.
Hannukainen JC, Borra R, Linderborg K, et al. Liver and pancreatic fat content and metabolism in healthy monozygotic twins with discordant physical activity[J]. J Hepatol, 2011, 54(3): 545-552.
Wang CY, Ou HY, Chen MF, et al. Enigmatic ectopic fat: prevalence of nonalcoholic fatty pancreas disease and its associated factors in a Chinese population[J]. J Am Heart Assoc, 2014, 3(1): e000297.
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