肌细胞内脂质与胰岛素抵抗关系的~1-HMRS研究  

Measurement of Intracellular Lipids in Human Leg Muscle by^1H-MR Spectroscopy:a Primary Study for the Relationship with Insulin Resistance

作　　者：张磊[1] 金真[1] 刘彦君[2] 倪彩虹[2] 曾亚伟[1] 王彦[1] 许樟荣[2] 

机构地区：[1]解放军第306医院磁共振室,北京100101 [2]解放军第306医院糖尿病中心,北京100101

出　　处：《放射学实践》2005年第2期106-109,共4页Radiologic Practice

基　　金：总装备部后勤部基金资助项目(ZZWS02005)

摘　　要：目的:利用磁共振波谱(1H MRS)成像技术测定小腿骨骼肌细胞内脂质(IMCL)含量,初步探讨IMCL水平 与Ⅱ型糖尿病的关系,为进一步分析IMCL与胰岛素抵抗机制奠定方法学基础。方法:利用1H MRS成像技术测定10例 青年健康男性和29例(男12,女17)初诊为Ⅱ型糖尿病患者的右侧小腿比目鱼肌IMCL,计算IMCL相对于肌酸及磷酸肌 酸(Cr)的比值(IMCL/Cr)。分别测量正常组和糖尿病组的身高、体重、血压、空腹及餐后2h血糖及胰岛素水平、血总胆固 醇(TC)、三酰甘油、高密度脂蛋白胆固醇(HDL)、低密度脂蛋白胆固醇(LDL)、糖化血红蛋白含量及腰臀比。结果:正常组 和糖尿病组IMCL/Cr分别为1.64±0.54和2.75±0.86,两组间差异有极显著性意义(t=3.76,P<0.001),而糖尿病组 内男、女性之间IMCL/Cr差异无显著性意义。糖尿病组IMCL/Cr与患者血糖、胰岛素水平、TC、三酰甘油、HDL、LDL、 糖化血红蛋白含量及腰臀比无关。结论:1H MRS能够简便、无创地测量人体骨骼肌IMCL含量,可作为一种新型的检测 人体胰岛素抵抗的方法应用于临床研究。Objective:To assess the possible application of the muscular intra-myocellular lipids (IMCL) measurement by using 1H magnetic resonance spectroscopy ( 1H-MRS). Methods: 1H-MRS was performed on 10 male healthy volunteers and 29 cases of neuly diagnosed type Ⅱ diabetes mellitus (12 male and 17 female).Peaks of IMCL and creatin (Cr) in right soleus muscle were measured.The ratios of IMCL/Cr were calculated and compared between healthy volunteers and diabetics.In diabetics,the values of body height,weight,blood pressure,pre- and post-meal glucose and insulin levels,total cholesterol,triglyceride,low- and high- density lipoprotein cholesterol,glycosylated hemoglobin,waist-hip-ratio were measured, and their associations with IMCL/Cr were assessed. Results:The IMCL/Cr level of the diabetics (2.75±0.86) were significantly higher (t=3.76,P<0.001) than the normal subjects (1.64±0.54).No difference was observed in IMCL/Cr level between the male and female diabetics.Also the IMCL/Cr ratio was not related to any above-mentioned variants.Conclusion:Non-invasive 1H-MRS is specialized and feasible to measure the intra-myocellular lipids in muscle,which can demonstrate the difference between healthy subjects and diabetics,and this might be used as a indication of insulin resistance in the clinical research.

关 键 词：糖尿病 非胰岛素依赖型 脂类 骨骼肌 磁共振波谱学 

分 类 号：R587.1[医药卫生—内分泌]