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  

MR Quantification of Total Liver Fat in Patients with Impaired Glucose Tolerance and with Normal Tolerance

作　　者：蔡华崧[1] 翟凤仪[1] 杨君[1] 董帜[1] 郑可国[1] 洪庆奋[1] 李子平[1] 冯仕庭[1] 

机构地区：[1]中山大学附属第一医院医学影像科,广东广州510080

出　　处：《中山大学学报（医学科学版）》2015年第3期396-402,共7页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：国家自然科学基金青年(81000626);广东省自然科学基金(S2013010016004);珠江科技新星专项(2012J2200084);中央高校基本科研业务费专项资金(10ykpy11)

摘　　要：【目的】利用MR定量测定糖耐量正常(NGT)试验者及糖耐量异常(IGT)患者的全肝脂肪含量,分析该两类人群的全肝脂肪含量与临床指标之间的相关性。【方法】收集NGT及IGT患者共63例,行上腹部MRI检查,其中有T1WI DIXON序列,其中42例NGT,21例为IGT患者。NGT组再根据体质量指数(BMI)分为NGT-Fat(BMI≥25,18例)和NGT-Lean(BMI<25组,24例)。测量并计算每个受试者的全肝脂肪含量(FVF),并对全肝脂肪含量与相应临床及实验室检查结果进行统计相关性研究,同时对IGT组,NGT-Fat组和NGT-Lean组之间的肝脏脂肪含量差异进行评价。【结果】所有受试者的FVF值范围从4.2%到28.8%。FVF值与BMI(P=0.005),腰臀比(WHR,P=0.0 44),低密度脂蛋白胆固醇(LDL-C,P=0.033),空腹血浆胰岛素(FPI,P=0.018),胰岛素抵抗指数(HOMA-IR,P=0.018)及胰岛β细胞指数(HOMAβ,P=0.005)呈正相关。IGT组和NGTFat组的FVF值显著高于NGT-Lean组(P=0.003,0.006)。【结论】高BMI、WHR及LDL-C的个体全肝脂肪含量较高。BMI≥25的个体更有可能发展为IGT。FVF值较高的个体表现出更高的胰岛素抵抗性,具有更高的风险发展为2型糖尿病。[Objective] To measure the total liver fat in subjects with normal tolerance and the patients with impaired glucose tolerance （IGT） by using MR and to explore the correlations between liver fat content and clinical index in these two groups.[Methods] 63 subjects were enrolled and each of them underwent upper-abdominal MRI examination that involved T1WI VIBE Dixon sequence.21 was clinically diagnosed with IGT （collectively as IGT group） while 42 showed normal glucose tolerance,（collectively as NGT group）.NGT group was further divided into NGT-Fat （BMI ≥ 25,18 subjects） and NGT-Lean （BMI ＜ 25,24 subjects）.The total liver fat contents was measured and compared with clinical findings and laboratory results in order to determine statistical correlations between these parameters.Differences among IGT,NGT-Fat and NGT-Lean groups were evaluated.[Results] For all the subjects,fat volume fractions （FVF） ranged from 4.2％ to 28.8％,positive correlations was observed with BMI（P =0.005）,waist hip ratio （WHR） （P =0.044）,low density lipoprotein-cholesterol （LDL-C） （P =0.033）,fasting plasma insulin （FPI） （P =0.018）.homeostasis model assessment insulin resistance （HOMA-IR） （P =0.018） and homeostasis model assessment （HOMAβ） （P =0.005）.FVF of IGT group （P =0.003） and NGT-Fat group （P =0.006） were significantly higher than those of NGT-Lean group.[Conclusion] People with higher BMI,WHR and LDL-C levels tend to have higher liver fat content.Patients with BMI ≥ 25 are more likely to develop to IGT.Patients with higher FVF showed higher resistance to insulin,thus obtained a higher risk of developing type 2 diabetes mellitus.

关 键 词：脂肪肝 MR脂肪定量 糖耐量异常 糖耐量正常 

分 类 号：R445.2[医药卫生—影像医学与核医学]