2型糖尿病治疗后近期骨骼肌改变的MR氢谱研究  

1H magnetic resonance spectroscopy study on the short term changes of skeletal muscle after treatment in type 2 diabetes mellitus

作　　者：孙沛毅[1] 宋英儒[2] 陈青云[3] 

机构地区：[1]广西中医药大学第一附属医院放射科,南宁530023 [2]广西医科大学第一附属医院放射科,南宁530021 [3]广西医科大学第一附属医院内分泌科,南宁530021

出　　处：《磁共振成像》2015年第11期833-837,共5页Chinese Journal of Magnetic Resonance Imaging

基　　金：广西教育厅科研项目(编号:201010LX034)

摘　　要：目的探讨非消瘦2型糖尿病治疗后,MR氢谱(1H MR spectroscopy,1H-MRS)测定骨骼肌细胞内脂质(intramyocellular lipid,IMCL)及细胞外脂质(extramyocellular lipdid,EMCL)相对含量的变化特点,并分析IMCL相对含量与评估胰岛素抵抗指标(HOMA-IR指数)的关系。材料与方法搜集初发非消瘦2型糖尿病患者30例,其中胰岛素联合二甲双胍药物治疗组20例,非药物治疗组10例;健康志愿者10名作对照组。所有受检者分别于第0周(0 d)、2周(14 d)、4周(28 d)行1H-MRS扫描,测定右小腿比目鱼肌内IMCL及EMCL相对含量。期间治疗组每次1H-MRS扫描前测定HOMA-IR指数。利用SPSS17.0统计软件包,对各组IMCL及EMCL前后比较用方差分析或秩和检验,治疗组IMCL与HOMA-IR指数做线性回归分析。结果药物治疗组4周时IMCL相对含量及HOMA-IR指数变化统计学差异有显著性意义(P值分别为0.008、0.015),且对应呈降低趋势。治疗组IMCL相对含量与对应HOMA-IR指数均呈正相关关系。结论 1H-MRS测定的小腿比目鱼肌IMCL可量化、敏感地反映非消瘦2型糖尿病治疗后胰岛素抵抗状态变化,能为临床评估胰岛素抵抗提供帮助。Objective：To evaluate the changes of intramyocellular lipid （IMCL） and extramyocellular lipid （EMCL） at the soleus of right leg by 1H magnetic resonance spectroscopy （1H-MRS） after treatment within 4 weeks and correlate to insulin resistance index （HOMA-IR） in incipient non-thin type 2 diabetes. Materials and Methods：Thirty incipience non-thin type 2 diabetes were collected, and divided into insulin with metformin treatment group （n=20）, no-drug treatment group （n=10）. Healthy volunteers acted as control group （n=10）. All groups were underwent 1H-MRS at the soleus of right leg. IMCL and EMCL were evaluated at 0 days, 14 days （2 weeks）, and 28 days （4 weeks）. HOMA-IR of treatment group was measured corresponding to duration of 1H-MRS scans. Statistical analysis was performed using SPSS 17.0 package. One-way ANOVA or Kruskal-Wallis test were used to analyze the difference of IMCL and EMCL at each group. Pearson correlations were evaluated between IMCL and HOMA-IR in the treatment group. Results：IMCL and HOMA-IR were obviously reduced in drug treatment group at 4 weeks （P=0.008, 0.015）. IMCL in treatment group correlated to HOMA-IR positively. Conclusions：IMCL at soleus evaluated by 1H-MRS of non-thin type 2 diabetes was sensitive and quantiifed to the changes of insulin resistance level during short term treatment.

关 键 词：磁共振波谱学 肌肉 糖尿病 2型 脂类代谢紊乱 

分 类 号：R445.2[医药卫生—影像医学与核医学] R322.74[医药卫生—诊断学]