初诊2型糖尿病患者肝脏脂肪沉积的^1H MRS量化及其与血清甘油三酯和胰岛素抵抗的关系研究  

^1 H MRS quantification of ectopic fat accumulation in liver and its relationship with serum triglyceride and insulin resistance in patients with newly diagnosed type 2 diabetes mellitus

作　　者：刘朋[1] 靳二虎[1] 张洁[1] 洪旭[2] 尹洁[2] 于恒池[2] 史凯宁 杨正汉[1] 

机构地区：[1]首都医科大学附属北京友谊医院放射科,北京100050 [2]首都医科大学附属北京友谊医院内分泌科,北京100050 [3]通用电气(中国)医疗集团,北京100176

出　　处：《临床和实验医学杂志》2016年第15期1478-1481,共4页Journal of Clinical and Experimental Medicine

基　　金：北京市自然科学基金资助项目(编号:7122048)

摘　　要：目的分析初诊2型糖尿病（T2DM）患者肝脏脂肪含量与血清甘油三酯（TG）、身高体重指数（BMI）及胰岛素抵抗的关系。方法在3.0T磁共振系统应用单体素点分辨波谱序列（PRESS）对32例初诊T2DM患者和32例无糖尿病志愿者的肝脏进行1H MRS扫描,应用SAGE软件测量其脂肪和水的峰下面积,计算肝脏脂肪分数。分析肝脏脂肪含量与BMI、TG以及胰岛素抵抗指数（HOMA-IR）的相关性。结果 32例初诊T2DM患者和32例无糖尿病志愿者的平均肝脏脂肪分数分别为24.84（8.79~33.21）%和6.50（3.31~16.85）%,差异有统计学意义（P=0.006）。相关性分析表明,初诊T2DM患者的肝脏脂肪含量与TG（r=0.615,P=0.000）、BMI（r=0.557,P=0.001）中度相关,与HOMA-IR低度相关（r=0.355,P=0.046）。无糖尿病志愿者的肝脏脂肪含量与TG高度相关（r=0.740,P=0.000）,与BMI（r=0.666,P=0.000）中度相关。结论初诊T2DM患者的肝脏脂肪含量高于无糖尿病人群,且与TG、BMI及HOMA-IR有相关性。Objective To quantify the liver fat content in newly diagnosed type 2 diabetes mellitus（T2DM）by applying 1 H MRS in vivo, and investigate its relationships with serum triglyceride（TG）,body mass index（BMI）and insulin resistance. Methods Thirty - two T2DM sub-jects and the same number of volunteers without diabetes were included in this study. All T2DM subjects were newly diagnosed according to the clinical criteria without any therapy. The liver spectroscopy at the right lobe was acquired by single - voxel PRESS sequence on 3. 0 T MR Scan-ner. The liver fat content（LFC）was calculated in each case. Spearman correlations between LFC and BMI,TG,and the homeostasis model as-sessment of insulin resistance（HOMA - IR）were performed in order to investigate their relationships. Results The mean values of LFC in 32 T2DM subjects and 32 volunteers without T2DM were 24. 84（8. 79 ~ 33. 21）% and 6. 50（3. 31 ~ 16. 85）% ,respectively,there was statistically significant differences（ P = 0. 006）. Moderate correlations were found between LFC and TG（ r = 0. 615,P = 0. 000）,BMI（ r = 0. 557,P =0. 001）in T2DM subjects,as well as low correlation was found between LFC and HOMA - IR. High correlations were found between LFC and TG （ r = 0. 740,P = 0. 000）,and moderate correlations were found between LFC and BMI（ r = 0. 666,P = 0. 000）in volunteers without diabetes. Conclusion LFC in patients with newly diagnosed T2DM was higher than those without diabetes,and correlated to TG,BMI and insulin resist-ance.

关 键 词：2型糖尿病 肝脏脂肪沉积 氢质子磁共振波谱成像 甘油三酯 胰岛素抵抗 

分 类 号：R587.1[医药卫生—内分泌] R445.2[医药卫生—内科学]