磁共振胰腺脂肪定量测定预测糖耐量异常及2型糖尿病  

Pancreatic Fat Quantification by MRI:Potential Biomarker of Impaired Glucose Tolerance and Type 2 Diabetes

作　　者：梁伟强[1] 彭振鹏[2] 高进云[3] 王猛[2] LIANG Wei-qiang;PENG Zhen-peng;GAO Jin-yun;WANG Meng(Department of Radiology,Xinhui Hospital of Traditional Chinese Medicine,Jiangmen 529100,China;Department of Radiology,The First Affiliated Hospital,SUN Yat-sen University,Guangzhou 510080,China;Department of Radi-ology,Shenzhen Traditional Chinese Medicine Hospital,Shenzhen 518033,China)

机构地区：[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

出　　处：《中山大学学报（医学科学版）》2021年第2期250-256,共7页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：国家自然科学基金(81971684)。

摘　　要：【目的】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】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】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】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】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】A to⁃tal 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 andβ-cell dysfunction.MRI scanning with the iterative decomposition of water and fat with echo asymmetry and least square esti⁃mation 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】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 ab⁃normality(IGT and T2DM)was 5.68%(P<0.001;AUC:0.871;sensitivity:92.7%;specificity:71.7%).【Conclusion】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).

关 键 词：脂肪体积分数 胰腺 2型糖尿病 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R587.1[医药卫生—诊断学]