基于磁共振成像非糖尿病老年人脑白质损伤与胰岛素抵抗相关性分析  

Correlation between brain white matter lesions and insulin resistance in non-diabetic elderly individuals based on magnetic resonance imaging

作　　者：李梅 袁芳 邢希子 谢峰[3] 张华 LI Mei;YUAN Fang;XING Xizi;XIE Feng;ZHANG Hua(School of Clinical and Basic Medicine,Shandong First Medical University,Jinan 250117 China;Shandong Cancer Hospital and Institute,Shandong First Medical University&Shandong Academy of Medical Sciences,Jinan 250117 China;Jinan lichen District of Traditional Chinese Medicine,Jinan 250199 China)

机构地区：[1]山东第一医科大学(山东省医学科学院)临床与基础医学院(基础医学研究所),山东济南250117 [2]山东第一医科大学附属肿瘤医院(山东省肿瘤防治研究院,山东省肿瘤医院),山东济南250117 [3]济南市历城区中医院,山东济南250199

出　　处：《中国辐射卫生》2025年第1期96-101,共6页Chinese Journal of Radiological Health

基　　金：国家自然科学基金项目(81973139)。

摘　　要：目的 探讨基于磁共振成像非糖尿病老年人脑白质损伤与甘油三酯-葡萄糖(TyG)指数之间的关系。方法 2018年6月-2019年12月于山东济南地区筛选523例年龄≥60岁的非糖尿病老年人。根据TyG指数的四分位数分组,第一分位数(Q1)组133例、第二分位数(Q2)组127例、第三分位数(Q3)组132例、第四分位数(Q4)组131例。入选者行颅脑MRI扫描,评估脑室旁、皮质深部和总脑白质损伤(WML)体积,进行Fazekas评分。结果 与Q1组、Q2组和Q3组相比,Q4组的脑室旁、深部和总WML体积均显著上升(P <0.05);Q4组脑室旁、深部和总WML的Fazekas评分≥2所占比例大于Q1组和Q2组(P <0.05);Q4组深部WML的Fazekas评分≥2所占比例高于Q3组(P <0.05)。TyG分别与脑室旁、深部及总WML体积正相关(r=0.401、r=0.405、r=0.445,均P <0.001)。校正混杂因素后,TyG指数仍与脑室旁、深部和总WML体积呈显著正相关(P <0.001)。logistic回归分析显示,与Q1组相比,Q3组Q4组脑室旁WML的Fazekas评分≥2的分别是1.950倍(95%CI:1.154~3.294,P=0.013)和3.411倍(95%CI:1.984~5.863,P <0.001),总WML的Fazekas评分≥2的风险分别是2.529倍(95%CI:1.444~4.430,P=0.001)和4.486倍(95%CI:2.314~8.696,P <0.001);Q4组深部WML Fazekas评分≥2的风险是Q1组的2.953倍,(95%CI:1.708~5.106,P <0.001)。结论 TyG指数升高是非糖尿病老年人脑白质损伤的独立危险因素。Objective To investigate the relationship between brain white matter lesions(WML)and triglyceride glucose(TyG)index in non-diabetic elderly individuals based on magnetic resonance imaging.Methods A total of 523 non-dia-betic elderly individuals aged≥60 years were selected from Jinan,Shandong Province,China from June 2018 to December 2019.According to the quartiles of TyG index,there were 133 participants in the first quartile(Q1)group,127 in the second quartile(Q2)group,132 in the third quartile(Q3)group,and 131 in the fourth quartile(Q4)group.All participants under-went brain magnetic resonance imaging to evaluate paraventricular,deep,and total WML volumes,as well as Fazekas scores.Results Compared with Q1,Q2,and Q3 groups,Q4 group showed significant increase in periventricular,deep,and total WML volumes(P<0.05).The proportion of participants with a Fazekas score≥2 in the periventricular,deep,and total WML was higher in the Q4 group compared with the Q1 and Q2 groups(P<0.05).The proportion of participants with a Fazekas score≥2 in deep WML was higher in Q4 group than in Q3 group(P<0.05).TyG index was significantly posit-ively correlated with periventricular,deep,and total WML volumes(r=0.401,0.405,and 0.445,P<0.001).After adjusting for confounding factors,TyG index was still significantly positively correlated with periventricular,deep,and total WML volumes(P<0.001).Logistic regression analysis showed that compared with Q1 group,the risk of Fazekas score≥2 in pe-riventricular WML was 1.950-fold(95%confidence interval[CI]:1.154-3.294,P=0.013)in Q3 group and 3.411-fold(95%CI:1.984-5.863,P<0.001)in Q4 group,the risk of Fazekas score≥2 in total WML was 2.529-fold(95%CI:1.444-4.430,P=0.001)in Q3 group and 4.486-fold(95%CI:2.314-8.696,P<0.001)in Q4 group.The risk of Fazekas score≥2 in deep WML was 2.953-fold(95%CI:1.708-5.106,P<0.001)in Q4 group compared with Q1 group.Conclusion Increased TyG index is an independent risk factor for WML in non-diabetic elderly individuals.

关 键 词：脑白质损伤 胰岛素抵抗 甘油三酯-葡萄糖指数 非糖尿病老年人 

分 类 号：R445.2[医药卫生—影像医学与核医学]