浙江省舟山海岛地区青少年腹部脂肪定量^(1)H-MRS联合血清IGF-1对NAFLD严重程度的评估价值  

Value of^(1)H-MRS abdominal fat quantification combined with serum IGF-1 in assessing severity of NAFLD in adolescents in Zhoushan Island area

作　　者：吴帆 章杰 孙文 李嘉霖 张文奇 白敏 Fan Wu;Jie Zhang;Wen Sun;Jia-Lin Li;Wen-Qi Zhang;Min Bai(Department of Radiology,Zhoushan Women and Children’s Hospital,Zhoushan 316000,Zhejiang Province,China;Department of Pediatrics,Zhoushan Women and Children’s Hospital,Zhoushan 316000,Zhejiang Province,China)

机构地区：[1]舟山市妇女儿童医院放射科,浙江省舟山市316000 [2]舟山市妇女儿童医院儿科,浙江省舟山市316000

出　　处：《世界华人消化杂志》2025年第4期308-315,共8页World Chinese Journal of Digestology

基　　金：浙江省医药卫生科技计划项目,No.2024KY518.

摘　　要：背景舟山海岛地区由于其独特的生活环境,尤其对青少年肥胖的研究报道较少,在个性化医疗的今天,更加精细化的诊断对患者疾病的治疗效果更有意义,且我国有广阔的海岸线,同时目前临床尚缺少氢质子磁共振波谱(^(1)H-magnetic resonance spectroscopy,^(1)H-MRS)、血清胰岛素样生长因子-1(insulin-like growth factor-1,IGF-1)联合在非酒精性脂肪性肝病(non-alcoholic fatty liver disease,NAFLD)病情评估中的相关研究.目的探讨海岛地区青少年腹部脂肪定量^(1)H-MRS联合IGF-1对NAFLD严重程度的评估价值.方法选取2022-01/2024-06舟山市妇女儿童医院收治的99例疑似NAFLD青少年患者,根据病理诊断分为非NAFLD组(41例),轻度NAFLD组(37例),中重度NAFLD组(21例).比较三组代谢相关指标[体质量指数(body mass index,BMI)、餐后2 h血糖(2-hour postprandial glucose,2HPG)、甘油三酯(triglycerides,TG)、总胆固醇(total cholesterol,TC)、谷丙转氨酶(alanine aminotransferase,ALT)、谷草转氨酶(aspartate aminotransferase,AST)、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)].比较三组^(1)H-MRS波谱值、波谱内肝脏脂肪(intrahepatic lipid,IHL)、血清IGF-1,以Pearson相关系数法分析IHL、血清IGF-1与代谢相关指标、^(1)H-MRS波谱值的相关性,采用点二列相关性分析IHL、血清IGF-1与病情严重程度的相关性,分析IHL、血清IGF-1对NAFLD严重程度的评估价值.结果中重度NAFLD组HDL-C低于非NAFLD组、轻度NAFLD组,BMI、2HPG、ALT、AST、TG、TC、LDL-C均高于非NAFLD组、轻度NAFLD组(P<0.05);相比于非NAFLD组、轻度NAFLD组,中重度NAFLD组水峰峰值较低,脂峰峰值较高(P<0.05);中重度NAFLD组IHL水平高于非NAFLD组、轻度NAFLD组,IGF-1低于非NAFLD组、轻度NAFLD组(P<0.05);BMI、2HPG、ALT、AST、TG、TC、LDL-C与IHL呈正相关,与IGF-1呈负相关(P<0.05),HDL-C、水峰峰值、脂峰�BACKGROUND The Zhoushan Island area,characterized by its unique living environment,has limited reported data on obesity and related metabolic disorders.In the era of personalized medical care,more refined diagnosis is critical for the treatment of patients’diseases.Despite China's extensive coastline,there is still a lack of relevant research exploring the combined use of^(1)H-magnetic resonance spectroscopy(^(1)H-MRS)and insulin-like growth factor-1(IGF-1)in the evaluation of non-alcoholic fatty liver disease(NAFLD)in adolescents.AIM To explore the utility of quantitative^(1)H-MRS of adolescent abdominal fat combined with serum IGF-1 in evaluating the severity of NAFLD in adolescents from the Zhoushan Island area.METHODS A total of 99 adolescent patients with suspected NAFLD who were admitted to Zhoushan Women’s and Children’s Hospital from January 2022 to June 2024 were selected.They were divided into a non-NAFLD group(41 cases),a mild NAFLD group(37 cases),and a moderate to severe NAFLD group(21 cases)according to pathological diagnosis.Metabolic-related indicators[body mass index(BMI),2-hour postprandial glucose(2HPG),triglycerides(TG),total cholesterol(TC),alanine aminotransferase(ALT),aspartate aminotransferase(AST),high-density lipoprotein cholesterol(HDL-C),and low-density lipoprotein cholesterol(LDL-C)]were compared among the three groups.The^(1)H-MRS spectral values,intrahepatic lipid(IHL),and serum IGF-1 were also compared among the three groups.The correlation between IHL,serum IGF-1,metabolic related indicators,and^(1)H-MRS spectral values was analyzed using Pearson correlation.The correlation between IHL,serum IGF-1,and disease severity was analyzed by point-biserial correlation.The value of IHL and serum IGF-1 for evaluating the severity of NAFLD was analyzed.RESULTS In the moderate to severe NAFLD group,HDL-C levels were lower than those of the other two groups,while BMI,2HPG,ALT,AST,TG,TC,and LDL-C levels were higher than those of the other two groups(P<0.05).Compared to the non-NAFLD group

关 键 词：非酒精性脂肪性肝病 青少年 胰岛素样生长因子-1 氢质子磁共振波谱 水峰峰值 脂峰峰值 

分 类 号：R575.5[医药卫生—消化系统]