~1H-MRS评价绝经后2型糖尿病患者腰椎骨髓脂质变化

MR spectroscopy assessing for marrow lipid content in postmenopausal females with type 2 diabetes

目的 利用轻质子磁共振波谱技术（1 H-MRS）评价绝经后2型糖尿病（T2DM）腰椎骨髓脂质含量（MLC）变化规律。方法 收集绝经后T2DM患者（n=30）及年龄匹配的健康受试者（n=20）行L3椎体1 H-MRS扫描以计算MLC值及双能X线骨密度测定仪测定L1~L4椎体骨密度（BMD）。测定受检者空腹血糖（FPG）、糖化血红蛋白（HbA1c）及胰岛素（FINS）水平。结果 T2DM组BMD（1.180±0.198）g/cm2与健康对照组BMD（1.113±0.187）g/cm2无统计学差异。T2DM组MLC（76.3±18.3）%明显高于正常受试者（65.7±14.0）%（P〈0.001）,校正受试者T2DM病程、体质分数、FINS及BMD混杂因素,T2DM组MLC值仍高于健康受试者（P=0.020）。Logistic逐步回归分析表明,MLC是T2DM患者的负性影响因素（OR=2.031,P=0.008）。结论 绝经后T2DM患者骨髓脂肪增高,1 H-MRS测定MLC可作为T2DM随诊方法之一。

Objective To explore the changing process of vertebral marrow lipid content （MLC） using MR spectroscopy （MRS） in postmenopausal females with type 2 diabetes （T2DM）. Methods T2DM Patients （n= 30） and age-matched healthy controls （n= 20） underwent MRS and DXA scanning to determine MLC and BMD values. Blood glucose （FPG）, hemoglobin Alc （HbAlc） and fasting insulin （FINS） were measured after fasting for 12 h. Results There was no signifi- cant difference in BMD between T2DM patients （1. 180±0. 198） g/cm2 and controls （1. 113±0. 187） g/cm2. T2DM pa- tients had higher FF （76.3±18.3） % than that of controls （65.7±14.0%） （ P 〈0. 001）. After adjustment for disease duration, BMI, FINS and BMD, the difference between groups remained significantly. Logistic regression analysis re- vealed that MLC was independent indicator for T2DM （OR=2. 031, P =0. 008）. Conclusion Postmenopausal T2DM pa- tients have higher marrow fat content of vertebral bodies. MRS may be a useful tool to detect MLC for the follow-up of T2DM patients.