磁共振波谱成像评估初发2型糖尿病患者骨髓脂肪含量

Marrow fat content in newly diagnosed type 2 diabetes assessed by MR spectroscopy

目的探讨磁共振波谱成像(MRS)定量评估初发2型糖尿病(T2DM)骨髓脂肪含量变化及其与胰岛素抵抗的相关性。方法初发T2DM患者及年龄匹配的正常对照组(n=32/组)行双能X线骨密度测定及股骨颈MRS扫描,分别获得骨密度(BMD)及骨髓脂肪分数(FF)。检查2组研究对象空腹血糖(FPG)、糖化血红蛋白(Hb A1c)、胰岛素(FINS)及血脂指标(TC、TG、HDL-C、LDL-C),利用稳态模式评估法评价胰岛素抵抗(HOMA-IR)。结果初发T2DM组BMD值与对照组无统计学差异。初发T2DM组FF值显著高于正常对照组(P<0.001),校正糖代谢、脂代谢及BMD值,2组间FF值仍存在统计学差异(F值=16.763,P=0.012)。FF与HOMA-IR呈中度正相关性(r=0.683,P<0.001),校正BMI,FF与HOMA-IR仍然存在正相关性(r=0.592,P=0.018)。结论初发T2DM患者骨髓脂肪增高,骨髓脂肪增多可能是胰岛素抵抗的影响因素之一。

Objective To investigate the temporal change of marrow fat fraction（ FF） in newly diagnosed T2 DM using MR spectroscopy（ MRS） and to elucidate the association between FF and HOMA-IR. Methods T2 DM patients and age-matched healthy controls（ n = 32 / group） underwent DXA and MRS scanning to obtain BMD and FF values. Blood glucose（ FPG）,hemoglobin A1c（ Hb A1c）,fasting insulin（ FINS） and blood lipids（ TC,TG,HDL-C and LDL-C） were measured and HOMA-IR was calculated by the homeostasis model assessment. Results BMD in T2 DM patients didn＇t differ from the control group. FF in T2 DM patients was significantly higher than that of controls（ P〈0. 001）. The difference between groups remained significantly after controlling for glucose metabolism,blood lipids and BMD（ F = 16. 763,P = 0. 012）. FF was positively correlated to HOMA-IR even adjustment for BMI（ r = 0. 592,P = 0. 018）. Conclusion Newly diagnosed T2 DM patients exhibit higher marrow fat content and marrow fat content may be one of the influencing factors related to insulin resistance.