磁共振多回波DIXON技术对2型糖尿病患者骨骼肌脂肪含量的定量评估

Quantitative assessment of skeletal muscle fat content in type 2 diabetic patients by magnetic resonance multi-echo DIXON technique

目的利用磁共振多回波水脂分离(multi-echo DIXON,mDIXON)技术分析2型糖尿病(type 2 diabetes mellitus,T2DM)患者大腿肌肉和椎旁肌肉的脂肪含量与健康对照组之间的差异,并探究其与病程、甘油三酯葡萄糖(triglyceride and glucose,TyG)指数等的关系。材料和方法本研究前瞻性招募42例临床诊断为T2DM的患者,并招募44例年龄、性别相匹配的健康志愿者作为对照组。所有受试者接受大腿和腹部mDIXON序列扫描,用独立样本t检验比较两组受试者各肌肉的脂肪分数(fat fraction,FF)值的差异并运用多元线性回归和逻辑回归的方法分析各肌肉FF值与病程和TyG指数等的相关性。结果T2DM组大腿各肌群FF值均高于对照组,腰方肌FF值显著高于健康对照组(t=3.402,P<0.001),其余椎旁肌肉FF值在两组间的差异无统计学意义(P>0.05)。T2DM组女性的大腿肌群FF值均显著高于男性(P<0.001),T2DM组的股外侧肌、股内侧肌、股直肌的FF值与病程呈正相关(r=0.057、0.073、0.125,P均<0.001)。竖脊肌和股外侧肌的FF值升高是TyG指数升高的危险因素(OR=1.934,P<0.001;OR=2.516,P<0.001)。结论mDIXON序列具有较好的评估骨骼肌脂肪含量的能力;T2DM患者骨骼肌脂肪含量高于健康人,结合病程、TyG指数等进一步分析T2DM患者骨骼肌脂肪含量的变化,有利于指导临床对T2DM患者的诊疗。

Objective:Using the magnetic resonance multi-echo DIXON(mDIXON)technique analyze the differences between thigh muscle and paravertebral muscle fat content between patients with type 2 diabetes mellitus(T2DM)and healthy controls and explore the relationship of each skeletal muscle fat content with duration,triglyceride glucose(TyG)index,and other indicators.Materials and methods:The study prospectively enrolled 42 clinically diagnosed T2DM patients and 44 age,gender,and recruitment-matched healthy volunteers as the control group.All subjects underwent thigh and abdomen mDIXON sequence scanning.An independent-sample t-test was employed to compare the fat fraction(FF)values of each muscle group between the two groups.Multivariate linear regression and logistic regression analyses were conducted to assess the correlation between FF values,duration of diabetes,and TyG index.Results:The FF values of all thigh muscle groups in the T2DM group were higher than those in the control group,and the FF value of the quadratus lumborum was significantly higher than that in the healthy control group(t=3.402,P<0.001).There was no significant difference in the FF value of the other paravertebral muscles between the two groups(P>0.05).The thigh muscle FF values of females in the T2DM group were significantly higher than those of males(P<0.001).The FF values of vastus lateralis,vastus medialis,and rectus femoris in the T2DM group were positively correlated with the course of the disease(r=0.057,0.073,0.125,P<0.001).Increased FF values of erector spinae and vastus lateralis are a risk factor for a high TyG index(OR=1.934,P<0.001;OR=2.516,P<0.001).Conclusions:The mDIXON sequence has a good ability to evaluate skeletal muscle fat content.Skeletal muscle fat content is higher in patients with T2DM than in healthy people.Combined with the course of the disease and TyG index,further analysis of the changes in skeletal muscle fat content in T2DM patients is helpful to guide the clinical diagnosis and treatment of T2DM patients.