应用磁共振mDixon Quant技术定量评价不同糖耐量患者腹部脂肪沉积的研究

Quantitative Evaluation of Abdominal Fat Deposition in Patients with Different Glucose Tolerance by MRI mDixon Quant Technique

目的 应用磁共振mDixon Quant技术定量分析不同糖耐量人群腹部脂肪沉积的特点,探讨不同糖耐量人群腹部内脏、椎体及椎旁肌肉的脂肪沉积规律,为糖尿病防治提供新的思路。方法 前瞻性搜集2019年9月至2020年12月确诊的IGR和T2DM患者共98例,同时纳入38名健康志愿者作为对照组。测量并比较各组肝、脾、胰腺、肾、L_(3)椎体、腰大肌脂肪分数(FF值)的差异。采用受试者工作特征(ROC)曲线及有序多元Logistic回归分析各个参数的诊断价值。结果 IGR组和T2DM组内肝左叶、肝右叶及全肝FF值,胰头、胰体及胰尾部FF值的差异均具有统计学意义(P均<0.05);对照组上述FF值中差异均无统计学意义。不同组间,除肾FF值外,其他各FF值差异均具有统计学意义(P均<0.05)。多元Logistic回归分析显示L_(3)椎体FF值每升高一个百分位,糖耐量进入下一个阶段的风险增加1.48倍。结论 磁共振mDixon Quant可以无创、精确、全面评估T2DM不同糖耐量阶段的腹部脂肪沉积变化情况。不同糖耐量水平往往伴随着多个器官的脂肪再分布,IGR组、T2DM患者更易发生肝左叶、胰头、胰尾的脂肪沉积;L_(3)椎体FF值与糖耐量关系更加密切,对糖尿病不同状态存在预测价值。

Objective To analyze the characteristics of abdominal fat deposition in people with different glucose toler⁃ance by using mDixon Quant quantitatively,and to explore the relationship between the progression of type 2 diabetes(T2DM)and abdominal fat deposition.Methods 98 patients with impaired glucose regulation(IGR)and T2DM diag⁃nosed from September 2019 to December 2020 were prospectively collected,and 38 healthy volunteers were included as the control group.The fat fraction(FF)of liver,spleen,pancreas,kidney,L_(3) vertebral body and psoas major muscle in each group were measured and compared.The diagnostic value of each parameter was analyzed by ROC curve analysis and or⁃dered multivariate logistic regression.Results There were significant differences between IGR group and T2DM group in FF values of left lobe,right lobe and whole liver,and in FF values of head,body and tail of pancreas(P<0.05).There were no significant differences in the normal control group.Among different groups,except for the renal FF value,the differ⁃ences of other FF values were statistically significant(P<0.05).Multivariate logistic regression analysis showed that the risk of glucose tolerance entering the next stage increased 1.48 times with each percentile increase of FF value of L_(3) verte⁃bral body.Conclusion mDixon Quant can evaluate the changes of abdominal fat deposition in different glucose tolerance stages in a non⁃invasive,accurate and comprehensive manner.Different glucose tolerance levels are often accompanied by fat redistribution in multiple organs.IGR and T2DM patients are more prone to fat deposition in the left lobe of liver,head of pancreas and tail of pancreas.Furthermore,the FF value of L_(3) vertebral body is more closely related to glucose tolerance,which has predictive value for different states of diabetes.