磁共振脂肪定量技术分析腹腔内脏脂肪含量与2型糖尿病关系的Meta分析

Meta-analysis of the relationship between abdominal visceral fat content and type 2 diabetes by magnetic resonance fat quantification techniques

目的:基于Meta分析评估磁共振脂肪定量技术在腹腔内脏脂肪含量与2型糖尿病(T2DM)关系中的效能,进而探讨以腹腔内脏脂肪含量预测T2DM发病的可行性。方法:检索PubMed、Embase、The Cochrane Library、知网和万方数据库自1995年1月1日至2023年3月31日关于腹腔内脏脂肪与T2DM关系的中英文文献,依据纳入及排除标准独立筛选文献、提取数据并进行质量评估。最后采用STATA 12.0软件进行统计分析并绘制森林图。采用亚组分析的方法寻找异质性来源,绘制漏斗图以评估是否存在发表偏倚。结果:共纳入16篇文献。共1814例受试者,其中T2DM组759例,健康对照(HC)组1055例。T2DM患者的胰腺及肝脏异位脂肪沉积含量高于健康人群,且腹腔内脏脂肪含量亦高于健康人群。T2DM组患者的胰腺脂肪分数(PFF)[加权均数差(WMD)=2.71,95%CI 2.01~3.41]、肝脏脂肪分数(HFF)(WMD=6.03,95%CI 4.10~7.95)、腹腔内脏脂肪面积(VFA)(WMD=77.71,95%CI 39.98~115.43)及皮下脂肪组织面积(SFA)(WMD=27.72,95%CI 6.76~48.69)均大于HC组,且组间差异有统计学意义(P<0.01)。结论:T2DM患者的腹腔内脏脂肪组织、皮下脂肪组织、肝脏及胰腺脂肪含量明显高于健康人群。磁共振脂肪定量技术为定量测量腹腔内脏脂肪及异位脂肪沉积提供了一种有效的无创性方法指标,在未来用于脂肪定量科研中具有较大的发展前景。

Objective:Based on Meta-analysis,the efficacy of magnetic resonance fat quantification technique in the relationship between abdominal visceral fat content and type 2 diabetes mellitus(T2DM)was evaluated,and the feasibility of predicting the incidence of T2DM with abdominal visceral fat content was discussed.Methods:Chinese and English literatures on the relationship between abdominal visceral fat and T2DM were searched from PubMed,Embase,The Cochrane Library,CNKI and Wanfang Database from January 1,1995 to March 31,2023.The literatures were independently screened according to inclusion and exclusion criteria,and the data were extracted and evaluated for quality.Finally,STATA 12.0 software was used for statistical analysis and forest map drawing.Subgroup analysis was used to find the source of heterogeneity,and a funnel plot was drawn to assess the presence of publication bias.Results:A total of 16 literatures were included.A total of 1814 subjects were enrolled,including 759 in T2DM group and 1055 in healthy control group.The content of ectopic fat deposition in pancreas and liver of patients with T2DM was higher than that of healthy people,and the content of visceral fat in abdominal cavity was also higher than that of healthy people.In T2DM patients,pancreatic fat fraction(PFF)(WMD=2.71,95%CI 2.01-3.41),hepatic fat fraction(HFF)(WMD=6.03,95%CI 4.10-7.95),visceral fat area(VFA)(WMD=77.71,95%CI 39.98-115.43)and subcutaneous fat area(SFA)(WMD=27.72,95%CI 6.76-48.69)were higher than those in the healthy control group,and the difference between groups was statistically significant(P<0.01).Conclusion:The contents of visceral fat,subcutaneous fat,liver and pancreas fat in the patients with T2DM were significantly higher than those in the control group.Magnetic resonance fat quantification technology provides an effective non-invasive biological index for the quantitative measurement of visceral fat and ectopic fat deposition in the abdominal cavity,and has great prospects for the development of fat quantification research in the future.