胰腺脂肪含量及分布与2型糖尿病发生的关系

Study on the relationship between pancreatic fat content,distribution and development of type 2 diabetes mellitus

目的:应用磁共振Dixon技术测量胰腺脂肪含量,观察胰腺脂肪含量及脂肪分布对2型糖尿病(T2DM)发生的影响,并探讨胰腺脂肪含量及其分布情况对T2DM发生的预测价值。方法:回顾性分析147例接受腹部MRI和T1加权Dixon成像检查的病人,分为T2DM组59例、风险组病人38例及对照组50例,获得胰头、胰体、胰尾脂肪分数,收集病人的年龄、性别、吸烟及饮酒史、空腹血糖(FPG)、总胆固醇(TC)、高密度脂蛋白(HDL-C)、三酰甘油(TG)、低密度脂蛋白(LDL-C)、肝功能、血清肌酐(Cr)、体质量指数(BMI),比较各组数值差异。同时按BMI水平分为BMI正常组46例、超重组79例及肥胖组22例,分析T2DM组、风险组及对照组的胰腺各部位脂肪分数的差异。并进一步做logistic回归分析,以确定胰腺脂肪分布对T2DM发生的影响。结果:T2DM组、风险组与对照组之间的年龄、吸烟及饮酒比例、BMI、ALT、AST、Cr、TC、TG、HDL-C、LDL-C差异均无统计学意义(P>0.05)。3组病人的胰腺头、体、尾部及平均脂肪分数差异均有统计学意义(P<0.05~P<0.01),T2DM组的腺头、体和平均脂肪分数均高于对照组(P<0.05~P<0.01),T2DM和风险组胰尾的脂肪分数均高于对照组(P<0.01)。在BMI正常组中,T2DM组的胰头、体、尾及平均脂肪分数均为高于对照组(P<0.05);超重组中,T2DM组胰尾和平均脂肪分数高于对照组(P<0.05);在肥胖组中,3组不同部位及平均脂肪分数差异均无统计学意义(P>0.05)。多因素logistic结果显示,胰腺尾部的脂肪分数高是T2DM的独立危险因素(OR=1.685,95%CI:1.174~2.419,P<0.01),胰头、胰体脂肪分数、BMI、TC、TG及LDL-C水平与T2DM间关联无统计学意义(P>0.05)。结论:胰腺脂肪含量增加与T2DM相关,而胰尾脂肪含量的增加也会增加T2DM的发生风险。

Objective:To measure the pancreatic fat content using magnetic resonance Dixon technique,observe the effects of pancreatic fat content and fat distribution on the occurrence of type 2 diabetes mellitus(T2DM),and explore the predictive value of pancreatic fat content and distribution on the occurrence of T2DM.Methods:A total of 147 patients with abdominal MR Dixon sequence scanning examination were retrospectively analyzed.The patients were divided into the T2DM group(59 patients),risk group(38 patients)and control group(50 patients).The fat fraction of pancreatic head,pancreatic body and pancreatic tail in three groups were obtained.The age,sex,smoking and drinking history,fasting plasma glucose(FPG),total cholesterol(TC),high-density lipoprotein(HDL-C),triglyceride(TG),low-density lipoprotein(LDL-C),liver function,serum creatinine(Cr)and body mass index(BMI)were compared among three groups.The patients were divided into the normal BMI group,overweight BMI group and obesity group according to the level of BMI.The differences of pancreatic fat fraction among T2DM group,risk group and control group were analyzed.Logistic regression analysis was further conducted to determine the impact of pancreatic fat distribution on T2DM.Results:There was no statistical significance in the age,smoking and drinking ratio,BMI,ALT,AST,TC,TG,HDL-C,LDL-C among T2DM group,risk group and control group(P>0.05).The differences of the head,body,tail and average fat fraction of pancreas among three groups were statistically significant(P<0.05 to P<0.01).The head,body and average fat fraction of pancreas in the T2DM group were higher than those in control group(P<0.05 to P<0.01),and the fat fraction of pancreatic tail in the T2DM and risk groups were higher than those in control group(P<0.01).In the normal BMI group,the head,body,tail and average fat fraction of pancreas in the T2DM group were higher than those in control group(P<0.05).In the overweight group,the pancreatic tail and mean fat fraction in the T2DM group were higher than those in control group(P<0.05).In the obese group,there was no statistical significance in different parts and average fat fraction among three groups(P>0.05).The results of multivariate logistic results showed that the high fat fraction in the tail of the pancreas was an independent risk factor for T2DM(OR=1.685,95%CI:1.174-2.419,P<0.01),there was no statistical significance in the association between pancreatic head,body fat fraction,BMI,TC,TG and LDL-C levels and for T2DM(P>0.05).Conclusions:The increase of pancreatic fat content is related to T2DM,and the increase of pancreatic tail fat content also increases the risk of T2DM.