初诊2型糖尿病患者肝脏脂肪沉积的1HMRS量化及其与血清甘油三酯和胰岛素抵抗的关系研究

摘要

Objective To quantify the liver fat content in newly diagnosed type 2 diabetes mellitus(T2DM)by applying 1 H MRS in vivo, and investigate its relationships with serum triglyceride(TG),body mass index(BMI)and insulin resistance. Methods Thirty - two T2DM sub-jects and the same number of volunteers without diabetes were included in this study. All T2DM subjects were newly diagnosed according to the clinical criteria without any therapy. The liver spectroscopy at the right lobe was acquired by single - voxel PRESS sequence on 3. 0 T MR Scan-ner. The liver fat content(LFC)was calculated in each case. Spearman correlations between LFC and BMI,TG,and the homeostasis model as-sessment of insulin resistance(HOMA - IR)were performed in order to investigate their relationships. Results The mean values of LFC in 32 T2DM subjects and 32 volunteers without T2DM were 24. 84(8. 79 ~ 33. 21)% and 6. 50(3. 31 ~ 16. 85)% ,respectively,there was statistically significant differences( P = 0. 006). Moderate correlations were found between LFC and TG( r = 0. 615,P = 0. 000),BMI( r = 0. 557,P =0. 001)in T2DM subjects,as well as low correlation was found between LFC and HOMA - IR. High correlations were found between LFC and TG ( r = 0. 740,P = 0. 000),and moderate correlations were found between LFC and BMI( r = 0. 666,P = 0. 000)in volunteers without diabetes. Conclusion LFC in patients with newly diagnosed T2DM was higher than those without diabetes,and correlated to TG,BMI and insulin resist-ance.%目的：分析初诊2型糖尿病（T2DM）患者肝脏脂肪含量与血清甘油三酯（TG）、身高体重指数（BMI）及胰岛素抵抗的关系。方法在3.0T 磁共振系统应用单体素点分辨波谱序列（PRESS）对32例初诊 T2DM 患者和32例无糖尿病志愿者的肝脏进行1 H MRS 扫描，应用 SAGE 软件测量其脂肪和水的峰下面积，计算肝脏脂肪分数。分析肝脏脂肪含量与 BMI、TG 以及胰岛素抵抗指数（HOMA - IR）的相关性。结果32例初诊 T2DM 患者和32例无糖尿病志愿者的平均肝脏脂肪分数分别为24.84（8.79~33.21）%和6.50（3.31~16.85）%，差异有统计学意义（ P ＝0.006）。相关性分析表明，初诊 T2DM 患者的肝脏脂肪含量与 TG（ r ＝0.615，P ＝0.000）、BMI（ r ＝0.557，P ＝0.001）中度相关，与 HOMA - IR 低度相关（ r ＝0.355，P ＝0.046）。无糖尿病志愿者的肝脏脂肪含量与 TG 高度相关（ r ＝0.740，P ＝0.000），与 BMI（ r ＝0.666，P ＝0.000）中度相关。结论初诊 T2DM 患者的肝脏脂肪含量高于无糖尿病人群，且与TG、BMI 及 HOMA - IR 有相关性。