多模式MRI在研究2型糖尿病患者脂质代谢中的应用

发布时间：2018-05-14 06:42

本文选题：2型糖尿病 + 多模式MRI　；参考：《南京大学》2014年硕士论文

【摘要】：目的运用3.0T磁共振双回波同反相位技术(DEI, dual-echo in-phase and out-of-phase MR imaging)、氢质子磁共振波谱分析(1H-MRS, proton magnetic resonance spectroscopy)等多模式MRI方法无创评估2型糖尿病患者肝脏、腹部及骨骼肌脂肪分布,并与脂肪代谢相关临床指标综合评价病程进展,探讨各因素间相关性。材料与方法研究对象选自南京市鼓楼医院门诊2011年1月至2011年12月新诊断及已诊断2型糖尿病患者共58例,受试者禁食8小时,于同一天分别进行人体学特征检测、血生化指标检测及磁共振多种序列扫描,磁共振扫描用于测量并计算肝脏脂质含量、骨骼肌细胞内脂质含量、骨骼肌细胞外脂质含量及腹壁皮下脂质面积、腹腔内脏脂质面积、腹部脂质总面积。将2型糖尿病患者是否合并脂肪肝组间进行差异性比较,将肝脏、腹部及骨骼肌不同部位脂质含量及临床资料进行单因素和多因素回归分析。结果在2型糖尿病患者是否合并脂肪肝分组中,葡萄糖负荷后2小时血糖(2hPPG)、腹腔内脏脂肪面积(VAT)、腹部脂肪总面积(TA)、双回波同反相位所测得肝脏脂肪变指数(HFF)、肝脏1H-MRS所测肝脏相对脂肪含量(RLC)有显著差异(p0.05)。在脂肪代谢指标单因素及多因素回归分析中显示,身体质量指数(BMI)与腹部脂肪面积指标(VAT、SAT、TA)及肝脏脂肪含量指标(HFF、RLC)呈显著正相关(P0.01),且对脂肪面积指标(VAT、SAT、TA)有正向影响；2hPPG与VAT、TA呈正相关(P0.05),且2hPPG对VAT有正向影响；血清脂肪含量指标中,总胆固醇、低密度脂蛋白与VAT、TA呈正相关(P0.05)；肝功能指标中,丙氨酸转氨酶与肝脏脂肪含量(HFF、RLC)均呈正相关。结论：对于2型糖尿病患者治疗过程中,应关注患者脂肪代谢,积极并及早预防、治疗异位脂质的堆积、脂肪肝等脂肪代谢紊乱性疾病,因脂肪含量与血糖、血脂、肝功能指标明显相关,而利用3.0T磁共振的相关技术如双回波同反相位技术及磁共振波谱技术能更好的定量检测身体中的异位脂质。
[Abstract]:Objective to evaluate the distribution of fat in liver, abdomen and skeletal muscle of patients with type 2 diabetes mellitus (DM) by using 3.0T dual-echo imaging technique, dual-echo in-phase and out-of-phase Mr imaging technique and proton magnetic resonance spectroscopy (HNMR). Methods 1H-MRS, proton magnetic resonance spectroscopy) and other multimode MRI methods were used to evaluate the fat distribution in liver, abdomen and skeletal muscle of patients with type 2 diabetes mellitus (T2DM). The progress of the disease was evaluated comprehensively with the clinical indexes related to fat metabolism, and the correlation between various factors was discussed. Materials and methods from January 2011 to December 2011, 58 newly diagnosed and diagnosed patients with type 2 diabetes mellitus were selected from the outpatient clinic of Gulou Hospital in Nanjing City. The subjects fasted for 8 hours, and the anthropometric characteristics were tested on the same day. Blood biochemical indexes and MRI scanning were used to measure and calculate liver lipid content, intracellular lipid content, extracellular lipid content of skeletal muscle, subcutaneous lipid area of abdominal wall, and visceral lipid area of abdominal cavity. Total area of abdominal lipids. The difference of type 2 diabetes mellitus patients with fatty liver was compared. The contents of lipids in liver, abdomen and skeletal muscle and clinical data were analyzed by univariate and multivariate regression analysis. Results in the subgroup of type 2 diabetic patients with fatty liver, Two hours after glucose loading, there were significant differences in blood glucose (PPG), visceral fat area (VATA), total abdominal fat area (TAA), liver fat change index (HFF) and liver relative fat content (RLC) measured by 1H-MRS in 2 hours after glucose loading. Univariate and multivariate regression analysis showed that, The body mass index (BMI) was positively correlated with the abdominal fat area index (VATA SATTAA) and the liver fat content index (HFFN RLC), and had a positive correlation with the fat area index (VATSATTAA), and 2hPPG had a positive effect on VAT. Total cholesterol, low density lipoprotein (LDL) and VATTA were positively correlated (P 0.05), and alanine aminotransferase (alt) was positively correlated with liver fat content (HFFN RLC). Conclusion: in the course of treatment of type 2 diabetes mellitus, attention should be paid to the fat metabolism of the patients, to prevent and prevent ectopic lipid accumulation, fatty liver and other disorders of fat metabolism due to fat content and blood sugar, blood lipid. The liver function parameters were significantly correlated, and the correlation techniques of 3.0T MRI, such as dual-echo in-phase technique and magnetic resonance spectroscopy (MRI), could be used to quantitatively detect the ectopic lipid in the body.
【学位授予单位】：南京大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R587.1;R445.2

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