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  • 谢林均,李俊茹,夏春潮,黎英,杨志刚,李真林,彭婉琳,高越,刘茜,胡碧月.磁共振氢谱定量评价2型糖尿病合并非酒精性脂肪肝病患者心肌三酰[J].第二军医大学学报,2019,40(3):290-296    [点击复制]
  • XIE Lin-jun,LI Jun-ru,XIA Chun-chao,LI Ying,YANG Zhi-gang,LI Zhen-lin,PENG Wan-lin,GAO Yue,LIU Xi,HU Bi-yue.1H-magnetic resonance spectroscopy quantitatively evaluating myocardial triglyceride content of type 2 diabetes patients with nonalcoholic fatty liver disease[J].Acad J Sec Mil Med Univ,2019,40(3):290-296   [点击复制]
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磁共振氢谱定量评价2型糖尿病合并非酒精性脂肪肝病患者心肌三酰
谢林均1,李俊茹2,夏春潮3*,黎英3,杨志刚3,李真林3,彭婉琳3,高越3,刘茜3,胡碧月3
0
(1. 四川大学华西第二医院放射科, 出生缺陷与相关妇儿疾病教育部重点实验室, 成都 610041;
2. 四川大学华西医院门诊部, 成都 610041;
3. 四川大学华西医院放射科, 成都 610041
*通信作者)
摘要:
目的应用磁共振氢谱(1H-MRS)对2型糖尿病(T2DM)合并非酒精性脂肪肝病(NAFLD)患者心肌三酰甘油含量进行定量评价,探讨心肌三酰甘油含量与心功能参数、血清生物化学指标等的相关性。方法纳入2017年1月至2018年8月确诊的52例T2DM患者。测定患者血清生物化学指标,并应用1H-MRS扫描评价患者左心室功能和心肌三酰甘油相对含量。采用Dixon技术行腹部磁共振成像扫描评价肝脏脂肪含量百分比。应用Pearson相关分析探讨心肌三酰甘油含量与心功能参数、血清生物化学指标等的相关性。结果腹部Dixon技术评价显示,合并NAFLD组T2DM患者肝脏脂肪含量百分比高于未合并NAFLD组患者[(14.99±5.21)% vs (3.51±1.75)%],差异有统计学意义(t=-7.209,P<0.01)。1H-MRS分析结果显示,合并NAFLD组T2DM患者的心肌三酰甘油相对含量为(1.87±0.55)%,高于未合并NAFLD组患者的(1.19±0.48)%,差异有统计学意义(t=-4.105,P<0.01)。T2DM患者心肌三酰甘油相对含量与肝脏脂肪含量百分比、室间隔厚度(IVS)、空腹血糖及左心室重构指数(LVMVR)均呈正相关(r=0.582、0.293、0.318、0.282,P=0.001、0.035、0.021、0.042)。结论 1H-MRS可无创定量评价T2DM合并NAFLD患者的心肌三酰甘油代谢异常,且心肌三酰甘油相对含量与肝脏脂肪含量百分比、IVS、空腹血糖及LVMVR有关。
关键词:  2型糖尿病  非酒精性脂肪肝  磁共振波谱学  磁共振成像  心肌  三酰甘油类
DOI:10.16781/j.0258-879x.2019.03.0290
投稿时间:2018-11-08修订日期:2019-02-22
基金项目:国家自然科学基金(81471722,81771897,81771887),四川省青年科技创新研究团队专项计划(2017TD0005),成都市科技惠民计划(2015-HM01-00473-SF).
1H-magnetic resonance spectroscopy quantitatively evaluating myocardial triglyceride content of type 2 diabetes patients with nonalcoholic fatty liver disease
XIE Lin-jun1,LI Jun-ru2,XIA Chun-chao3*,LI Ying3,YANG Zhi-gang3,LI Zhen-lin3,PENG Wan-lin3,GAO Yue3,LIU Xi3,HU Bi-yue3
(1. Department of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu 610041, Sichuan, China;
2. Department of Outpatient, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China;
3. Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China
*Corresponding author)
Abstract:
Objective To quantitatively assess the myocardial triglyceride (TG) content in type 2 diabetes mellitus (T2DM) patients with non-alcoholic fatty liver disease (NAFLD) using 1H-magnetic resonance spectroscopy (1H-MRS), and to explore the correlation of TG content with cardiac function parameters and serum biochemical indexes. Methods Fifty-two T2DM patients diagnosed from Jan. 2017 to Aug. 2018 were enrolled. Serum biochemical parameters were measured, and left ventricular function and myocardial relative TG content were evaluated by 1H-MRS. Dixon technique was used to perform abdominal magnetic resonance imaging to evaluate the percentage of liver lipid content. Pearson correlation analysis was used to investigate the correlation between myocardial relative TG content and cardiac function parameters and serum biochemical indicators. Results The abdominal Dixon technique showed that the percentage of liver lipid content of the T2DM patients with NAFLD was higher than that of the patients without NAFLD ([14.99±5.21]% vs[3.51±1.75]%), and the difference was significant (t=-7.209, P<0.01). 1H-MRS showed that the myocardial relative TG content was higher in the T2DM patients with NAFLD than that in the patients without NAFLD ([1.87±0.55]% vs[1.19±0.48]%), and the difference was significant (t=-4.105, P<0.01). The myocardial relative TG content of the T2DM patients was significantly positively correlated to the percentage of liver lipid content, interventricular septal thickness (IVS), fasting blood-glucose and left ventricular mass to end-diastolic volume ratio (LVMVR; r=0.582, 0.293, 0.318, and 0.282; P=0.001, 0.035, 0.021, and 0.042). Conclusion 1H-MRS is a non-invasive quantitative evaluation method for the abnormal metabolism of myocardial TG in the T2DM patients with NAFLD. The myocardial relative TG content of the T2DM patients with NAFLD is related to the percentage of liver lipid content, IVS, fasting blood glucose and LVMVR.
Key words:  type 2 diabetes mellitus  non-alcoholic fatty liver  magnetic resonance spectroscopy  magnetic resonance imaging  myocardium  triglyceride