Distribution patterns of intramyocellular and extramyocellular fat by magnetic resonance imaging in subjects with diabetes, prediabetes and normoglycaemic controls
Distribution patterns of intramyocellular and extramyocellular fat by magnetic resonance imaging in subjects with diabetes, prediabetes and normoglycaemic controls
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DOI：
10.1111/dom.14413
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发表时间：
2021-05-17
影响因子：
5.8
通讯作者：
Bamberg, Fabian
中科院分区：
文献类型：
--
作者：
Kiefer, Lena S.;Fabian, Jana;Bamberg, Fabian
目的评估分布的肌细胞内脂质（IMCLs）和肌细胞外脂质（EMCLs），以及总脂肪含量在腹部骨骼肌磁共振成像（MRI）使用专用的分割算法与2型糖尿病（T2 D），糖尿病前期和normoceremic controls.Materials和方法主题从一个基于人群的队列被归类为T2 D，糖尿病前期或normoceremic控制。通过多回波狄克逊MRI对全部肌脂肪变性、IMCL和EMCL进行定量，以腹部骨骼肌的质子密度脂肪分数（%）表示。（中位年龄56.0 [IQR：49.0-64.0]岁，56.4%为男性，中位体重指数[BMI]：27.2 kg/m2），129例（38.3%）被归类为糖代谢受损（T2 D：49例[14.5%];前驱糖尿病：80例[23.7%]）。非肥胖受试者的IMCL显著高于EMCL（5.7% [IQR：4.8%-7.0%] vs. 4.1% [IQR：2.7%-5.8%]，P < .001），而肥胖受试者的IMCL和EMCL数量相等且显著较高（均为6.7%，P < .001）。糖尿病前期和T2 D患者的IMCL和EMCL显著高于血糖正常的对照组（P <0.001）。在单变量分析中，糖尿病前期和T2 D与IMCL显著相关（糖尿病前期：β：0.76，95% CI：0.28-1.24，P = .002; T2 D：β：1.56，95% CI：0.66-2.47，P < .001）和EMCL（糖尿病前期：β：1.54，95%CI：0.56-2.51，P = .002; T2 D：β：2.15，95%CI：1.33-2.96，P < .001）。在调整年龄和性别后，IMCL与糖尿病前期的相关性减弱（P = 0.06），而对于T2 D，IMCL和EMCL仍显著正相关（P <0.02）。结论T2 D、糖尿病前期和正常血糖对照者IMCL和EMCL的数量和分布比例存在显著差异。因此，这些肌内脂肪分布的MRI模式可能作为成像生物标志物在正常和受损的糖代谢。
Aim To evaluate the distribution of intramyocellular lipids (IMCLs) and extramyocellular lipids (EMCLs) as well as total fat content in abdominal skeletal muscle by magnetic resonance imaging (MRI) using a dedicated segmentation algorithm in subjects with type 2 diabetes (T2D), prediabetes and normoglycaemic controls.Materials and Methods Subjects from a population-based cohort were classified with T2D, prediabetes or as normoglycaemic controls. Total myosteatosis, IMCLs and EMCLs were quantified by multiecho Dixon MRI as proton-density fat-fraction (in %) in abdominal skeletal muscle.Results Among 337 included subjects (median age 56.0 [IQR: 49.0-64.0] years, 56.4% males, median body mass index [BMI]: 27.2 kg/m(2)), 129 (38.3%) were classified with an impaired glucose metabolism (T2D: 49 [14.5%]; prediabetes: 80 [23.7%]). IMCLs were significantly higher than EMCLs in subjects without obesity (5.7% [IQR: 4.8%-7.0%] vs. 4.1% [IQR: 2.7%-5.8%], P < .001), whereas the amounts of IMCLs and EMCLs were shown to be equal and significantly higher in subjects with obesity (both 6.7%, P < .001). Subjects with prediabetes and T2D had significantly higher amounts of IMCLs and EMCLs compared with normoglycaemic controls (P < .001). In univariable analysis, prediabetes and T2D were significantly associated with both IMCLs (prediabetes: beta: 0.76, 95% CI: 0.28-1.24, P = .002; T2D: beta: 1.56, 95% CI: 0.66-2.47, P < .001) and EMCLs (prediabetes: beta: 1.54, 95% CI: 0.56-2.51, P = .002; T2D: beta: 2.15, 95% CI: 1.33-2.96, P < .001). After adjustment for age and gender, the association of IMCLs with prediabetes attenuated (P = 0.06), whereas for T2D, both IMCLs and EMCLs remained significantly and positively associated (P < .02).Conclusion There are significant differences in the amount and distribution ratio of IMCLs and EMCLs between subjects with T2D, prediabetes and normoglycaemic controls. Therefore, these patterns of intramuscular fat distribution by MRI might serve as imaging biomarkers in both normal and impaired glucose metabolism.