Magnetic resonance spectroscopy to measure hepatic triglyceride content: prevalence of hepatic steatosis in the general population
Magnetic resonance spectroscopy to measure hepatic triglyceride content: prevalence of hepatic steatosis in the general population
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DOI：
10.1152/ajpendo.00064.2004
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发表时间：
2005-02-01
影响因子：
5.1
通讯作者：
Dobbins, RL
中科院分区：
文献类型：
--
作者：
Szczepaniak, LS;Nurenberg, P;Dobbins, RL
尽管非酒精性脂肪性肝病（NAFLD）的患病率越来越高，但用于诊断该疾病的标准仍然定义不清。局部质子磁共振波谱（MRS）可以准确测量肝脏甘油三酯含量（HTGC），但仅在小型研究中使用。在这里，MRS用于分析来自达拉斯心脏研究（DHS）的2349名参与者的HTGC分布。结果表明，重复的HTGC测量值高度相关（r = 0.99, P < 0.001），测量值之间的变异系数很低（8.5%），验证了该方法的重复性。摄入高脂肪食物对测量结果没有显著影响，从左、右肝叶测量的结果也相似。为了确定HTGC的“正常上限”，研究人员对来自DHS的345名没有可识别的肝脂肪变性危险因素的受试者（非肥胖、非糖尿病、少量饮酒、肝功能检查正常、无已知肝脏疾病的受试者）的HTGC分布进行了检查。这些受试者HTGC的第95百分位数为5.56%，相当于肝脏甘油三酯水平为55.6 mg/g。以这个值作为临界值，达拉斯县肝脂肪变性的患病率估计为33.6%。因此，MRS提供了一种敏感、定量、无创的方法来测量HTGC，当应用于美国大城市人群时，发现肝脂肪变性的患病率惊人地高。
Despite the increasing prevalence of nonalcoholic fatty liver disease (NAFLD), the criteria used to diagnose the disorder remain poorly defined. Localized proton magnetic resonance spectroscopy (MRS) accurately measures hepatic triglyceride content (HTGC) but has been used only in small research studies. Here, MRS was used to analyze the distribution of HTGC in 2,349 participants from the Dallas Heart Study (DHS). The reproducibility of the procedure was validated by showing that duplicate HTGC measurements were high correlated ( r = 0.99, P < 0.001) and that the coefficient of variation between measurements was low (8.5%). Intake of a high-fat meal did not significantly affect the measurements, and values were similar when measurements were made from the right and left hepatic lobes. To determine the "upper limit of normal" for HTGC, the distribution of HTGC was examined in the 345 subjects from the DHS who had no identifiable risk factors for hepatic steatosis (nonobese, nondiabetic subjects with minimal alcohol consumption, normal liver function tests, and no known liver disease). The 95th percentile of HTGC in these subjects was 5.56%, which corresponds to a hepatic triglyceride level of 55.6 mg/g. With this value as a cutoff, the prevalence of hepatic steatosis in Dallas County was estimated to be 33.6%. Thus MRS provides a sensitive, quantitative, noninvasive method to measure HTGC and, when applied to a large urban US population, revealed a strikingly high prevalence of hepatic steatosis.