MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
Diabetes Metab Res Rev. 2013 Feb;29(2):125-9. doi: 10.1002/dmrr.2370.
This experimental study explores a novel magnetic resonance imaging/spectroscopic (MRI/MRS) method that measures changes in renal metabolism in a diabetic rat model. This hyperpolarized metabolic MRI/MRS method allows monitoring of metabolic processes in seconds by >10 000-fold enhancement of the MR signal. The method has shown that the conversion of pyruvate to bicarbonate, i.e. pyruvate dehydrogenase (PDH) activity, is significantly altered in the myocardium already at the onset of diabetes, and the predominant Warburg effect is a valuable cancer maker via the lactate dehydrogenase (LDH) activity. We hypothesize that a similar change in PDH and LDH could be found in the early diabetic kidney.
In a streptozotocin rat model of type 1 diabetes, hyperpolarized (13) C-MRI and blood oxygenation level-dependent (1) H-MRI was employed to investigate the changes in renal metabolism in the diabetic and the control kidneys in vivo.
The diabetic kidney showed a 149% increase in the lactate/pyruvate ratio compared with the control rat kidney, whereas the bicarbonate/pyruvate ratio was unchanged between the diabetic and the control rat kidneys, consistent with literature findings. These metabolic findings paralleled a reduced intrarenal oxygen availability as found by blood oxygenation level-dependent MRI.
Hyperpolarized (13) C-MRI shows promise in the diagnosis and monitoring of early renal changes associated with diabetes, with the pyruvate/lactate ratio as an imaging biomarker for regional renal changes.
本实验研究探索了一种新的磁共振成像/光谱（MRI/MRS）方法，该方法可测量糖尿病大鼠模型中肾脏代谢的变化。这种超极化代谢 MRI/MRS 方法通过将 MR 信号增强>10000 倍，可在数秒内监测代谢过程。该方法已经表明，在糖尿病发病初期，心肌中的丙酮酸向碳酸氢盐的转化（即丙酮酸脱氢酶（PDH）活性）发生显著改变，而主要的瓦博格效应通过乳酸脱氢酶（LDH）活性成为有价值的癌症标志物。我们假设在早期糖尿病肾脏中也可以发现 PDH 和 LDH 的类似变化。
在 1 型糖尿病的链脲佐菌素大鼠模型中，采用超极化（13）C-MRI 和血氧水平依赖（1）H-MRI 来研究糖尿病和对照组大鼠肾脏中代谢的变化。
与对照组大鼠肾脏相比，糖尿病肾脏中的乳酸/丙酮酸比值增加了 149%，而碳酸氢盐/丙酮酸比值在糖尿病和对照组大鼠肾脏之间没有变化，与文献结果一致。这些代谢发现与通过血氧水平依赖 MRI 发现的肾内氧供应减少相平行。
超极化（13）C-MRI 有望用于诊断和监测与糖尿病相关的早期肾脏变化，丙酮酸/乳酸比值作为局部肾脏变化的成像生物标志物。
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