Heber Sophia D, Hetterich Holger, Lorbeer Roberto, Bayerl Christian, Machann Jürgen, Auweter Sigrid, Storz Corinna, Schlett Christopher L, Nikolaou Konstantin, Reiser Maximilian, Peters Annette, Bamberg Fabian
Department of Diagnostic and Interventional Radiology, University of Tuebingen, Tuebingen, Germany.
Institute of Clinical Radiology, Ludwig-Maximilian-University Hospital, Munich, Germany.
PLoS One. 2017 May 17;12(5):e0177154. doi: 10.1371/journal.pone.0177154. eCollection 2017.
BACKGROUND/OBJECTIVE: Despite the relevance of pancreatic fat content in the development of metabolic diseases, its association with impaired glucose metabolism, diabetes, and other adipose tissue compartments remains unclear. Thus, we determined differences in pancreatic fat content by magnetic resonance imaging (MRI) between subjects with prediabetes, diabetes, and normal controls in a cohort from the general population.
Subjects without history of cardiovascular disease with established diabetes or prediabetes as well as normal controls were included and underwent whole-body MRI on a 3T scanner. Pancreatic fat content was quantified by measuring the proton-density fat fraction (PDFFpanc) using a 3D multi-echo GRE sequence (increment: 1.23 ms, 6 echoes) by placing ROIs in the pancreatic head, body, and tail by independent readers. In addition, hepatic fat content as well as abdominal subcutaneous and visceral adipose tissue (SAT and VAT) were measured by multi-echo GRE and 3D 2-point volume-interpolated DIXON MRI, respectively. Univariate and multivariate analyses were employed to determine associations.
A total of 385 subjects were included in the analysis (median age: 57 years, 58.2% males), of them 53 were classified as subjects with diabetes, 95 as prediabetes, and 237 as controls (13.8%, 24.7%, and 61.6%; respectively). The median PDFFpanc was 5.2% [IQR 3.3-9.4], and significantly higher in subjects with prediabetes and diabetes as compared to controls (PDFFpanc: 6.2% [IQR: 3.5-12] vs. 8.6% [IQR: 4.3-17.5] vs. 4.9% [3.1-7.4], p<0.001, respectively). After adjusting for age, gender and BMI the association was attenuated (all p>0.12). While in univariate analysis BMI, PDFFhepatic, SAT and VAT were associated with PDFFpanc (all p<0.05), only VAT predicted PDFFpanc independently (β: 0.02, 95%-confidence interval: 0.01-0.04, p<0.001).
While pancreatic fat content differs significantly between subjects with prediabetes, diabetes and controls, this association may be confounded by age, gender, and the amount of VAT in this cross-sectional study.
背景/目的：尽管胰腺脂肪含量在代谢性疾病的发生发展中具有重要意义，但其与葡萄糖代谢受损、糖尿病以及其他脂肪组织区域之间的关联仍不明确。因此，我们通过磁共振成像（MRI）测定了普通人群队列中糖尿病前期、糖尿病患者和正常对照者之间胰腺脂肪含量的差异。
纳入无心血管疾病史的已确诊糖尿病或糖尿病前期患者以及正常对照者，并在3T扫描仪上进行全身MRI检查。通过独立阅片者在胰腺头部、体部和尾部放置感兴趣区（ROI），使用3D多回波GRE序列（增量：1.23毫秒，6个回波）测量质子密度脂肪分数（PDFFpanc）来量化胰腺脂肪含量。此外，分别通过多回波GRE和3D两点容积内插DIXON MRI测量肝脏脂肪含量以及腹部皮下和内脏脂肪组织（SAT和VAT）。采用单变量和多变量分析来确定关联。
共有385名受试者纳入分析（中位年龄：57岁，男性占58.2%），其中53名被归类为糖尿病患者，95名作为糖尿病前期患者，237名作为对照者（分别占13.8%、24.7%和61.6%）。PDFFpanc的中位数为5.2%[四分位数间距（IQR）：3.3 - 9.4]，糖尿病前期和糖尿病患者的该值显著高于对照者（PDFFpanc：6.2%[IQR：3.5 - 12] vs. 8.6%[IQR：4.3 - 17.5] vs. 4.9%[3.1 - 7.4]，p < 0.001）。在对年龄调整年龄、性别和体重指数（BMI）后，这种关联减弱（所有p > 0.12）。在单变量分析中，BMI、PDFFhepatic、SAT和VAT与PDFFpanc相关（所有p < 0.05），但只有VAT能独立预测PDFFpanc（β：0.02，95%置信区间：0.01 - 0.04，p < 0.001）。
在这项横断面研究中，糖尿病前期、糖尿病患者和对照者之间的胰腺脂肪含量存在显著差异，但这种关联可能受到年龄、性别和VAT量的混淆。
