磁共振成像：质子密度脂肪分数评估 2 型糖尿病巴马小型猪进展过程中的胰腺脂肪浸润。

Magnetic resonance imaging: Proton density fat fraction for assessment of pancreatic fatty infiltration during progression of T2DM bama minipigs.

机构信息

First Affiliated Hospital of Guangxi Medical University, Radiology Department, Guangxi, China.

First Affiliated Hospital of Guangxi Medical University, Pathology Department, Guangxi, China.

出版信息

J Magn Reson Imaging. 2019 Dec;50(6):1905-1913. doi: 10.1002/jmri.26754. Epub 2019 Apr 21.

DOI:10.1002/jmri.26754

PMID:31006935

Abstract

BACKGROUND

Recent studies have highlighted the correlation between diabetes and pancreatic fat infiltration. However, pancreatic fat content (PFC) is rarely confirmed by pathological results, and a change of PFC during progression of type 2 diabetes (T2DM) is currently controversial.

PURPOSE

To evaluate the relationship of MRI-pancreatic proton density fat fraction to serologic changes and histology in an experimental model of diabetes.

STUDY TYPE

Prospective animal study.

ANIMAL MODEL

Thirteen Bama pigs were randomly assigned to diabetes (n = 7) or control (n = 6) groups. Pigs in the diabetic group received high-fat/high-sugar feed, combined with three doses of streptozotocin injections.

FIELD STRENGTH/SEQUENCE: 3.0T, IDEAL-IQ sequence.

ASSESSMENT

Starting in the fifth month, biochemical changes were evaluated; all pigs underwent axial MRI with the IDEAL-IQ sequence to measured pancreatic fat fraction (PFF). PFC was measured by the Soxhlet extraction method. Pancreatic fat distribution and pancreas islet morphology were observed by histopathology.

STATISTICAL TESTS

A Mann-Whitney U-test, independent-samples t-test, Pearson correlation, Spearman correlation, single-measure intraclass correlation coefficient (ICC) were performed.

RESULTS

During the development of T2DM, the PFF, weight, fasting blood glucose (FBG), triglyceride (TG), total cholesterol (TCHO), low-density lipoprotein (LDL), and HOMA-IR (insulin resistance) of the experimental group showed an upward trend; fasting insulin (INS), high-density lipoprotein (HDL), and HOMA-β showed decreasing trends. At the end of the fifteenth month, FBG (mmol/L) was 18.06 ± 6.03 and 5.06 ± 1.41 (P < 0.001), PFF (%) was 36.52 ± 4.07 and 27.75 ± 3.73 (P = 0.002), INS (mU/L) was 21.59 ± 2.93 and 29.32 ± 3.27 (P = 0.001), HOMA-IR was 16.83 ± 4.22 and 6.70 ± 2.45 (P < 0.001), HOMA-β was 1.50 ± 0.24 and 2.77 ± 0.45 (P < 0.001), between the experimental and control groups. There were strong and moderate positive correlations between PFF and PFC (r = 0.968, P < 0.001), and FBG (r = 0.657, P = 0.015), and HOMA-IR (r = 0.608, P = 0.028).

DATA CONCLUSION

MRI-proton density fat fraction can measure the fat content of the pancreas with great accuracy and repeatability; PFF is a potential biomarker that can reflect the different stages of diabetes development.

LEVEL OF EVIDENCE

2 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;50:1905-1913.

摘要

背景

最近的研究强调了糖尿病与胰腺脂肪浸润之间的相关性。然而，胰腺脂肪含量（PFC）很少通过病理结果证实，并且 2 型糖尿病（T2DM）进展过程中 PFC 的变化目前存在争议。

目的

评估 MRI 胰腺质子密度脂肪分数与实验性糖尿病模型中血清学变化和组织学的关系。

研究类型

前瞻性动物研究。

动物模型

13 头巴马猪被随机分为糖尿病（n = 7）或对照组（n = 6）。糖尿病组猪接受高脂肪/高糖饲料，联合三次链脲佐菌素注射。

场强/序列：3.0T，IDEAL-IQ 序列。

评估

从第五个月开始评估生化变化；所有猪均进行轴向 MRI 检查，使用 IDEAL-IQ 序列测量胰腺脂肪分数（PFF）。通过索氏提取法测量 PFC。通过组织病理学观察胰腺脂肪分布和胰岛形态。

统计检验

采用 Mann-Whitney U 检验、独立样本 t 检验、Pearson 相关、Spearman 相关、单测组内相关系数（ICC）。

结果

在 T2DM 发展过程中，实验组的 PFF、体重、空腹血糖（FBG）、甘油三酯（TG）、总胆固醇（TCHO）、低密度脂蛋白（LDL）和 HOMA-IR（胰岛素抵抗）呈上升趋势；空腹胰岛素（INS）、高密度脂蛋白（HDL）和 HOMA-β呈下降趋势。在第十五个月末，FBG（mmol/L）为 18.06 ± 6.03 和 5.06 ± 1.41（P < 0.001），PFF（%）为 36.52 ± 4.07 和 27.75 ± 3.73（P = 0.002），INS（mU/L）为 21.59 ± 2.93 和 29.32 ± 3.27（P = 0.001），HOMA-IR 为 16.83 ± 4.22 和 6.70 ± 2.45（P < 0.001），HOMA-β 为 1.50 ± 0.24 和 2.77 ± 0.45（P < 0.001），实验组和对照组之间存在差异。PFF 与 PFC（r = 0.968，P < 0.001）和 FBG（r = 0.657，P = 0.015）和 HOMA-IR（r = 0.608，P = 0.028）之间存在强和中度正相关。