Department of Radiology, Dokuz Eylül University School of Medicine, İzmir, Turkey.
Division of Endocrinology, Dokuz Eylül University School of Medicine, İzmir, Turkey.
Turk J Gastroenterol. 2020 Aug;31(8):588-595. doi: 10.5152/tjg.2020.19114.
BACKGROUND/AIMS: Lipodystrophy is a rare metabolic disorder characterized by near total or partial lack of subcutaneous adipose tissue and associated with insulin resistance. We aimed to evaluate the efficacy of magnetic resonance spectroscopy imaging (MRS) to explore the fat content of the liver in patients with lipodystrophy and to determine the relationship between the liver fat accumulation and clinical presentations of lipodystrophy.
Between July 2014 and February 2016, 34 patients with lipodystrophy were assessed by MRS for quantification of hepatic steatosis. All patients had metabolic abnormalities associated with insulin resistance. Metabolic parameters and the MRS findings were analyzed to identify potential correlations between the liver fat content and disease severity.
The MRS fat ratios (MRS-FR) were markedly higher, indicating severe hepatic steatosis in lipodystrophy. Patients with generalized and partial lipodystrophy had comparable levels of MRS-FRs, although patients with generalized lipodystrophy were significantly younger. Patients with genetically based lipodystrophy had elevated MRS-FR compared to those with acquired lipodystrophy (p=0.042). The MRS-FR was positively correlated with liver enzyme alanine aminotransferase (p=0.028) and serum adiponectin (p=0.043).
Our data suggest that MRS might be an effective, noninvasive imaging method to quantify hepatic fat content in patients with lipodystrophy. Further studies are needed to validate the technique and threshold values which would allow accurate comparison of data acquired by different machines and centers.
背景/目的：脂肪营养不良是一种罕见的代谢紊乱，其特征是几乎完全或部分缺乏皮下脂肪组织，并与胰岛素抵抗有关。我们旨在评估磁共振波谱成像（MRS）评估脂肪营养不良患者肝脏脂肪含量的有效性，并确定肝脏脂肪堆积与脂肪营养不良临床表现之间的关系。
在 2014 年 7 月至 2016 年 2 月期间，34 例脂肪营养不良患者接受 MRS 评估以量化肝脂肪变性。所有患者均存在与胰岛素抵抗相关的代谢异常。分析代谢参数和 MRS 结果，以确定肝脏脂肪含量与疾病严重程度之间的潜在相关性。
MRS 脂肪比（MRS-FR）明显升高，表明脂肪营养不良中存在严重的肝脂肪变性。全身性和部分性脂肪营养不良患者的 MRS-FR 水平相当，尽管全身性脂肪营养不良患者明显更年轻。遗传性脂肪营养不良患者的 MRS-FR 高于获得性脂肪营养不良患者（p=0.042）。MRS-FR 与肝酶丙氨酸氨基转移酶（p=0.028）和血清脂联素（p=0.043）呈正相关。
我们的数据表明，MRS 可能是一种有效的、非侵入性成像方法，可用于量化脂肪营养不良患者的肝脏脂肪含量。需要进一步的研究来验证该技术和阈值，以便能够准确比较不同机器和中心获得的数据。
