Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China.
Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, China.
Front Endocrinol (Lausanne). 2021 Mar 30;12:536018. doi: 10.3389/fendo.2021.536018. eCollection 2021.
Skeletal muscle fat content is one of the important contributors to insulin resistance (IR), but its diagnostic value remains unknown, especially in the Chinese population. Therefore, we aimed to analyze differences in skeletal muscle fat content and various functional MRI parameters between diabetic patients and control subjects to evaluate the early indicators of diabetes. In addition, we aimed to investigate the associations among skeletal muscle fat content, magnetic resonance parameters of skeletal muscle function and IR in type 2 diabetic patients and control subjects.
We enrolled 12 patients (age:29-38 years, BMI: 25-28 kg/m) who were newly diagnosed with type 2 diabetes (intravenous plasma glucose concentration≥11.1mmol/l or fasting blood glucose concentration≥7.0mmol/l) together with 12 control subjects as the control group (age: 26-33 years, BMI: 21-28 kg/m). Fasting blood samples were collected for the measurement of glucose, insulin, 2-hour postprandial blood glucose (PBG2h), and glycated hemoglobin (HbAlc). The magnetic resonance scan of the lower extremity and abdomen was performed, which can evaluate visceral fat content as well as skeletal muscle metabolism and function through transverse relaxation times (T2), fraction anisotropy (FA) and apparent diffusion coefficient (ADC) values.
We found a significant difference in intermuscular fat (IMAT) between the diabetes group and the control group (<0.05), the ratio of IMAT in thigh muscles of diabetes group was higher than that of control group. In the entire cohort, IMAT was positively correlated with HOMA-IR, HbAlc, T2, and FA, and the T2 value was correlated with HOMA-IR, PBG2h and HbAlc (<0.05). There were also significant differences in T2 and FA values between the diabetes group and the control group (<0.05). According to the ROC, assuming 8.85% of IMAT as the cutoff value, the sensitivity and specificity of IMAT were 100% and 83.3%, respectively. Assuming 39.25ms as the cutoff value, the sensitivity and specificity of T2 value were 66.7% and 91.7%, respectively. All the statistical analyses were adjusted for age, BMI and visceral fat content.
Deposition of IMAT in skeletal muscles seems to be an important determinant for IR in type 2 diabetes. The skeletal muscle IMAT value greater than 8.85% and the T2 value greater than 39.25ms are suggestive of IR.
骨骼肌脂肪含量是胰岛素抵抗(IR)的重要影响因素之一,但它的诊断价值尚不清楚,尤其是在中国人群中。因此,我们旨在分析糖尿病患者和对照组之间骨骼肌脂肪含量和各种功能磁共振参数的差异,以评估糖尿病的早期指标。此外,我们还旨在研究 2 型糖尿病患者和对照组中骨骼肌脂肪含量、骨骼肌功能磁共振参数与 IR 之间的关系。
我们纳入了 12 名新诊断为 2 型糖尿病的患者(年龄:29-38 岁,BMI:25-28kg/m²)(静脉血浆葡萄糖浓度≥11.1mmol/L 或空腹血糖浓度≥7.0mmol/L),并将 12 名年龄在 26-33 岁、BMI 为 21-28kg/m²的对照组纳入研究。采集空腹血样,测量血糖、胰岛素、餐后 2 小时血糖(PBG2h)和糖化血红蛋白(HbAlc)。进行下肢和腹部磁共振扫描,通过横向弛豫时间(T2)、分数各向异性(FA)和表观扩散系数(ADC)值评估内脏脂肪含量以及骨骼肌代谢和功能。
我们发现糖尿病组和对照组之间的肌间脂肪(IMAT)存在显著差异(<0.05),糖尿病组大腿肌肉的 IMAT 比值高于对照组。在整个队列中,IMAT 与 HOMA-IR、HbAlc、T2 和 FA 呈正相关,T2 值与 HOMA-IR、PBG2h 和 HbAlc 呈负相关(<0.05)。糖尿病组和对照组之间的 T2 和 FA 值也存在显著差异(<0.05)。根据 ROC 分析,假设 IMAT 为 8.85%作为截断值,IMAT 的灵敏度和特异性分别为 100%和 83.3%。假设 T2 值为 39.25ms 作为截断值,T2 值的灵敏度和特异性分别为 66.7%和 91.7%。所有的统计分析均针对年龄、BMI 和内脏脂肪含量进行了调整。
骨骼肌中 IMAT 的沉积似乎是 2 型糖尿病中 IR 的一个重要决定因素。骨骼肌 IMAT 值大于 8.85%和 T2 值大于 39.25ms 提示存在 IR。