Institute for Community Medicine, University Medicine Greifswald, Walther Rathenau Str. 48, 17475, Greifswald, Germany.
Department of Zoology, University of Malakand, Chakdara, 18800, Pakistan.
Sci Rep. 2021 Jun 24;11(1):13276. doi: 10.1038/s41598-021-92681-3.
The aim of our study was to investigate the association of hepatic steatosis derived from quantitative ultrasound and magnetic resonance imaging (MRI) with prediabetes in a large population-based study conducted in Northeast Germany. Hepatic steatosis was assessed through transabdominal ultrasound and quantitative MRI. For analysis we included 1622 subjects with MRI who participated in an oral glucose tolerance test and reported no known type 2 diabetes mellitus (T2DM). We classified participants as proposed by the American Diabetes Association: isolated impaired fasting glucose (i-IFG), isolated impaired glucose tolerance (i-IGT), combined IFG and IGT (IFG + IGT), and undiagnosed T2DM. Regression models were adjusted for age, sex body mass index and alcohol consumption. We observed positive associations of hepatic steatosis with glycated hemoglobin, fasting glucose and insulin, 2-h glucose and insulin, as well as homeostasis model assessment-insulin resistance index. Similarly, individuals having hepatic steatosis as defined by MRI had a higher relative risk ratio (RR) to be in the prediabetes groups i-IFG (RR = 1.6; 95% confidence interval (CI) 1.2; 2.2), i-IGT (RR = 3.3, 95% CI 2.0; 5.6) and IFG + IGT (RR = 2.5, 95% CI 1.6; 3.9) or to have undiagnosed T2DM (RR = 4.8, 95% CI 2.6; 9.0). All associations were attenuated when defining hepatic steatosis by ultrasound. Hepatic steatosis is associated with prediabetes and undiagnosed T2DM in the general population. Quantitative liver MRI revealed stronger associations with prediabetes and undiagnosed T2DM compared to ultrasound, which indicates the higher sensitivity and specificity of MRI to determine hepatic steatosis.
本研究旨在通过在德国东北部进行的一项大型人群研究，调查基于定量超声和磁共振成像（MRI）的肝脂肪变性与糖尿病前期的相关性。通过腹部超声和定量 MRI 评估肝脂肪变性。我们纳入了 1622 名接受 MRI 检查且报告无已知 2 型糖尿病（T2DM）的受试者，并进行口服葡萄糖耐量试验。我们根据美国糖尿病协会的建议对参与者进行分类：孤立性空腹血糖受损（i-IFG）、孤立性葡萄糖耐量受损（i-IGT）、IFG 和 IGT 并存（IFG+IGT）和未诊断的 T2DM。回归模型调整了年龄、性别、体重指数和饮酒。我们观察到肝脂肪变性与糖化血红蛋白、空腹血糖和胰岛素、2 小时血糖和胰岛素以及稳态模型评估-胰岛素抵抗指数呈正相关。同样，根据 MRI 定义为肝脂肪变性的个体患有糖尿病前期的相对风险比（RR）更高，包括 i-IFG（RR=1.6；95%置信区间 [CI] 1.2；2.2）、i-IGT（RR=3.3，95% CI 2.0；5.6）和 IFG+IGT（RR=2.5，95% CI 1.6；3.9）或未诊断的 T2DM（RR=4.8，95% CI 2.6；9.0）。当通过超声定义肝脂肪变性时，所有关联均减弱。肝脂肪变性与普通人群中的糖尿病前期和未诊断的 T2DM 相关。与超声相比，定量肝 MRI 与糖尿病前期和未诊断的 T2DM 相关性更强，这表明 MRI 检测肝脂肪变性的敏感性和特异性更高。
