影像学胰腺脂肪与儿童代谢合并症的关联。
Association of pancreatic fat on imaging with pediatric metabolic co-morbidities.
机构信息
Division of Endocrinology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Division of Pediatric Endocrinology, University of Kentucky College of Medicine, 2195 Harrodsburg Rd, Suite 125, Lexington, KY, 40504, USA.
出版信息
Pediatr Radiol. 2023 Sep;53(10):2030-2039. doi: 10.1007/s00247-023-05669-8. Epub 2023 Apr 28.
BACKGROUND
The relationship between pancreatic fat on imaging and metabolic co-morbidities has not been established in pediatrics. We sought to investigate the relationship between pancreatic fat measured by MRI and endocrine/exocrine dysfunctions along with the metabolic co-morbidities in a cohort of children.
OBJECTIVE
To investigate relationships between pancreatic fat quantified by MRI and endocrine and exocrine conditions and metabolic co-morbidities in a cohort of children. MATERIALS AND METHODS: This was a retrospective review of pediatric patients (n = 187) who had a clinically indicated MRI examination between May 2018 and February 2020. After 51 patients without useable imaging data were excluded, the remaining 136 subjects comprised the study sample. Laboratory studies were assessed if collected within 6 months of MRI and patient charts were reviewed for demographic and clinical information. MRI proton density fat fraction (PDFF) sequence had been acquired according to manufacturer's specified parameters at a slice thickness of 3 mm. Two blinded radiologists independently collected PDFF data.
RESULTS
The median age at MRI was 12.1 (IQR: 9.0-14.8) years and the majority of patients were Caucasian (79%), followed by African American and Hispanic at 12% and 11% respectively. There was a higher median pancreas fat fraction in patients with exocrine conditions (chronic pancreatitis or exocrine insufficiency) compared to those without (3.5% vs 2.2%, p = 0.03). There was also a higher median fat fraction in the head of pancreas in patients with endocrine insufficient conditions (insulin resistance, pre-diabetes, type 1 and type 2 diabetes) compared to those without endocrine insufficiency when excluding patients with active acute pancreatitis (3.5% vs 2.0%, p = 0.04). Patients with BMI > 85% had higher mean fat fraction compared to patients with BMI ≤ 85% (head: 3.8 vs 2.4%, p = 0.01; body: 3.8 vs 2.5%, p = 0.005; tail: 3.7 vs 2.7%, p = 0.049; overall pancreas fat fraction: 3.8 vs 2.6%, p = 0.002).
CONCLUSION
Pancreas fat is elevated in patients with BMI > 85% and in those with exocrine and endocrine insufficiencies.
背景
在儿科领域，影像学上的胰腺脂肪与代谢合并症之间的关系尚未确定。我们旨在研究一组儿童中通过 MRI 测量的胰腺脂肪与内分泌/外分泌功能障碍以及代谢合并症之间的关系。
目的
通过 MRI 定量检测胰腺脂肪，探讨其与儿童内分泌和外分泌状况及代谢合并症之间的关系。
材料与方法
这是一项回顾性研究，纳入了 2018 年 5 月至 2020 年 2 月期间因临床需要进行 MRI 检查的儿科患者（n=187）。排除 51 例影像学数据不可用的患者后，其余 136 例患者纳入研究样本。如果在 MRI 检查后 6 个月内进行了实验室研究，则评估实验室研究结果，并查阅患者病历以获取人口统计学和临床信息。MRI 质子密度脂肪分数（PDFF）序列采用制造商规定的参数在 3mm 层厚下采集。两名盲法放射科医生独立采集 PDFF 数据。
结果
MRI 检查时的中位年龄为 12.1 岁（IQR：9.0-14.8），大多数患者为白种人（79%），其次为非裔美国人（12%）和西班牙裔（11%）。有外分泌疾病（慢性胰腺炎或外分泌功能不全）的患者胰腺脂肪分数中位数高于无外分泌疾病的患者（3.5% vs. 2.2%，p=0.03）。在排除活动性急性胰腺炎患者后，有内分泌功能不全（胰岛素抵抗、前驱糖尿病、1 型和 2 型糖尿病）的患者胰头部脂肪分数中位数也高于无内分泌功能不全的患者（3.5% vs. 2.0%，p=0.04）。BMI＞85%的患者脂肪分数平均值高于 BMI≤85%的患者（胰头部：3.8 vs. 2.4%，p=0.01；胰体部：3.8 vs. 2.5%，p=0.005；胰尾部：3.7 vs. 2.7%，p=0.049；胰腺总体脂肪分数：3.8 vs. 2.6%，p=0.002）。
结论
BMI＞85%的患者和有外分泌及内分泌功能不全的患者胰腺脂肪升高。
Zotero 插件