摘要
目的探讨中青年超重/肥胖人群胰腺脂肪含量与早期2型糖尿病(T2DM)的相关性。资料与方法回顾性研究2018年7月—2020年12月在青岛市市立医院进行腹部定量CT扫描的超重/肥胖(体重指数≥24 kg/m^(2))患者,60例超重/肥胖合并T2DM作为研究组,40例超重/肥胖无T2DM作为对照组。采用定量CT测量胰腺头、体、尾部脂肪含量、肝脏脂肪含量、L2/3椎间隙水平皮下脂肪面积、内脏脂肪面积、总脂肪面积、内脏脂肪面积与总脂肪面积比值。收集患者的性别、年龄、体重指数、总胆固醇、甘油三酯、游离脂肪酸、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、尿酸等,分析两组患者胰腺头、体、尾部脂肪含量、肝脏脂肪含量、L2/3椎间隙水平皮下脂肪面积、内脏脂肪面积、总脂肪面积、内脏脂肪面积与总脂肪面积比值及临床检验指标的差异;分析早期T2DM的相关影响因素;采用受试者工作特征(ROC)曲线评估影响因素的预测价值。结果研究组甘油三酯、游离脂肪酸、尿酸、胰腺头、体、尾部脂肪含量、肝脏脂肪含量、L2/3椎间隙水平内脏脂肪面积、L2/3椎间隙水平内脏脂肪面积与总脂肪面积比均高于对照组(t=2.178~4.433,P均<0.05);研究组L2/3椎间隙水平皮下脂肪面积(t=−2.170,P=0.034)、高密度脂蛋白胆固醇低于对照组(t=−2.376,P=0.022)。二元Logistic回归分析显示,校正性别、年龄、体重指数等因素后,胰腺头部脂肪含量是早期T2DM的危险因素(OR=1.261,95%CI 1.023~1.556,P=0.030)。ROC曲线分析显示,胰腺头部脂肪含量预测早期T2DM的曲线下面积为0.802,最佳截断值为16.9%,敏感度为60.0%,特异度为87.5%。结论胰腺头部脂肪含量可能是超重/肥胖人群早期T2DM的危险因素,胰腺头部脂肪含量可以预测早期T2DM。
Purpose To investigate the relationship between fat content of pancreas and early stage of type 2 diabetes mellitus(T2DM)in young and middle-aged overweight/obese people.Materials and Methods Overweight/obese(body mass index≥24 kg/m^(2))patients who underwent abdominal quantitative CT scan in Qingdao Municipal Hospital from July 2018 to December 2020 were retrospectively studied.Sixty overweight/obese patients with T2DM were recruited as the study group,and 40 overweight/obese patients without T2DM were selected as the control group.Quantitative CT was used to measure the fat content in the pancreas head,body and tail,as well as the fat content of the liver,the subcutaneous fat area,the visceral fat area,the total fat area,the ratio of visceral fat to total fat area at the L2/3 intervertebral space level.Clinical indicators including gender,age,body mass index,total cholesterol,triglyceride,free fatty acid,high density lipoprotein cholestreol,low density lipoprotein cholestreol.The difference of the indexes between the two groups were analyzed.The related influencing factors associated with early stage of T2DM were analyzed.Receiver operating characteristic(ROC)curve was used to evaluate the predictive value of the influencing factors.Results In the study group,triglycerides,free fatty acid,uric acid,the fat content of the pancreas head,body and tail,the fat content of the liver,visceral fat area at the L2/3 intervertebral level,visceral fat area to total fat area ratio at the L2/3 intervertebral level were higher than those in the control group(t=2.178-4.433,P<0.05);subcutaneous fat area at the L2/3 intervertebral space level(t=−2.170,P=0.034)and high density lipoprotein cholesterol(t=−2.376,P=0.022)in the study group were lower than those in the control group(P<0.05).Binary Logistic regression analysis showed that fat of the pancreatic head was a risk factor for early stage of T2DM after adjusting for gender,age,body mass index and other factors(OR=1.261,95%CI 1.023-1.556,P=0.030).ROC analysis showed that the area under curve(AUC)of the fat content of pancreatic head in predicting early stage of T2DM was 0.802,and the optimal cut-off value was 16.9%.The sensitivity and specificity were 60.0%and 87.5%,respectively.Conclusion The fat content of the pancreas head can be used as a reference index for predicting early stage of T2DM in overweight/obese people.
作者
王雨竹
郁万江
李烁
杨秋实
李啸扬
WANG Yuzhu;YU Wanjiang;LI Shuo;YANG Qiushi;LI Xiaoyang(Department of Medical Imaging,Weifang Medical University,Weifang 261053,China;Qingdao Municipal Hospital Affiliated to Qingdao University,Qingdao 266071,China;不详)
出处
《中国医学影像学杂志》
CSCD
北大核心
2022年第6期620-624,共5页
Chinese Journal of Medical Imaging
关键词
糖尿病
2型
肥胖
胰腺
脂肪测量
体层摄影术
X线计算机
Diabetes mellitus,type 2
Obesity
Pancreas
Fat measurement
Tomography,X-ray computed
