河北医科大学学报 ›› 2022, Vol. 43 ›› Issue (11): 1311-1317.doi: 10.3969/j.issn.1007-3205.2022.11.015

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2型糖尿病与非糖尿病患者腰椎骨髓脂肪分数值定量比较

  

  1. 1.河北省石家庄市第二医院医学影像科，河北 石家庄 050051；2.河北省石家庄市第三医院导管室，河北 石家庄 050051

  • 出版日期:2022-11-25 发布日期:2022-12-28
  • 作者简介:崔凤珍（1983-），女，河北沧州人，河北省石家庄市第二医院副主任医师，医学硕士，从事医学影像诊断研究。
  • 基金资助:
    石家庄市科学技术研究与发展计划项目(211460463)

Quantitative analysis of lumbar bone marrow fat content in patients with type 2 diabetes mellitus and non-diabetic patients

  1. 1.Department of Radiology, the Second Hospital of Shijiazhuang City, Hebei Province, Shijiazhuang 
    050051， China； 2.Department of Catheter Lab, the Third Hospital of Shijiazhuang City, 
    Hebei Province, Shijiazhuang 050051， China

  • Online:2022-11-25 Published:2022-12-28

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摘要： 目的 比较2型糖尿病（type 2 diabetes mellitus，T2DM）与非糖尿病患者腰椎骨髓脂肪含量。
方法 前瞻性选择行腰椎MRI检查的患者100例，均采用磁共振非对称回波最小二乘估算法迭代水脂分离（water and fat with Echo Asymmetry and Least squares estimation,IDEAL）序列扫描。测量腰椎骨髓IDEAL-fat、IDEAL-water信号值，计算腰椎骨髓脂肪分数值（bone marrow fat fraction，BMFFIDEAL）。比较T2DM组和非糖尿病组腰椎骨髓IDEAL-fat、IDEAL-water平均信号值、BMFFIDEAL值，并分析与性别、年龄、体重指数（body mass index，BMI）及糖化血红蛋值的关系。
结果 T2DM组、非糖尿病组腰椎骨髓IDEAL-fat和IDEAL-water平均信号值差异无统计学意义（P＞0.05），T2DM组腰椎骨髓BMFFIDEAL值高于非糖尿病组(P＜0.05)。T2DM组男性与女性、体重正常组与超重组腰椎骨髓BMFFIDEAL值差异无统计学意义（P＞0.05），非糖尿病组男性与女性、体重正常组与超重组腰椎骨髓BMFFIDEAL值差异均无统计学意义（P＞0.05）。T2DM组、非糖尿病组L1~L5各椎体间骨髓IDEAL-fat值差异无统计学意义(P＞0.05)。T2DM组、非糖尿病组L1~L5各椎体间骨髓IDEAL-water信号以及BMFFIDEAL值差异有统计学意义(P＜0.05)；T2DM组L1骨髓BMFFIDEAL值低于L3椎体，非糖尿病组L1骨髓IDEAL-water信号值高于L3椎体，L1骨髓BMFFIDEAL值低于L3及L4椎体(P＜0.05)。T2DM组腰椎骨髓BMFFIDEAL值与年龄呈正相关，非糖尿病组腰椎骨髓BMFFIDEAL值与年龄呈正相关，T2DM患者腰椎骨髓BMFFIDEAL与糖化血红蛋白呈正相关(P＜0.05)。
结论 T2DM患者腰椎骨髓脂肪含量高于非糖尿病患者，与年龄、糖化血红蛋白有关，与性别、BMI无明显关系。


关键词: 糖尿病, 2型, 腰椎, 骨髓, 磁共振成像

Abstract: Objective To compare the bone marrow fat(BMF) content of lumbar spine between type 2 diabetes mellitus(T2DM) patients and non-diabetic patients. 
Methods We conducted a prospective analysis of 100 patients who underwent lumbar MRI iterative decomposition of water and fat with echo asymmetry and least-squares estimation(IDEAL) sequence. The IDEAL-fat and IDEAL-water signal values of lumbar bone marrow were measured. The BMF fraction(BMFFIDEAL) was calculated. The difference of mean IDEAL-fat signal value, mean IDEAL-water signal value and the BMFFIDEAL value of lumbar bone marrow between T2DM group and non-diabetic group were compared, and their correlation with age, gender, body mass index(BMI) and glycated hemoglobin A 1c(HbAlc) were analyzed. 
Results There was no significant difference in the mean IDEAL-fat signal value and mean IDEAL-water signal value of lumbar bone marrow between T2DM group and non-diabetic group(P＞0.05). The BMFFIDEAL value of lumbar bone marrow in T2DM group was higher than that in non-diabetic group(P＜0.05). There was no significant difference in the BMFFIDEAL value of lumbar bone marrow between male and female group, and between normal group and overweight group in T2DM group(P＞0.05), as well as in non-diabetic group(P＞0.05). There was no significant difference in the IDEAL-fat value among L1-L5 in both T2DM group and non-diabetic group(P＞0.05). There was significant difference in the IDEAL-water value and BMFFIDEAL value among L1-L5 in both T2DM group and non-diabetic group(P＜0.05). The BMFFIDEAL value of L1 of bone marrow was lower than that of L3 in T2DM group. The IDEAL-water value of L1 was higher than that of L3， and BMFFIDEAL value of L1 was lower than that of L3and L4 in non-diabetic group(P＜0.05). The BMFFIDEAL value of lumbar bone marrow was positively correlated with age in T2DM group and non-diabetic group. The BMFFIDEAL value of lumbar bone marrow was positively correlated with HbAlc value in T2DM group(P＜0.05). 
Conclusion The BMF content of lumbar spine in T2DM patients was higher than that in non-diabetic patients, which is associated with age and HbAlc, but not related to gender and BMI.


Key words: diabetes mellitus, type 2, lumbar vertebrae, bone marrow, magnetic resonance imaging 

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