磁共振氢谱定量评价2型糖尿病合并非酒精性脂肪肝病患者心肌三酰

目的应用磁共振氢谱（¹H-MRS）对2型糖尿病（T2DM）合并非酒精性脂肪肝病（NAFLD）患者心肌三酰甘油含量进行定量评价，探讨心肌三酰甘油含量与心功能参数、血清生物化学指标等的相关性。方法纳入2017年1月至2018年8月确诊的52例T2DM患者。测定患者血清生物化学指标，并应用¹H-MRS扫描评价患者左心室功能和心肌三酰甘油相对含量。采用Dixon技术行腹部磁共振成像扫描评价肝脏脂肪含量百分比。应用Pearson相关分析探讨心肌三酰甘油含量与心功能参数、血清生物化学指标等的相关性。结果腹部Dixon技术评价显示，合并NAFLD组T2DM患者肝脏脂肪含量百分比高于未合并NAFLD组患者[（14.99±5.21）% vs （3.51±1.75）%]，差异有统计学意义（t=－7.209，P<0.01）。¹H-MRS分析结果显示，合并NAFLD组T2DM患者的心肌三酰甘油相对含量为（1.87±0.55）%，高于未合并NAFLD组患者的（1.19±0.48）%，差异有统计学意义（t=－4.105，P<0.01）。T2DM患者心肌三酰甘油相对含量与肝脏脂肪含量百分比、室间隔厚度（IVS）、空腹血糖及左心室重构指数（LVMVR）均呈正相关（r=0.582、0.293、0.318、0.282，P=0.001、0.035、0.021、0.042）。结论 ¹H-MRS可无创定量评价T2DM合并NAFLD患者的心肌三酰甘油代谢异常，且心肌三酰甘油相对含量与肝脏脂肪含量百分比、IVS、空腹血糖及LVMVR有关。

1H-magnetic resonance spectroscopy quantitatively evaluating myocardial triglyceride content of type 2 diabetes patients with nonalcoholic fatty liver disease

Objective To quantitatively assess the myocardial triglyceride (TG) content in type 2 diabetes mellitus (T2DM) patients with non-alcoholic fatty liver disease (NAFLD) using ¹H-magnetic resonance spectroscopy (¹H-MRS), and to explore the correlation of TG content with cardiac function parameters and serum biochemical indexes. Methods Fifty-two T2DM patients diagnosed from Jan. 2017 to Aug. 2018 were enrolled. Serum biochemical parameters were measured, and left ventricular function and myocardial relative TG content were evaluated by ¹H-MRS. Dixon technique was used to perform abdominal magnetic resonance imaging to evaluate the percentage of liver lipid content. Pearson correlation analysis was used to investigate the correlation between myocardial relative TG content and cardiac function parameters and serum biochemical indicators. Results The abdominal Dixon technique showed that the percentage of liver lipid content of the T2DM patients with NAFLD was higher than that of the patients without NAFLD ([14.99±5.21]% vs[3.51±1.75]%), and the difference was significant (t=-7.209, P<0.01). ¹H-MRS showed that the myocardial relative TG content was higher in the T2DM patients with NAFLD than that in the patients without NAFLD ([1.87±0.55]% vs[1.19±0.48]%), and the difference was significant (t=-4.105, P<0.01). The myocardial relative TG content of the T2DM patients was significantly positively correlated to the percentage of liver lipid content, interventricular septal thickness (IVS), fasting blood-glucose and left ventricular mass to end-diastolic volume ratio (LVMVR; r=0.582, 0.293, 0.318, and 0.282; P=0.001, 0.035, 0.021, and 0.042). Conclusion ¹H-MRS is a non-invasive quantitative evaluation method for the abnormal metabolism of myocardial TG in the T2DM patients with NAFLD. The myocardial relative TG content of the T2DM patients with NAFLD is related to the percentage of liver lipid content, IVS, fasting blood glucose and LVMVR.