声辐射力脉冲成像评估2型糖尿病胰岛素抵抗患者肝脏功能

目的应用声辐射力脉冲成像(ARFI)中的声触诊组织量化(VTQ)技术评估2型糖尿病(T2DM)胰岛素抵抗(IR)患者肝脏弹性的改变。方法收集62例T2DM患者,分为IR组(n=32)和非IR组(n=30);检测空腹血糖、空腹胰岛素、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、总胆固醇(TC)、甘油三酯(TG),并计算稳态模型IR指数;应用VTQ技术测定肝脏剪切波速度(SWV),分析其与IR及脂代谢相关血液指标的相关性。结果 IR组平均肝脏SWV值为(1.33±0.18)m/s,非IR组平均肝脏SWV值为(1.04±0.10)m/s,差异有统计学意义(P0.05)。随着肝脏SWV值升高,TC、TG、LDL-C升高而HDL-C降低。结论 T2DM患者肝脏SWV值与IR情况及血脂水平有密切关系;ARFI技术可用于评估T2DM IR患者的肝脏弹性及脂代谢情况。

Evaluation of hepatic elasticity in patients with type 2 diabetes mellitus and insulin resistance by acoustic radiation force impulse imaging

Objective To evaluate the elasticity change of liver in patients with type 2 diabetes mellitus (T2DM) with insulin resistance (IR) using virtual touch tissue quantification (VTQ) of acoustic radiation force impulse (ARFI). Methods Sixty-two T2DM patients were enrolled and divided into IR group (n=32)and non-IR group (n=30). Fasting blood glucose, fasting insulin, serum low-density lipoproteincholesterol (LDL-C), serum high-density lipoproteincholisterol (HDL-C), total cholesterol (TC), and triglyceride (TG) were detected, and homeostasis model assessment of insulin resistance (HOMA-IR) was calculated. Liver shear wave velocity (SWV) was measured by VTQ and its correlation with the blood values (TC, TG, LDL-C, HDL-C, HOMA-IR) was analyzed. Results The liver SWV was (1.33±0.18)m/s in IR group and (1.04±0.10)m/s in non-IR group (P<0.05). When liver SWV increased, the value of TC, TG, LDL-C also raised,while the value of HDL-C decreased. Conclusion Liver SWV is related to lipid metabolism and IR in T2DM patients. ARFI technique can be used to assess liver elasticity and lipid metabolism of T2DM patients with IR.