Correlation Between Skeletal Muscle Fat Content And Insulin Resistance In Patients With Type 2 Diabetes Mellitus Using MR DIXON-QUANT Quantitative Technique

Objective: 1.To investigate the correlation between skeletal muscle fat content and the degree of insulin resistance in patients with type 2 diabetes and healthy people.2.Analyze the correlation between magnetic resonance parameters of skeletal muscle and insulin resistance.3.Analyze the differences in skeletal muscle fat content and various parameters between healthy people and diabetics to explore the early warning indicators of skeletal muscle magnetic resonance signals in patients with diabetes.Methods: We collected 12 newly diagnosed type 2 diabetic patients who met the first endocrinology clinic of Shengjing Hospital affiliated to China Medical University from December 2017 to December 2018(in accordance with the 1999 World Health Organization(WHO)diagnostic criteria)and There were 12 volunteers living in Shenyang in the same period,a total of 24 people.The mean age was 34.33±3.98 years(experimental group),28.92±3.52 years(control group);body mass index(BMI,unit:kg/m2): 23.92±3.35(experimental group),24.78±3.27(control group).All subjects were enrolled in the Department of Clinical Laboratory of Shengjing Hospital affiliated to China Medical University,including laboratory indicators such as fasting blood glucose,fasting insulin,triglycerides and glycated hemoglobin.All subjects underwent magnetic resonance imaging of the lower extremities at 12 o'clock in the evening before the check-up at 6 o'clock in the morning.The magnetic resonance scan of the lower extremity was performed using Philips Ingenia 3.0T magnetic resonance imaging.The scan ranged from the femoral neck to the knee joint.The scan sequence included the vector.The T1 WI,T2WI,m Dixon-quant,T2 mapping and DTI sequences,in which m Dixon – quant sequence(Philips Healthcare)is a magnetic resonance scanning technique based on the principle of chemical shift-based water-fat separation technology,using Philip post-processing workstation for skeletal muscle parts Fat quantification(IMAT,SFAT,SCAT)and measurement of skeletal muscle magnetic resonance parameters(T2,ADC,FA).The independent sample T test,multiple linear regression and pearson were used to analyze the muscle fat content of each part and the magnetic resonance parameters of the thigh muscle.The ROC curve was used to explore the cutoff value and diagnostic efficacy of the above values in the diagnosis of type 2 diabetes.Results: Among the muscle components of the experimental group and the control group,only IMAT was significantly different(P<0.05),and there were significant differences in the magnetic resonance parameters between the experimental group and the control group(P<0.05).Among the partial fats,IMAT was positively correlated with T2 and FA values in HOMA-IR,Hb Alc and magnetic resonance parameters;SFAT was positively correlated with HOMA-IR.The FA value of the thigh skeletal muscle was related to all laboratory indicators of type 2 DM in this experiment.The T2 value was related to the laboratory index except TG,and the ADC value was only positively correlated with the TG value.Taking the clinical diagnosis as the gold standard,the ROC curve was prepared,and the IMAT accounted for 9.08% as the cutoff value.The diagnostic sensitivity to type 2 DM was 83.3%,the specificity was 91.7%;the SFAT ratio was3.83% as the cutoff value.The diagnostic sensitivity was 50.0%,the specificity was66.7%;the T2 value was 39.25 ms as the cutoff value,the diagnostic sensitivity was66.7%,the specificity was 91.7%;the FA value was 0.58 as the cutoff value,and its diagnostic sensitivity was 41.7%.91.8%.IMAT,SFAT,T2 and FA values The area under the ROC curve for type 2 DM was 0.917,0.656,0.840 and 0.774,respectively.Conclusion: Deposition of IMAT and SFAT in skeletal muscle is one of the important body composition determinants of insulin resistance in type 2 DM.And the proportion of more SCAT has nothing to do with insulin resistance.When the subject's skeletal muscle T2 value is greater than 39.25 ms and the IMAT is greater than 9.08%,attention should be paid to the possibility of insulin resistance in the subject.