mDixon-Quant定量肾周及腹部脂肪对2型糖尿病早期肾功能改变的预测价值OA

Objective To investigate the predictive value of quantitatively assessing perirenal and abdominal fat using the mDixon-Quant technique for early renal function changes in patients with type 2 diabetes mellitus(T2DM).Methods Seventy-five patients with T2DM(mean age,49.65±13.45 years)were prospectively enrolled.According to the urinary albumin creatinine ratio,patients were divided into a normal albuminuria(NAU)group(n=44)and a microalbuminuria(MAU)group(n=31).In addition,41 age-and sex-matched healthy volunteers were enrolled as a control group.All subjects underwent abdominal mDixon-Quant MRI scanning.Perirenal fat thickness(PRFT)of both kidneys,visceral fat area(VFA),and subcutaneous fat area(SFA)were measured.Independent sample t-test and Mann-Whitney U test were used for comparison between the two groups,while one-way analysis of variance,Kruskal-Wallis test,and chi-square test were used for comparison among three groups.Logistic regression analysis was applied to identify factors associated with early diabetic renal function changes.Pearson or Spearman correlation analyses were used to assess the relationships between total PRFT and clinical characteristics.Receiver operating characteristic(ROC)curve analysis was performed to evaluate the performance of total PRFT,and the area under the curve(AUC)was calculated.Results Compared with the control group,body weight,body mass index(BMI),systolic blood pressure,diastolic blood pressure,VFA,SFA,L-PRFT,R-PRFT,and total PRFT were significantly increased in both the NAU group and the MAU group(all P<0.05).Compared with the NAU group,the MAU groups showed significantly lower estimated glomerular filtration rate(eGFR)and diastolic blood pressure(both P<0.05),while the proportion of males,systolic blood pressure,serum creatinine(SCr),and urea-to-creatinine ratio(UCR)were significantly higher(all P<0.05).Multifactorial logistic regression analysis showed that diastolic blood pressure and total PRFT were independent associated with NAU status in patients with T2DM(P<0.05),and total PRFT remained an independent factor after adjusting diastolic blood pressure(P<0.05).Total PRFT was also an independent associated with MAU status in patients with T2DM(P<0.05).Body weight and BMI were positively correlated with total PRFT(r=0.642 and 0.616,respectively,both P<0.001).ROC curve analysis demonstrated that total PRFT had good predictive performance for NAU and MAU status,with AUC values of 0.822 and 0.810,respectively.Conclusions The mDixon-Quant technique enables noninvasive and quantitative assessment of perirenal and abdominal fat.Perirenal fat,in particular,shows predictive value for early renal function changes in patients with type 2 diabetes mellitus.