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Quantification of ectopic fat storage in the liver and pancreas using six-point Dixon MRI and its association with insulin sensitivity and β-cell function in patients with central obesity

  • Magnetic Resonance
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Abstract

Objectives

To assess the association of ectopic fat deposition in the liver and pancreas quantified by Dixon magnetic resonance imaging (MRI) with insulin sensitivity and β-cell function in patients with central obesity.

Materials and methods

A cross-sectional study of 143 patients with central obesity with normal glucose tolerance (NGT), prediabetes (PreD), and untreated type 2 diabetes mellitus (T2DM) was conducted between December 2019 and March 2022. All participants underwent routine medical history taking, anthropometric measurements, and laboratory tests, including a standard glucose tolerance test to quantify insulin sensitivity and β-cell function. The fat content in the liver and pancreas was measured with MRI using the six-point Dixon technique.

Results

Patients with T2DM and PreD had a higher liver fat fraction (LFF) than those with NGT, while those with T2DM had a higher pancreatic fat fraction (PFF) than those with PreD and NGT. LFF was positively correlated with homeostatic model assessment of insulin resistance (HOMA-IR), while PFF was negatively correlated with homeostatic model assessment of insulin secretion (HOMA-β). Furthermore, using a structured equation model, we found LFF and PFF to be positively associated with glycosylated hemoglobin via HOMA-IR and HOMA-β, respectively.

Conclusions

In patients with central obesity, the effects of LFF and PFF on glucose metabolism.

were associated with HOMA-IR and HOMA-β, respectively. Ectopic fat storage in the liver and pancreas quantified by MR Dixon imaging potentially plays a notable role in the onset ofT2DM.

Clinical relevance statement

We highlight the potential role of ectopic fat deposition in the liver and pancreas in the development of type 2 diabetes in patients with central obesity, providing valuable insights into the pathogenesis of the disease and potential targets for intervention.

Key Points

• Ectopic fat deposition in the liver and pancreas is associated with T2DM.

• T2DM and prediabetes patients had higher liver and pancreatic fat fractions than normal individuals.

• The results provide valuable insights into pathogenesis of T2DM and potential targets for intervention.

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Abbreviations

AUC:

Area under the curve

BMI:

Body mass index

CT:

Computed tomography

DI:

Disposition index

FBG:

Fasting blood glucose

FPI:

Fasting plasma insulin

HbA1c:

Glycosylated hemoglobin 1 C

HOMA-IR:

Homeostatic model assessment of insulin resistance

HOMA-β:

Homeostatic model assessment of insulin secretion

IR:

Insulin resistance

ISIM :

Matsuda insulin sensitivity index

LFF:

Liver fat fraction

MRI:

Magnetic resonance imaging

MRS:

Magnetic resonance spectroscopy

NGT:

Normal glucose tolerance

OGTT:

Oral glucose tolerance test

PreD:

Prediabetes

PDFF:

Proton density fat fraction.

PFF:

Pancreatic fat fraction

SEM:

Structural equation modeling

SSCs:

Standardized structure coefficients

T2DM:

Type 2 diabetes mellitus

US:

Ultrasonography

WC:

Waist circumference

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Acknowledgements

We would like to thank the staff at the affiliated Wuxi People’s Hospital of Nanjing Medical University for their help.

Funding

This study has received funding from Wuxi Science and Technology Development Fund (GrantNumber:BJ2020005) and the Top Talent Support Program for young and middle-aged people of Wuxi Health Committee (Grant Number:Y20212024).

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Author notes

  1. Meng-Jiao Cao, Wen-Jun Wu and Qun-Feng Tang contributed equally.

Authors and Affiliations

  1. Department of Radiology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, No. 299 Qingyang Road, Wuxi , Jiangsu Province, 214000, China

    Meng-Jiao Cao, Jing-Wen Chen, Xiang-Ming Fang & Qun-Feng Tang

  2. Department of Endocrinology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, No. 299 Qingyang Road, Wuxi , Jiangsu Province, 214000, China

    Wen-Jun Wu, Ye Ren, Xiao-Wen Zhu & Hai-Yan Cheng

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  1. Meng-Jiao Cao
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Correspondence to Wen-Jun Wu or Qun-Feng Tang.

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The scientific guarantor of this publication is Dr. Wu Wenjun, China.

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Cao, MJ., Wu, WJ., Chen, JW. et al. Quantification of ectopic fat storage in the liver and pancreas using six-point Dixon MRI and its association with insulin sensitivity and β-cell function in patients with central obesity. Eur Radiol 33, 9213–9222 (2023). https://doi.org/10.1007/s00330-023-09856-x

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