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• Clinical Article •
Quantitative measurement of renal fat in patients with type 2 diabetes mellitus: Comparison between Dixon and HISTO MRS techniques
LI Yi  XIE Lianghua  LIU Liu  ZHAO Xiaofang  YANG Ping  TANG Huali  MAO Yun 

LI Y, XIE L H, LIU L, et al. Quantitative measurement of renal fat in patients with type 2 diabetes mellitus: Comparison between Dixon and HISTO MRS techniques[J]. Chin J Magn Reson Imaging, 2023, 14(9): 86-91. DOI:10.12015/issn.1674-8034.2023.09.015.


[Abstract] Objective To compare the concordance of renal fat quantification measures based on the six-echo water-fat separation (Dixon) and high-speed T2-corrected multiecho magnetic resonance spectroscopic (HISTO MRS) techniques, and to investigate their predictive ability for renal function impairment. Provide a basis for determining the extent of renal lipotoxicity in patients with type 2 diabetes mellitus (T2DM) and for monitoring treatment efficacy.Materials and Methods This prospective study enrolled 172 patients with T2DM and 55 healthy subjects. Renal proton density fat fraction (PDFF) was obtained through abdominal 3 T MRI using Dixon and HISTO MRS techniques, recorded as D-PDFF and H-PDFF. The intraclass correlation coefficient was used to evaluate the consistency between the two techniques within the same group. The subjects were divided into healthy subjects, normal renal function group in T2DM patients (N-T2DM), mild to moderate renal function impairment group in T2DM patients (M-T2DM), and severe renal function impairment group in T2DM patients (S-T2DM) based on the presence or absence of T2DM and estimated glomerular filtration rate (eGFR), and inter-group differences were compared. Pearson correlation and multiple linear regression analyses were performed to investigate whether D-PDFF and H-PDFF are independent risk factors for decreased eGFR.Results The interclass correlation coefficient was 0.185 for D-PDFF and H-PDFF. After adjusting for confounding factors, the difference in D-PDFF between healthy participants and T2DM patients was statistically significant (P＜0.001), while the difference in H-PDFF was not statistically significant (P＞0.05). After adjustment, the differences in D-PDFF between the healthy participant group and the N-T2DM group, the healthy participant group and the M-T2DM group, and the N-T2DM group and the M-T2DM group were all statistically significant (all P≤0.001). The differences in H-PDFF among the groups were not statistically significant (all P＞0.05). D-PDFF was independently and negatively associated with increased eGFR (β=-0.168, P=0.016) after correction for confounders and was identified as an independent risk factor for renal impairment. H-PDFF values did not correlate with eGFR (β=-0.008, P=0.918).Conclusions The two magnetic resonance fat quantification techniques are poorly concordant in the kidney. Dixon-based PDFF is more responsive to increased renal ectopic fat accumulation (RELA) and renal function impairment in patients with T2DM than HISTO MRS-based PDFF. Therefore, Dixon-based PDFF may be a more suitable method for monitoring RELA in patients with T2DM.
[Keywords] diabetes mellitus, type 2；diabetic nephropathies；lipid accumulation；renal lipotoxicity；renal function；quantitative measurement of fat；magnetic resonance imaging

LI Yi   XIE Lianghua   LIU Liu   ZHAO Xiaofang   YANG Ping   TANG Huali   MAO Yun*  

Department of Radiology, the First Hospital of Chongqing Medical University, Chongqing 404100, China

Corresponding author: Mao Y, E-mail: maoyun1979@163.com

Conflicts of interest   None.

Received  2023-04-11
Accepted  2023-08-09
DOI: 10.12015/issn.1674-8034.2023.09.015
LI Y, XIE L H, LIU L, et al. Quantitative measurement of renal fat in patients with type 2 diabetes mellitus: Comparison between Dixon and HISTO MRS techniques[J]. Chin J Magn Reson Imaging, 2023, 14(9): 86-91. DOI:10.12015/issn.1674-8034.2023.09.015.

[1]
DE VRIES A P, RUGGENENTI P, RUAN X Z, et al. Fatty kidney: emerging role of ectopic lipid in obesity-related renal disease[J]. Lancet Diabetes Endocrinol, 2014, 2(5): 417-426. DOI: 10.1016/S2213-8587(14)70065-8.
[2]
XU T T, XU X Y, ZHANG L, et al. Lipidomics reveals serum specific lipid alterations in diabetic nephropathy[J/OL]. Front Endocrinol, 2021, 12: 781417 [2023-07-06]. https://www.frontiersin.org/articles/10.3389/fendo.2021.781417/full. DOI: 10.3389/fendo.2021.781417.
[3]
WEINBERG J M. Lipotoxicity[J]. Kidney Int, 2006, 70(9): 1560-1566. DOI: 10.1038/sj.ki.5001834.
[4]
NAWAZ S, CHINNADURAI R, AL-CHALABI S, et al. Obesity and chronic kidney disease: a current review[J]. Obes Sci Pract, 2023, 9(2): 61-74. DOI: 10.1002/osp4.629.
[5]
CASTRO B B A, FORESTO-NETO O, SARAIVA-CAMARA N O, et al. Renal lipotoxicity: insights from experimental models[J]. Clin Exp Pharmacol Physiol, 2021, 48(12): 1579-1588. DOI: 10.1111/1440-1681.13556.
[6]
KAWANAMI D, MATOBA K, UTSUNOMIYA K. Dyslipidemia in diabetic nephropathy[J/OL]. Ren Replace Ther, 2016, 2(1): 1-9 [2023-07-06]. https://rrtjournal.biomedcentral.com/articles/10.1186/s41100-016-0028-0#citeas. DOI: 10.1186/s41100-016-0028-0.
[7]
OPAZO-RÍOS L, MAS S, MARÍN-ROYO G, et al. Lipotoxicity and diabetic nephropathy: novel mechanistic insights and therapeutic opportunities[J/OL]. Int J Mol Sci, 2020, 21(7): 2632 [2023-07-06]. https://www.mdpi.com/1422-0067/21/7/2632. DOI: 10.3390/ijms21072632.
[8]
ZHANG Y, YAO H J, LI C, et al. Gandi capsule improved podocyte lipid metabolism of diabetic nephropathy mice through SIRT1/AMPK/HNF4A pathway[J/OL]. Oxid Med Cell Longev, 2022, 2022: 6275505 [2023-07-06]. https://www.hindawi.com/journals/omcl/2022/6275505/. DOI: 10.1155/2022/6275505.
[9]
KIM Y, LIM J H, KIM M Y, et al. The adiponectin receptor agonist AdipoRon ameliorates diabetic nephropathy in a model of type 2 diabetes[J]. J Am Soc Nephrol, 2018, 29(4): 1108-1127. DOI: 10.1681/ASN.2017060627.
[10]
KIM D H, PARK J S, CHOI H I, et al. The role of the farnesoid X receptor in kidney health and disease: a potential therapeutic target in kidney diseases[J]. Exp Mol Med, 2023, 55(2): 304-312. DOI: 10.1038/s12276-023-00932-2.
[11]
POGGIO E D, MCCLELLAND R L, BLANK K N, et al. Systematic review and meta-analysis of native kidney biopsy complications[J]. Clin J Am Soc Nephrol, 2020, 15(11): 1595-1602. DOI: 10.2215/CJN.04710420.
[12]
YOKOO T, CLARK H R, PEDROSA I, et al. Quantification of renal steatosis in type Ⅱ diabetes mellitus using dixon-based MRI[J]. J Magn Reson Imaging, 2016, 44(5): 1312-1319. DOI: 10.1002/jmri.25252.
[13]
JONKER J T, HEER P D, ENGELSE M A, et al. Metabolic imaging of fatty kidney in diabesity: validation and dietary intervention[J]. Nephrol Dial Transplant, 2018, 33(2): 224-230. DOI: 10.1093/ndt/gfx243.
[14]
WANG Y C, FENG Y L, LU C Q, et al. Renal fat fraction and diffusion tensor imaging in patients with early-stage diabetic nephropathy[J]. Eur Radiol, 2018, 28(8): 3326-3334. DOI: 10.1007/s00330-017-5298-6.
[15]
YU H Z, SHIMAKAWA A, MCKENZIE C A, et al. Multiecho water-fat separation and simultaneous R2* estimation with multifrequency fat spectrum modeling[J]. Magn Reson Med, 2008, 60(5): 1122-1134. DOI: 10.1002/mrm.21737.
[16]
YOO Y H, KIM H S, LEE Y H, et al. Comparison of multi-echo Dixon methods with volume interpolated breath-hold gradient echo magnetic resonance imaging in fat-signal fraction quantification of paravertebral muscle[J]. Korean J Radiol, 2015, 16(5): 1086-1095. DOI: 10.3348/kjr.2015.16.5.1086.
[17]
KIM D, KIM S K, LEE S J, et al. Simultaneous estimation of the fat fraction and R2(*) Via T2(*)-corrected 6-echo Dixon volumetric interpolated breath-hold examination imaging for osteopenia and osteoporosis detection: correlations with sex, age, and menopause[J]. Korean J Radiol, 2019, 20(6): 916-930. DOI: 10.3348/kjr.2018.0032.
[18]
PINEDA N, SHARMA P, XU Q, et al. Measurement of hepatic lipid: high-speed T2-corrected multiecho acquisition at 1H MR spectroscopy: a rapid and accurate technique[J]. Radiology, 2009, 252(2): 568-576. DOI: 10.1148/radiol.2523082084.
[19]
YING J, LIU D, YANG Q, et al. 3.0 T MRI double-echo hydro-lipid separation Dixon technique for quantitative determination of liver fat in patients with nonalcoholic fatty liver disease[J]. Chin J Magn Reson Imag, 2020, 11(7): 577-580. DOI: 10.12015/issn.1674-8034.2020.07.020.
[20]
ZHANG X X, ZHANG H, NAN J, et al. Muscle fat measurement by magnetic resonance technology: the progresses in muscle disease[J]. Chin J Magn Reson Imag, 2019, 10(6): 474-478. DOI: 10.12015/issn.1674-8034.2019.06.017.
[21]
GRIMM A, MEYER H, NICKEL M D, et al. Repeatability of Dixon magnetic resonance imaging and magnetic resonance spectroscopy for quantitative muscle fat assessments in the thigh[J]. J Cachexia Sarcopenia Muscle, 2018, 9(6): 1093-1100. DOI: 10.1002/jcsm.12343.
[22]
GASSENMAIER S, KÄHM K, WALTER S S, et al. Quantification of liver and muscular fat using contrast-enhanced Dual Source Dual Energy Computed Tomography compared to an established multi-echo Dixon MRI sequence[J/OL]. Eur J Radiol, 2021, 142: 109845 [2023-07-06]. https://www.ejradiology.com/article/S0720-048X(21)00326-0/fulltext. DOI: 10.1016/j.ejrad.2021.109845.
[23]
ZHAO F Y, CHEN Y D, ZHANG H T, et al. Multi-echo Dixon and breath-hold T2-corrected multi-echo single-voxel MRS for quantifying hepatic iron overload in rabbits[J]. Acta Radiol, 2023, 64(1): 13-19. DOI: 10.1177/02841851211063007.
[24]
STEVENS P E, LEVIN A, Improving Global Outcomes Chronic Kidney Disease Guideline Development Work Group Members of the Kidney Disease. Evaluation and management of chronic kidney disease: synopsis of the kidney disease: improving global outcomes 2012 clinical practice guideline[J]. Ann Intern Med, 2013, 158(11): 825-830. DOI: 10.7326/0003-4819-158-11-201306040-00007.
[25]
KOO T K, LI M Y. A guideline of selecting and reporting intraclass correlation coefficients for reliability research[J]. J Chiropr Med, 2016, 15(2): 155-163. DOI: 10.1016/j.jcm.2016.02.012.
[26]
SHEN Y, XIE L H, CHEN X J, et al. Renal fat fraction is significantly associated with the risk of chronic kidney disease in patients with type 2 diabetes[J/OL]. Front Endocrinol, 2022, 13: 995028 [2023-07-06]. https://www.frontiersin.org/articles/10.3389/fendo.2022.995028/full. DOI: 10.3389/fendo.2022.995028.
[27]
YU Y S, LAI C, QIN F J, et al. Quantitative magnetic resonance imaging study of renal lipid accumulation in children with obesity[J]. J Clin Radiol, 2022, 41(8): 1530-1534. DOI: 10.13437/j.cnki.jcr.2022.08.018.
[28]
ZHAO Y Z, GAN Y G, ZHOU J L, et al. Accuracy of multi-echo Dixon sequence in quantification of hepatic steatosis in Chinese children and adolescents[J]. World J Gastroenterol, 2019, 25(12): 1513-1523. DOI: 10.3748/wjg.v25.i12.1513.
[29]
ZHAN C Y, OLSEN S, ZHANG H C, et al. Detection of hepatic steatosis and iron content at 3 Tesla: comparison of two-point Dixon, quantitative multi-echo Dixon, and MR spectroscopy[J]. Abdom Radiol, 2019, 44(9): 3040-3048. DOI: 10.1007/s00261-019-02118-9.
[30]
KUKUK G M, HITTATIYA K, SPRINKART A M, et al. Comparison between modified Dixon MRI techniques, MR spectroscopic relaxometry, and different histologic quantification methods in the assessment of hepatic steatosis[J]. Eur Radiol, 2015, 25(10): 2869-2879. DOI: 10.1007/s00330-015-3703-6.
[31]
YURDAISIK I, NURILI F. Accuracy of multi-echo Dixon sequence in quantification of hepatic steatosis[J/OL]. Cureus, 2020, 12(2): e7103 [2023-07-06]. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7098411/. DOI: 10.7759/cureus.7103.
[32]
BAE J S, LEE D H, SUH K S, et al. Noninvasive assessment of hepatic steatosis using a pathologic reference standard: comparison of CT, MRI, and US-based techniques[J]. Ultrasonography, 2022, 41(2): 344-354. DOI: 10.14366/usg.21150.
[33]
MOLINA D K, DIMAIO V J M. Normal organ weights in women: part Ⅱ-the brain, lungs, liver, spleen, and kidneys[J]. Am J Forensic Med Pathol, 2015, 36(3): 182-187. DOI: 10.1097/PAF.0000000000000175.
[34]
MOLINA D K, DIMAIO V J M. Normal organ weights in men: part Ⅱ-the brain, lungs, liver, spleen, and kidneys[J]. Am J Forensic Med Pathol, 2012, 33(4): 368-372. DOI: 10.1097/PAF.0b013e31823d29ad.
[35]
BOBULESCU I A. Renal lipid metabolism and lipotoxicity[J]. Curr Opin Nephrol Hypertens, 2010, 19(4): 393-402. DOI: 10.1097/MNH.0b013e32833aa4ac.

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