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• Clinical Article •
Quantitative assessment of skeletal muscle fat content in type 2 diabetic patients by magnetic resonance multi-echo DIXON technique
YU Qingling  ZHOU Beibei  ZHANG Xinru  QIU Qianyi  YANG Yi  ZHANG Xiaodong 

Cite this article as: YU Q L, ZHOU B B, ZHANG X R, et al. Quantitative assessment of skeletal muscle fat content in type 2 diabetic patients by magnetic resonance multi-echo DIXON technique[J]. Chin J Magn Reson Imaging, 2024, 15(1): 145-151. DOI:10.12015/issn.1674-8034.2024.01.023.


[Abstract] Objective Using the magnetic resonance multi-echo DIXON (mDIXON) technique analyze the differences between thigh muscle and paravertebral muscle fat content between patients with type 2 diabetes mellitus (T2DM) and healthy controls and explore the relationship of each skeletal muscle fat content with duration, triglyceride glucose (TyG) index, and other indicators.Materials and methods The study prospectively enrolled 42 clinically diagnosed T2DM patients and 44 age, gender, and recruitment-matched healthy volunteers as the control group. All subjects underwent thigh and abdomen mDIXON sequence scanning. An independent-sample t-test was employed to compare the fat fraction (FF) values of each muscle group between the two groups. Multivariate linear regression and logistic regression analyses were conducted to assess the correlation between FF values, duration of diabetes, and TyG index.Results The FF values of all thigh muscle groups in the T2DM group were higher than those in the control group, and the FF value of the quadratus lumborum was significantly higher than that in the healthy control group (t=3.402, P<0.001). There was no significant difference in the FF value of the other paravertebral muscles between the two groups (P>0.05). The thigh muscle FF values of females in the T2DM group were significantly higher than those of males (P<0.001). The FF values of vastus lateralis, vastus medialis, and rectus femoris in the T2DM group were positively correlated with the course of the disease (r=0.057, 0.073, 0.125, P<0.001). Increased FF values of erector spinae and vastus lateralis are a risk factor for a high TyG index (OR=1.934, P<0.001; OR=2.516, P<0.001).Conclusions The mDIXON sequence has a good ability to evaluate skeletal muscle fat content. Skeletal muscle fat content is higher in patients with T2DM than in healthy people. Combined with the course of the disease and TyG index, further analysis of the changes in skeletal muscle fat content in T2DM patients is helpful to guide the clinical diagnosis and treatment of T2DM patients.
[Keywords] type 2 diabetes mellitus；skeletal muscle；fat quantification；magnetic resonance imaging

YU Qingling1   ZHOU Beibei1, 2   ZHANG Xinru1   QIU Qianyi1   YANG Yi1   ZHANG Xiaodong1*  

1 Department of Medical Imaging, the Third Affiliated Hospital of Southern Medical University (Academy of Orthopedics Guangdong Province), Guangzhou 510630, China

2 Department of Imaging, the Seventh Affiliated Hospital of Sun Yat-Sen University, Shenzhen 517108, China

Corresponding author: ZHANG X D, E-mail: ddautumn@126.com

Conflicts of interest   None.

Received  2023-04-27
Accepted  2024-01-04
DOI: 10.12015/issn.1674-8034.2024.01.023
Cite this article as: YU Q L, ZHOU B B, ZHANG X R, et al. Quantitative assessment of skeletal muscle fat content in type 2 diabetic patients by magnetic resonance multi-echo DIXON technique[J]. Chin J Magn Reson Imaging, 2024, 15(1): 145-151. DOI:10.12015/issn.1674-8034.2024.01.023.

[1]
CHO Y, PARK H S, HUH B W, et al. Prevalence and risk of diabetic complications in young-onset versus late-onset type 2 diabetes mellitus[J/OL]. Diabetes Metab, 2022, 48(6): 101389 [2023-05-01]. https://pubmed.ncbi.nlm.nih.gov/36255061/. DOI: 10.1016/j.diabet.2022.101389.
[2]
YANG T, LIU Y J, LI L, et al. Correlation between the triglyceride-to-high-density lipoprotein cholesterol ratio and other unconventional lipid parameters with the risk of prediabetes and Type 2 diabetes in patients with coronary heart disease: a RCSCD-TCM study in China[J/OL]. Cardiovasc Diabetol, 2022, 21(1): 93 [2023-05-01]. https://pubmed.ncbi.nlm.nih.gov/35659300/. DOI: 10.1186/s12933-022-01531-7.
[3]
BRØNS C, GRUNNET L G. MECHANISMS IN ENDOCRINOLOGY: skeletal muscle lipotoxicity in insulin resistance and type 2 diabetes: a causal mechanism or an innocent bystander?[J]. Eur J Endocrinol, 2017, 176(2): R67-R78. DOI: 10.1530/EJE-16-0488.
[4]
D'SOUZA K, MERCER A, MAWHINNEY H, et al. Whey peptides stimulate differentiation and lipid metabolism in adipocytes and ameliorate lipotoxicity-induced insulin resistance in muscle cells[J/OL]. Nutrients, 2020, 12(2): 425 [2023-05-01]. https://pubmed.ncbi.nlm.nih.gov/32041341/. DOI: 10.3390/nu12020425.
[5]
YU F Y, FAN Y P, SUN H, et al. Intermuscular adipose tissue in Type 2 diabetes mellitus: Non-invasive quantitative imaging and clinical implications[J/OL]. Diabetes Res Clin Pract, 2022, 187: 109881 [2023-05-01]. https://pubmed.ncbi.nlm.nih.gov/35483545/. DOI: 10.1016/j.diabres.2022.109881.
[6]
DIECKMEYER M, INHUBER S, SCHLÄGER S, et al. Association of thigh muscle strength with texture features based on proton density fat fraction maps derived from chemical shift encoding-based water-fat MRI[J/OL]. Diagnostics, 2021, 11(2): 302 [2023-05-01]. https://pubmed.ncbi.nlm.nih.gov/33668624/. DOI: 10.3390/diagnostics11020302.
[7]
FORBES S C, WALTER G A, ROONEY W D, et al. Skeletal muscles of ambulant children with Duchenne muscular dystrophy: validation of multicenter study of evaluation with MR imaging and MR spectroscopy[J]. Radiology, 2013, 269(1): 198-207. DOI: 10.1148/radiol.13121948.
[8]
LI J F, WANG Y J, ZHANG X S, et al. Associations of muscle size and fatty infiltration with bone mineral density of the proximal femur bone[J/OL]. Front Endocrinol, 2022, 13: 990487 [2023-05-01]. https://pubmed.ncbi.nlm.nih.gov/36237187/. DOI: 10.3389/fendo.2022.990487.
[9]
YU F Y, HE B, CHEN L, et al. Intermuscular fat content in young Chinese men with newly diagnosed type 2 diabetes: based on MR mDIXON-quant quantitative technique[J/OL]. Front Endocrinol, 2021, 12: 536018 [2023-05-01]. https://pubmed.ncbi.nlm.nih.gov/33868161/. DOI: 10.3389/fendo.2021.536018.
[10]
RUJIRACHUN P, WATTANACHAYAKUL P, PHICHITNITIKORN P, et al. Association of premature ventricular complexes and risk of ischemic stroke: a systematic review and meta-analysis[J]. Clin Cardiol, 2021, 44(2): 151-159. DOI: 10.1002/clc.23531.
[11]
JIAO Y, SU Y K, SHEN J, et al. Evaluation of the long-term prognostic ability of triglyceride-glucose index for elderly acute coronary syndrome patients: a cohort study[J/OL]. Cardiovasc Diabetol, 2022, 21(1): 3 [2023-05-01]. https://pubmed.ncbi.nlm.nih.gov/34991602/. DOI: 10.1186/s12933-021-01443-y.
[12]
ZHANG Q, WANG Z J, ZHOU Y R, et al. Expert interpretation of 2022 edition of clinical guidelines for the prevention and treatment of type 2 diabetes in the elderly in China[J]. Chin J Difficult Complicat Cases, 2022, 21(5): 445-449. DOI: 10.3969/j.issn.1671-6450.2022.05.001.
[13]
MASSIMINO E, IZZO A, RICCARDI G, et al. The impact of glucose-lowering drugs on sarcopenia in type 2 diabetes: current evidence and underlying mechanisms[J/OL]. Cells, 2021, 10(8): 1958 [2023-05-01]. https://pubmed.ncbi.nlm.nih.gov/34440727/. DOI: 10.3390/cells10081958.
[14]
OTSUKA Y, YAMADA Y, MAEDA A, et al. Effects of resistance training intensity on muscle quantity/quality in middle-aged and older people: a randomized controlled trial[J]. J Cachexia Sarcopenia Muscle, 2022, 13(2): 894-908. DOI: 10.1002/jcsm.12941.
[15]
KIEFER L S, FABIAN J, ROSPLESZCZ S, et al. Assessment of the degree of abdominal myosteatosis by magnetic resonance imaging in subjects with diabetes, prediabetes and healthy controls from the general population[J]. Eur J Radiol, 2018, 105: 261-268. DOI: 10.1016/j.ejrad.2018.06.023.
[16]
GREVE T, BURIAN E, ZOFFL A, et al. Regional variation of thigh muscle fat infiltration in patients with neuromuscular diseases compared to healthy controls[J]. Quant Imaging Med Surg, 2021, 11(6): 2610-2621. DOI: 10.21037/qims-20-1098.
[17]
IKEDA K, HORIE-INOUE K, INOUE S. Functions of estrogen and estrogen receptor signaling on skeletal muscle[J/OL]. J Steroid Biochem Mol Biol, 2019, 191: 105375 [2023-05-01]. https://pubmed.ncbi.nlm.nih.gov/31067490/. DOI: 10.1016/j.jsbmb.2019.105375.
[18]
NISHIMURA A, HARASHIMA S I, HOSODA K, et al. Sex-related differences in frailty factors in older persons with type 2 diabetes: a cross-sectional study[J/OL]. Ther Adv Endocrinol Metab, 2019, 10: 2042018819833304 [2023-12-09]. https://pubmed.ncbi.nlm.nih.gov/30858966/. DOI: 10.1177/2042018819833304.
[19]
BREDELLA M A. Sex differences in body composition[J]. Adv Exp Med Biol, 2017, 1043: 9-27. DOI: 10.1007/978-3-319-70178-3_2.
[20]
DELANEY K Z, SANTOSA S. Sex differences in regional adipose tissue depots pose different threats for the development of Type 2 diabetes in males and females[J/OL]. Obes Rev, 2022, 23(3): e13393 [2023-05-01]. https://pubmed.ncbi.nlm.nih.gov/34985183/. DOI: 10.1111/obr.13393.
[21]
SHI X L, LIU W J, ZHANG L L, et al. Sex-specific associations between low muscle mass and glucose fluctuations in patients with type 2 diabetes mellitus[J/OL]. Front Endocrinol, 2022, 13: 913207 [2023-12-09]. https://pubmed.ncbi.nlm.nih.gov/35909561/. DOI: 10.3389/fendo.2022.913207.
[22]
INHUBER S, SOLLMANN N, SCHLAEGER S, et al. Associations of thigh muscle fat infiltration with isometric strength measurements based on chemical shift encoding-based water-fat magnetic resonance imaging[J/OL]. Eur Radiol Exp, 2019, 3(1): 45 [2023-05-01]. https://pubmed.ncbi.nlm.nih.gov/31748839/. DOI: 10.1186/s41747-019-0123-4.
[23]
MORI H, KURODA A, YOSHIDA S, et al. High prevalence and clinical impact of dynapenia and sarcopenia in Japanese patients with type 1 and type 2 diabetes: findings from the Impact of Diabetes Mellitus on Dynapenia study[J]. J Diabetes Investig, 2021, 12(6): 1050-1059. DOI: 10.1111/jdi.13436.
[24]
VITALE J A, MESSINA C, ALBANO D, et al. Appendicular muscle mass, thigh intermuscular fat infiltration, and risk of fall in postmenopausal osteoporotic elder women[J]. Gerontology, 2021, 67(4): 415-424. DOI: 10.1159/000513597.
[25]
LI C W, YU K, SHYH-CHANG N, et al. Pathogenesis of sarcopenia and the relationship with fat mass: descriptive review[J]. J Cachexia Sarcopenia Muscle, 2022, 13(2): 781-794. DOI: 10.1002/jcsm.12901.
[26]
WANG N J, SUN Y, ZHANG H J, et al. Total and regional fat-to-muscle mass ratio measured by bioelectrical impedance and risk of incident type 2 diabetes[J]. J Cachexia Sarcopenia Muscle, 2021, 12(6): 2154-2162. DOI: 10.1002/jcsm.12822.
[27]
NEELAND I J, TURER A T, AYERS C R, et al. Dysfunctional adiposity and the risk of prediabetes and type 2 diabetes in obese adults[J]. JAMA, 2012, 308(11): 1150-1159. DOI: 10.1001/2012.jama.11132.
[28]
OGAMA N, SAKURAI T, KAWASHIMA S, et al. Association of glucose fluctuations with sarcopenia in older adults with type 2 diabetes mellitus[J/OL]. J Clin Med, 2019, 8(3): 319 [2023-12-09]. https://pubmed.ncbi.nlm.nih.gov/30845785/. DOI: 10.3390/jcm8030319.
[29]
IZZO A, MASSIMINO E, RICCARDI G, et al. A narrative review on sarcopenia in type 2 diabetes mellitus: prevalence and associated factors[J/OL]. Nutrients, 2021, 13(1): 183 [2023-05-01]. https://pubmed.ncbi.nlm.nih.gov/33435310/. DOI: 10.3390/nu13010183.
[30]
HU W C, MA Y Q, XING D M. Association of triglyceride-glucose index and the presence of low muscle mass in type 2 diabetes patients[J]. Clin Exp Med, 2023, 23(3): 943-949. DOI: 10.1007/s10238-022-00834-z.
[31]
ZHU Q Q, ZHANG T, CHEANG I, et al. Negative association between triglyceride glucose index and BMI-adjusted skeletal muscle mass index in hypertensive adults[J/OL]. BMC Musculoskelet Disord, 2023, 24(1): 571 [2023-05-01]. https://pubmed.ncbi.nlm.nih.gov/37442968/. DOI: 10.1186/s12891-023-06700-7.
[32]
KALINKOVICH A, LIVSHITS G. Sarcopenic obesity or obese sarcopenia: a cross talk between age-associated adipose tissue and skeletal muscle inflammation as a main mechanism of the pathogenesis[J]. Ageing Res Rev, 2017, 35: 200-221. DOI: 10.1016/j.arr.2016.09.008.
[33]
CAO C, KOH H C E, VAN VLIET S, et al. Increased plasma fatty acid clearance, not fatty acid concentration, is associated with muscle insulin resistance in people with obesity[J/OL]. Metabolism, 2022, 132: 155216 [2023-12-09]. https://pubmed.ncbi.nlm.nih.gov/35577100/. DOI: 10.1016/j.metabol.2022.155216.

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