非酒精性脂肪性肝病患者肝脏脂肪含量与铁含量的相关性

Correlation between Liver Fat Content and Iron Content in Patients with Non Alcoholic Fatty Liver Disease

摘要: 目的：磁共振mDIXON-Quant技术定量评估非酒精性脂肪肝病(non alcoholic fatty liver disease, NAFLD)患者肝脏脂肪含量与铁含量的相关性。方法：选取2021年3月至2022年9月在华北理工大学附属医院就诊经超声或CT检查诊断为脂肪肝并且无过量饮酒史的患者48例，作为非酒精性脂肪肝组；另外选取同时期健康体检者54名，作为对照组。所有受试者均进行上腹部mDIXON-Quant检查，由2名放射科医生(测量数据前均进行过培训)采用双盲法通过Philips ISP (Intellispace Portal)工作站对脂肪分数(Fat faction, FF)图、R2*图进行数据的测量。应用SPSS21.0软件对所有数据进行统计学分析。结果：两名医师所测得的数据可信度及一致性均良好(组内相关系数及alpha系数均 > 0.9)。脂肪肝组与正常对照组间年龄及性别无统计学差异(P > 0.05)。脂肪肝组体质量指数(Body mass index, BMI)、肝脏FF值、肝脏R2*值均高于正常对照组，差异具有统计学意义(P < 0.001)。Logistic回归分析显示肝脏R2*值(OR = 1.198, 95% CI = 1.071~1.339, P < 0.05)、BMI (OR = 1.955, 95% CI = 1.422~2.687, P < 0.05)是NAFLD的独立危险因素，随着肝脏R2*值及BMI值的增加，脂肪肝的风险增加。本组48例NAFLD患者肝脏脂肪分数与肝脏铁含量存在低度正相关性(rs = 0.307, P < 0.05)。结论：mDIXON-Quant可用于评估NAFLD患者肝脏铁含量，且可信度及一致性高。NAFLD患者肝脏铁含量高于正常人，且其肝脏脂肪含量与肝脏铁含量呈低度正相关。R2*值及BMI是NAFLD独立危险因素。

Abstract: Objective: Quantitative evaluation of the correlation between liver fat content and iron content in patients with non alcoholic fatty liver disease (NAFLD) by magnetic resonance mDIXON-Quant tech-nique. Methods: Forty-eight patients who were diagnosed with fatty liver by ultrasound or CT ex-amination and had no history of excessive drinking at the Affiliated Hospital of North China Univer-sity of Technology from March 2021 to September 2022 were selected as non alcoholic fatty liver group; an additional 54 healthy volunteers from the same period were selected as the control group. All subjects underwent an upper abdomen mDIXON-Quant examination and data were measured by two radiologists (who were trained before measuring the data) with double blind method via Philips ISP (Intellispace Portal) workstation for fat fraction mapping and R2* mapping. Data were analyzed by SPSS21.0. Results: The data obtained by the two radiologists were consistent and relia-ble (intra-class correlation coefficient and alpha coefficient > 0.9). There was no significant differ-ence in age and gender between the two groups (P > 0.05). The differences in body mass index (BMI), liver FF and liver R2* values between the two groups were statistically significant (P < 0.001). Logistic regression analysis showed that liver R2* values (OR = 1.198, 95% CI = 1.071~1.339, P < 0.05), BMI (OR = 1.955, 95% CI = 1.422~2.2687, P < 0.05) were independent risk factors for NAFLD, and the risk of fatty liver increased with increasing liver R2* value and BMI. There was a low posi-tive correlation between liver fat fraction and liver iron content in our group of 48 patients with NAFLD (rs = 0.307, P < 0.05). Conclusions: The mDIXON-Quant can be used to assess liver iron con-tent in non alcoholic fatty liver with high reliability and consistency. Patients with NAFLD had high-er liver iron levels than normal and their liver fat content had a low positive correlation with liver iron content. R2* values and BMI were independent risk factors for NAFLD.