Key result
Type 2 diabetes was significantly associated with higher amounts of intramyocellular (β 1.56; 95% CI 0.66-2.47) and extramyocellular lipids (β 2.15; 95% CI 1.33-2.96) compared with controls.
Why the study?
To evaluate the distribution of intramyocellular and extramyocellular lipids and total abdominal skeletal muscle fat by MRI in subjects with T2D, prediabetes, and normoglycaemic controls.
Does the distribution of intramyocellular and extramyocellular fat measured by MRI differ between subjects with T2D, prediabetes, and normoglycaemic controls?
Observational (n=337)
Does the distribution of intramyocellular and extramyocellular fat measured by MRI differ between subjects with T2D, prediabetes, and normoglycaemic controls?
Effect estimate: β 1.56 (95% CI 0.66-2.47)
p-value: p=<0.001
MRI-derived patterns of intramuscular fat distribution differ significantly across glucose metabolism states, potentially serving as imaging biomarkers for metabolic impairment.
Muscle fat on MRI may aid metabolic risk stratification; leaves open causality, progression prediction, and therapeutic targeting.
AIM: To evaluate the distribution of intramyocellular lipids (IMCLs) and extramyocellular lipids (EMCLs) as well as total fat content in abdominal skeletal muscle by magnetic resonance imaging (MRI) using a dedicated segmentation algorithm in subjects with type 2 diabetes (T2D), prediabetes and normoglycaemic controls. MATERIALS AND METHODS: Subjects from a population-based cohort were classified with T2D, prediabetes or as normoglycaemic controls. Total myosteatosis, IMCLs and EMCLs were quantified by multiecho Dixon MRI as proton-density fat-fraction (in %) in abdominal skeletal muscle. RESULTS: ), 129 (38.3%) were classified with an impaired glucose metabolism (T2D: 49 [14.5%]; prediabetes: 80 [23.7%]). IMCLs were significantly higher than EMCLs in subjects without obesity (5.7% [IQR: 4.8%-7.0%] vs. 4.1% [IQR: 2.7%-5.8%], P < .001), whereas the amounts of IMCLs and EMCLs were shown to be equal and significantly higher in subjects with obesity (both 6.7%, P < .001). Subjects with prediabetes and T2D had significantly higher amounts of IMCLs and EMCLs compared with normoglycaemic controls (P < .001). In univariable analysis, prediabetes and T2D were significantly associated with both IMCLs (prediabetes: β: 0.76, 95% CI: 0.28-1.24, P = .002; T2D: β: 1.56, 95% CI: 0.66-2.47, P < .001) and EMCLs (prediabetes: β: 1.54, 95% CI: 0.56-2.51, P = .002; T2D: β: 2.15, 95% CI: 1.33-2.96, P < .001). After adjustment for age and gender, the association of IMCLs with prediabetes attenuated (P = 0.06), whereas for T2D, both IMCLs and EMCLs remained significantly and positively associated (P < .02). CONCLUSION: There are significant differences in the amount and distribution ratio of IMCLs and EMCLs between subjects with T2D, prediabetes and normoglycaemic controls. Therefore, these patterns of intramuscular fat distribution by MRI might serve as imaging biomarkers in both normal and impaired glucose metabolism.
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Kiefer et al. (2021) conducted an observational in Type 2 diabetes and prediabetes (n=337). Type 2 diabetes and prediabetes vs. Normoglycaemic controls was evaluated on Intramyocellular lipids (IMCLs) and extramyocellular lipids (EMCLs) quantified by MRI (β 1.56, 95% CI 0.66-2.47, p=<0.001). Type 2 diabetes was significantly associated with higher amounts of intramyocellular (β 1.56; 95% CI 0.66-2.47) and extramyocellular lipids (β 2.15; 95% CI 1.33-2.96) compared with controls.
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