Research on the Relationship Between Ectopic Fat and Iron Deposition in the Liver and Pancreas, with Glucose Metabolism in Elderly Obese Patients.

IF 3 3区医学 Q3 ENDOCRINOLOGY & METABOLISM

Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy Pub Date : 2025-07-14 eCollection Date: 2025-01-01 DOI:10.2147/DMSO.S518292

Hao Nie, Min Liu, Junhong Duan, Hong Liu

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Abstract

Purpose: This study investigates the clinical significance of ectopic fat and iron deposition in the liver and pancreas for glucose metabolism in elderly obese patients, with a focus on their potential for early diabetes screening and intervention.

Methods: We conducted a cross-sectional study of 140 elderly obese patients (aged 65-80 years, BMI ≥28 kg/m²) who underwent MRI quantification of hepatic and pancreatic fat (MRI-PDFF) and iron content (R2* values), along with measurements of visceral and subcutaneous fat via T2-weighted imaging. Glucose metabolism was assessed through oral glucose tolerance testing and related biomarkers.

Results: Compared to normal glucose tolerance (NGT) and impaired glucose regulation (IGR) groups, elderly obese patients with type 2 diabetes mellitus (T2DM) showed significantly higher ectopic fat in the liver (16.6% vs 6.9-13.4%) and pancreas (13.5% vs 8.5-9.0%), as well as increased visceral fat area (198.0cm² vs 137.8-163.9cm²). Liver fat percentage >11.8% was identified as an independent risk factor for abnormal glucose metabolism (OR=2.05, 95% CI 1.22-3.14), with a 2.05-fold increased risk compared to lower levels. The optimal diagnostic thresholds were determined as 11.8% for liver fat (sensitivity 83.2%, specificity 56.1%; AUC = 0.823) and 6.9% for pancreatic fat (sensitivity 72.2%, specificity 50.2%; AUC = 0.688), highlighting their clinical utility for early risk stratification.

Conclusion: Ectopic fat deposition in the liver, particularly when exceeding 11.8%, is a significant independent risk factor for glucose metabolism abnormalities in elderly obese patients. Our findings demonstrate that MRI-based quantification of hepatic fat provides a valuable tool for early identification of diabetes risk, enabling targeted interventions to prevent disease progression. This study highlights the clinical importance of monitoring ectopic fat deposition in clinical practice for elderly obese populations.

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老年肥胖患者异位脂肪、肝胰铁沉积与糖代谢关系的研究。

目的：探讨肝胰腺异位脂肪和铁沉积对老年肥胖患者糖代谢的临床意义，并探讨其在早期糖尿病筛查和干预中的潜力。方法：我们对140例老年肥胖患者（65-80岁，BMI≥28 kg/m²）进行了横断面研究，他们接受了肝脏和胰腺脂肪（MRI- pdff）和铁含量（R2*值）的MRI量化，并通过t2加权成像测量了内脏和皮下脂肪。通过口服葡萄糖耐量试验和相关生物标志物评估葡萄糖代谢。结果：与糖耐量正常组（NGT）和糖调节功能受损组（IGR）相比，老年肥胖2型糖尿病（T2DM）患者肝脏（16.6% vs 6.9-13.4%）和胰腺（13.5% vs 8.5-9.0%）的异位脂肪明显增加，内脏脂肪面积增加（198.0cm²vs 137.8-163.9cm²）。肝脏脂肪百分比>11.8%被确定为糖代谢异常的独立危险因素（OR=2.05, 95% CI 1.22-3.14），与较低水平相比，风险增加2.05倍。肝脏脂肪的最佳诊断阈值为11.8%(敏感性83.2%，特异性56.1%；AUC = 0.823)，胰腺脂肪为6.9%(敏感性72.2%，特异性50.2%；AUC = 0.688)，突出了它们在早期风险分层中的临床应用。结论：肝脏异位脂肪沉积，特别是超过11.8%，是老年肥胖患者糖代谢异常的重要独立危险因素。我们的研究结果表明，基于mri的肝脂肪量化为早期识别糖尿病风险提供了有价值的工具，使有针对性的干预措施能够预防疾病进展。本研究强调了监测异位脂肪沉积在老年肥胖人群临床实践中的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy Pharmacology, Toxicology and Pharmaceutics-Pharmacology

CiteScore

5.90

自引率

6.10%

发文量

431

审稿时长

16 weeks

期刊介绍： An international, peer-reviewed, open access, online journal. The journal is committed to the rapid publication of the latest laboratory and clinical findings in the fields of diabetes, metabolic syndrome and obesity research. Original research, review, case reports, hypothesis formation, expert opinion and commentaries are all considered for publication.