Pelvis Magnetic Resonance Imaging to Diagnose Familial Partial Lipodystrophy.

Autor:	Adiyaman SC; Division of Endocrinology and Metabolism, Department of Internal Medicine, Dokuz Eylul University School of Medicine, Izmir 35330, Turkey., Altay C; Department of Radiology, Dokuz Eylul University School of Medicine, Izmir 35330, Turkey., Kamisli BY; Department of Internal Medicine, Dokuz Eylul University School of Medicine, Izmir 35330, Turkey., Avci ER; Department of Radiology, Dokuz Eylul University School of Medicine, Izmir 35330, Turkey., Basara I; Department of Radiology, Dokuz Eylul University School of Medicine, Izmir 35330, Turkey., Simsir IY; Division of Endocrinology, Department of Internal Medicine, Ege University School of Medicine, Izmir 35030, Turkey., Atik T; Department of Pediatric Genetics, Ege University School of Medicine, Izmir 35030, Turkey., Secil M; Department of Radiology, Dokuz Eylul University School of Medicine, Izmir 35330, Turkey., Oral EA; Division of Metabolism, Endocrinology and Diabetes, Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48105, USA., Akinci B; Depark, Dokuz Eylul University, Izmir 35330, Turkey.
Jazyk:	angličtina
Zdroj:	The Journal of clinical endocrinology and metabolism [J Clin Endocrinol Metab] 2023 Jul 14; Vol. 108 (8), pp. e512-e520.
DOI:	10.1210/clinem/dgad063
Abstrakt:	Context: The diagnosis of familial partial lipodystrophy (FPLD) is currently made based on clinical judgment. Objective: There is a need for objective diagnostic tools that can diagnose FPLD accurately. Methods: We have developed a new method that uses measurements from pelvic magnetic resonance imaging (MRI) at the pubis level. We evaluated measurements from a lipodystrophy cohort (n = 59; median age [25th-75th percentiles]: 32 [24-44]; 48 females and 11 males) and age- and sex-matched controls (n = 29). Another dataset included MRIs from 289 consecutive patients. Results: Receiver operating characteristic curve analysis revealed a potential cut-point of ≤13 mm gluteal fat thickness for the diagnosis of FPLD. A combination of gluteal fat thickness ≤13 mm and pubic/gluteal fat ratio ≥2.5 (based on a receiver operating characteristic curve) provided 96.67% (95% CI, 82.78-99.92) sensitivity and 91.38% (95% CI, 81.02-97.14) specificity in the overall cohort and 100.00% (95% CI, 87.23-100.00) sensitivity and 90.00% (95% CI, 76.34-97.21) specificity in females for the diagnosis of FPLD. When this approach was tested in a larger dataset of random patients, FPLD was differentiated from subjects without lipodystrophy with 96.67% (95% CI, 82.78-99.92) sensitivity and 100.00% (95% CI, 98.73-100.00) specificity. When only women were analyzed, the sensitivity and the specificity was 100.00% (95% CI, 87.23-100.00 and 97.95-100.00, respectively). The performance of gluteal fat thickness and pubic/gluteal fat thickness ratio was comparable to readouts performed by radiologists with expertise in lipodystrophy. Conclusion: The combined use of gluteal fat thickness and pubic/gluteal fat ratio from pelvic MRI is a promising method to diagnose FPLD that can reliably identify FPLD in women. Our findings need to be tested in larger populations and prospectively. (© The Author(s) 2023. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Databáze:	MEDLINE
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