目的·探讨单纯性肥胖症男性患者中大腿骨骼肌肌内脂肪组织（intramuscular adipose tissue，IMAT）含量与糖代谢的相关性。方法·选取2019年12月—2020年12月于上海交通大学医学院附属仁济医院内分泌科肥胖专病门诊就诊的80例单纯性肥胖症男性患者，根据口服葡萄糖耐量试验（oral glucose tolerance test，OGTT）结果将其分为糖耐量正常（normal glucose tolerance，NGT）组与糖调节受损（impaired glucose regulation，IGR）组。收集并比较2组患者的一般资料及实验室检测指标。采用mDixon-Quant技术测量2组患者的大腿各骨骼肌IMAT含量，并对其骨骼肌质子密度脂肪分数（proton density fat fraction，PDFF）进行比较。通过多因素Logistic回归模型分析IGR发生的独立影响因素。结果·与NGT组相比，IGR组患者的腰围较大（P=0.017），谷丙转氨酶、谷草转氨酶、γ-谷氨酰转移酶（γ-glutamyl transferase，GGT）、三酰甘油（triacylglycerol，TAG）、血清游离脂肪酸（nonestesterified fatty acid，NEFA）水平以及缝匠肌PDFF均较高（均P<0.05）。经对年龄、体质量指数、GGT、TAG、NEFA等混杂因素进行校正后，多因素Logistic回归分析的结果显示股外侧肌PDFF、半腱肌PDFF与缝匠肌PDFF是IGR发生的危险因素（均P<0.05）。结论·单纯性肥胖症男性患者中大腿股外侧肌IMAT、半腱肌IMAT、缝匠肌IMAT的含量升高将增加IGR的发生风险。

Objective ·To investigate the correlation between intramuscular adipose tissue (IMAT) content and glucose metabolism in male patients with obesity. Methods ·Eighty male patients with obesity were recruited from the Endocrinology Department of Renji Hospital, Shanghai Jiao Tong University School of Medicine from December 2019 to December 2020. According to the results of oral glucose tolerance test (OGTT), they were divided into normal glucose tolerance (NGT) group and impaired glucose regulation (IGR) group. General data and laboratory test indicators of the two groups were collected and compared. mDixon-Quant technique was used to measure the IMAT content in each skeletal muscle of the thigh in the two groups, and the proton density fat fractions (PDFF) of skeletal muscle in the two groups were compared. The multivariate Logistic regression model was used to analyze the independent influencing factors of IGR occurrence. Results ·Compared with the NGT group, patients in the IGR group had a larger waist circumference (P=0.017), higher glutamic-pyruvic transaminase level, glutamic-oxaloacetic transaminase level, γ-glutamyl transferase (GGT) level, triacylglycerol (TAG) level, nonestesterified fatty acid (NEFA) level and sartorius PDFF (all P<0.05). After adjusting for confounding factors such as age, body mass index, GGT, TAG and NEFA, the results of multivariate Logistic regression analysis showed that PDFF of vastus lateralis, semitendinosus and sartorius were the risk factors for IGR (all P<0.05). Conclusion ·Higher levels of IMAT content in vastus lateralis, semitendinosus and sartorius will increase the risk of IGR in male patients with obesity.