Correlation between Liver Fat Content and Metabolic Indexes in Patients with Non-alcoholic Fatty Liver Complicated with Type 2 Diabetes
WANG Si-chao, SUN Wei-xia, CHENG Yi-ping,et al
Department of Endocrinology, Department of Ultrasonic Diagnosis and Treatment, Shandong Provincial Hospital affiliated to Shandong University,Jinan, Shandong 250021, China
Abstract：【Objective】To evaluate the application of quantitative measurement of liver fat content (LFC) in patients with nonalcoholic fatty liver disease(NAFLD)complicated with type 2 diabetes mellitus(T2DM)by ultrasound, and to explore the correlation between quantitative results and metabolic indexes.【Methods】A total of 105 patients with NAFLD complicated with T2DM were selected as the observation group, and 43 T2DM patients without fatty liver disease were enrolled as the control group. The FLC was estimated by computer assisted ultrasound. Fully automatic biochemical analyzer detected various metabolic indexes such as serum uric acid (SUA), glutamic acid transaminase (ALT), aspartate aminotransferase (AST), total cholesterol (TC), triacylglycerol (TG), high-density lipoprotein cholesterol (HDL-C), Low-density lipoprotein cholesterol (LDL-C), blood urea nitrogen (BUN), free fatty acids (FFA), glycated hemoglobin (HbA1C), fasting blood glucose (FPG), fasting insulin (FINS), urine microalbumin (ALB ) and Urine creatinine (CREA). Insulin resistance index was calculated (HOMA-IR = FPG × FINS / 22.5). The differences in metabolic indexes between the two groups were compared and the correlation between LFC and each index was analyzed.【Results】The levels of ALT, TG, LDL-C, FPG, CREA, HOMA-IR, and LFC in the observation group were higher than those in the control group, while the level of HDL-C was lower than that in the control group; the differences were statistically significant (P<0.05). Correlation analysis showed that LFC was positively correlated with ALT and TG in the observation group; and LFC was positively correlated with ALT, AST, and TG in the control group (P<0.05).【Conclusion】 As a common complication of T2DM, NAFLD is used to quantitatively determine LFC by ultrasound. It is simple, low-cost, non-invasive and convenient, and can reflect changes in related indexes such as liver function and lipids. It can be used as a routine screening method for admission and provide a basis for early detection of liver fatty changes.
[1] Cobbina E, Akhlaghi F. Non-alcoholic fatty liver disease (NAFLD) -pathogenesis, classification, and effect on drug metabolizing enzymes and transporters[J].Drug Metab Rev,2017,49(2): 197-211.
[2] Ahn JM, Paik YH, Min SY,et al.Relationship between controlled attenuation parameter and hepatic steatosis as assessed by ultrasound in alcoholic or nonalcoholic fatty liver disease[J].Gut Liver,2016, 10(2): 295-302.
[3] 解育新, 季学磊, 秦信, 等. 超声定量分析非酒精性脂肪肝肝脏脂肪含量与代谢综合征及大血管病变的关系[J].临床超声医学杂志, 2018, 20(4): 250-253.
[4] 中华医学会糖尿病学分会.中国2型糖尿病防治指南(2017年版) [J].中国实用内科杂志,2018, 38(4): 292-344.
[5] 范建高. 中国非酒精性脂肪性肝病诊疗指南(2010年修订版) [J].中国医学前沿杂志(电子版), 2012,4(7): 4-10.
[6] Thijssen JM, Starke A, Weijers G,et al. Computer-aided B-mode ultrasound diagnosis of hepatic steatosis: a feasibility study[J].IEEE Trans Ultrason Ferroelectr Freq Control,2008, 55(6): 1343-1354.
[7] Xia MF, Yan HM, He WY, et al. Standardized ultrasound hepatic/renal ratio and hepatic attenuation rate to quantify liver fat content: an improvement method[J].Obesity (Silver Spring),2012, 20(2): 444-452.
[8] Zhang B, Ding F, Chen T, et al. Ultrasound hepatic/renal ratio and hepatic attenuation rate for quantifying liver fat content[J].World J Gastroenterol,2014, 20(47): 17985-17992.
[9] Mikolasevic I, Milic S, Turk Wensveen T, et al. Nonalcoholic fatty liver disease -A multisystem disease[J].World J Gastroenterol,2016, 22(43): 9488-9505.
[10] Hazlehurst JM, Woods C, Marjot T, et al. Non-alcoholic fatty liver disease and diabetes[J].Metabolism,2016, 65(8): 1096-1108.
[11] Ballestri S, Lonardo A, Bonapace S, et al. Risk of cardiovascular, cardiac and arrhythmic complications in patients with non-alcoholic fatty liver disease[J].World J Gastroenterol,2014, 20(7): 1724-1745.
[12] 王玮. 非酒精性脂肪肝超声诊断与血糖血脂、体质量指数的关系[J].激光生物学报,2018,27(4): 349-353.
[13] 张海玉, 刘自华. LDH浓度及估计肾小球滤过率与NAFLD关联性的性别差异[J].中南医学科学杂志. 2018. 46(05): 538-539+554.
[14] Sharaf El Din U, Salem MM, Abdulazim DO. Uric acid in the pathogenesis of metabolic, renal, and cardiovascular diseases: A review[J].J Adv Res,2017,8(5): 537-548.
[15] Huang HL, Lin WY, Lee LT, et al. Metabolic syndrome is related to nonalcoholic steatohepatitis in severely obese subjects[J].Obes Surg,2007, 17(11): 1457-1463.
2020, Vol. 37 
