Departments of Internal Medicine.
Clinical Pathology, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Eur J Gastroenterol Hepatol. 2019 Jul;31(7):859-864. doi: 10.1097/MEG.0000000000001354.
Previous studies have assessed serum fetuin-B and its relation to nonalcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (T2DM) and as a link between them through inducing insulin resistance (IR). Therefore, we examined the potential of serum fetuin-B to be an independent marker for NAFLD in patients with T2DM.
The study group consisted of 270 patients with T2DM. Clinical and laboratory features were evaluated. The NAFLD severity was graded by ultrasound into three subgroups: grade 0 (no fatty liver), grade 1 (mild fatty liver), and grade 2-3 (medium to severe fatty liver). Fetuin-B, retinol-binding protein-4, and adiponectin were measured.
Patients with grade 2-3 NAFLD had high fetuin-B levels in comparison with non-NAFLD group. Age and sex adjusted fetuin-B demonstrated positive correlations with triglycerides, γ-glutamyl transferase, fasting plasma glucose, 2-h postprandial plasma glucose, homeostasis model assessment of IR, fasting insulin, glycated hemoglobin, high-sensitivity C-reactive protein, and estimated glomerular filtration rate, but it had a negative correlation with serum creatinine. Adiponectin level was decreased with increasing NAFLD severity, but no difference was found in retinol-binding protein-4. The estimated odds ratio (OR) for the occurrence of grade 2-3 NAFLD was increased significantly with increasing levels of fetuin-B (OR: 3.92; 95% confidence interval: 2.14-8.32 vs. OR: 8.91; 95% confidence interval: 4.22-18.41). The OR of fetuin-B in the uppermost tertile group was still significant after controlling for homeostasis model assessment of IR, glycated hemoglobin, waist circumference, BMI, hepatic enzymes, high-density lipoprotein cholesterol, triglycerides, and high-sensitivity C-reactive protein.
Our study demonstrated that serum fetuin-B had an independent association with NAFLD in patients with T2DM.
先前的研究已经评估了血清胎球蛋白-B 及其与非酒精性脂肪性肝病（NAFLD）和 2 型糖尿病（T2DM）的关系，并通过诱导胰岛素抵抗（IR）将其作为它们之间的联系。因此，我们研究了血清胎球蛋白-B 作为 T2DM 患者 NAFLD 独立标志物的潜力。
研究组包括 270 名 T2DM 患者。评估了临床和实验室特征。通过超声将 NAFLD 严重程度分为三个亚组：0 级（无脂肪肝）、1 级（轻度脂肪肝）和 2-3 级（中重度脂肪肝）。测量胎球蛋白-B、视黄醇结合蛋白-4 和脂联素。
与非 NAFLD 组相比，2-3 级 NAFLD 患者的胎球蛋白-B 水平较高。年龄和性别调整后的胎球蛋白-B 与甘油三酯、γ-谷氨酰转移酶、空腹血糖、餐后 2 小时血糖、胰岛素抵抗评估的稳态模型、空腹胰岛素、糖化血红蛋白、高敏 C 反应蛋白和估算肾小球滤过率呈正相关，但与血清肌酐呈负相关。脂联素水平随 NAFLD 严重程度的增加而降低，但视黄醇结合蛋白-4 无差异。胎球蛋白-B 水平升高与 2-3 级 NAFLD 发生的估计比值比（OR）显著增加（OR：3.92；95%置信区间：2.14-8.32 vs. OR：8.91；95%置信区间：4.22-18.41）。在校正稳态模型评估的胰岛素抵抗、糖化血红蛋白、腰围、BMI、肝酶、高密度脂蛋白胆固醇、甘油三酯和高敏 C 反应蛋白后，胎球蛋白-B 最高三分位组的 OR 仍然显著。
我们的研究表明，血清胎球蛋白-B 与 T2DM 患者的 NAFLD 有独立关联。
