Wang Yun-Sheng, Ye Jun, Cao Yong-Hong, Zhang Rong, Han Xiao-Fang, Zou Ling-Ling, Kuang Lei, Zhang Ji, Lian Hu, Xia Jin-Xiang, Zhang Qiu, Dai Wu
Department of Endocrinology, The Second People's Hospital of Hefei, The Affiliated Hefei Hospital of Anhui Medical University, Hefei, 230011 Anhui China.
Department of Magnetic Resonance Imaging, The Second People's Hospital of Hefei, The Affiliated Hefei Hospital of Anhui Medical University, Hefei, 230011 Anhui China.
Diabetol Metab Syndr. 2020 Jun 8;12:51. doi: 10.1186/s13098-020-00558-8. eCollection 2020.
Previous literatures have implied that the liver fat deposition plays a crucial role in the development and progression of insulin resistance. In the present study, we aimed to investigate the association of liver fat content (LFC) with glucose metabolism status in the population of newly diagnosed type 2 diabetes mellitus (nT2DM), prediabetes mellitus (PDM) and normal controls (NC), and assessing if the LFC could as an indicator for the prediction of T2DM.
A total of 242 subjects (including 141 nT2DM patients, 48 PDM subjects and 53 NC) were enrolled. The levels of LFC were quantified by using the proton magnetic resonance spectroscopy ([H]-MRS) technique. Clinical and laboratory parameters of study subjects were collected by medical records and biochemical detection. One-way ANOVA or nonparametric test (Kruskal-Wallis) was applied for intergroup comparisons; intergroup comparison was performed in using of Bonferroni multiple-significance-test correction.
There were significantly increased LFC levels in nT2DM (14.72% ± 6.37%) than in PDM (9.62% ± 4.41%) and that of NC groups (5.11% ± 3.66%) (all < 0.001). The prevalence of nonalcoholic fatty liver disease (NAFLD) was also found to be increased in nT2DM (91.48%) than in PDM (85.41%) and that of NC (32.07%) groups. Correlation analysis revealed that the increase of LFC positively associated with fast plasma glucose (FPG), 2 h plasma glucose (PG), Delta G30 and homeostatic model assessment of insulin resistance (HOMA-IR), negatively associated with Delta Ins30, Delta C30, Ins30/G30 , CP30/G30 , Ins /G , CP /G , homeostatic model assessment for β-cell function index (HOMA-β) and matsuda insulin sensitivity index (Matsuda ISI). Multilinear regression analysis showed that LFC, body mass index (BMI) and diastolic blood pressure (DBP) contributed for the prediction of HOMA-IR, and total cholesterol (TC), age, waist circumference (WC) and low-density lipoprotein cholesterol (LDL-C) were the significant contributors for HOMA-β.
Our study revealed an increased LFC level and prevalence of NAFLD in nT2DM than in PDM and that of NC groups, the increase of LFC was closely associated with insulin resistance and impaired glucose metabolism status, may be regarded as potential indicator contributing to the development and progression of T2DM.
既往文献表明肝脏脂肪沉积在胰岛素抵抗的发生和发展中起关键作用。在本研究中，我们旨在探讨新诊断的2型糖尿病（nT2DM）、糖尿病前期（PDM）和正常对照（NC）人群中肝脏脂肪含量（LFC）与糖代谢状态的关系，并评估LFC是否可作为预测2型糖尿病的指标。
共纳入242名受试者（包括141例nT2DM患者、48例PDM受试者和53例NC）。采用质子磁共振波谱（[H]-MRS）技术定量LFC水平。通过病历记录和生化检测收集研究对象的临床和实验室参数。采用单因素方差分析或非参数检验（Kruskal-Wallis）进行组间比较；使用Bonferroni多重显著性检验校正进行组间比较。
nT2DM组的LFC水平（14.72%±6.37%）显著高于PDM组（9.62%±4.41%）和NC组（5.11%±3.66%）（均P<0.001）。还发现nT2DM组非酒精性脂肪性肝病（NAFLD）的患病率（91.48%）高于PDM组（85.41%）和NC组（32.07%）。相关性分析显示，LFC升高与空腹血糖（FPG）、餐后2小时血糖（PG）、Delta G30和胰岛素抵抗稳态模型评估（HOMA-IR）呈正相关，与Delta Ins30、Delta C30、Ins30/G30、CP30/G30、Ins/G、CP/G、β细胞功能指数稳态模型评估（HOMA-β）和松田胰岛素敏感性指数（Matsuda ISI）呈负相关。多线性回归分析显示，LFC、体重指数（BMI）和舒张压（DBP）有助于预测HOMA-IR，总胆固醇（TC）、年龄、腰围（WC）和低密度脂蛋白胆固醇（LDL-C）是HOMA-β的重要影响因素。
我们的研究显示，nT2DM组的LFC水平和NAFLD患病率高于PDM组和NC组，LFC升高与胰岛素抵抗和糖代谢状态受损密切相关，可能是2型糖尿病发生和发展的潜在指标。
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