Department of Internal Medicine, Seoul National University Bundang Hospital, 82 Gumi-ro, Bundang-gu, Seongnam-City, 13620, Republic of Korea.
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
Sci Rep. 2021 Dec 21;11(1):24372. doi: 10.1038/s41598-021-03870-z.
The association between nonalcoholic fatty liver (NAFL) or liver fibrosis and diabetic peripheral neuropathy (DPN) has not been well studied. We aimed to investigate the association of NAFL or liver fibrosis indices and DPN in individuals with type 2 diabetes. In this observational study, we included 264 individuals with type 2 diabetes, and calculated non-alcoholic fatty liver disease (NAFLD) liver fat score, NAFLD fibrosis score, and Fibrosis-4 (FIB-4) index to evaluate the status of NAFLD or liver fibrosis. DPN was diagnosed when the Michigan Neuropathy Screening Instrument-Physical Examination score was ≥ 2.5. The NAFLD fibrosis score and FIB-4 index were significantly higher in individuals with DPN than in those without DPN. Logistic analyses showed that the NAFLD fibrosis score and FIB-4 index were associated with DPN after adjustment for covariates (adjusted odds ratio 1.474 and 1.961, respectively). In the subgroup analysis, this association was only significant in the group with a high NAFLD liver fat score (> - 0.640). Serum levels of fetuin-A, a hepatokine, were decreased in individuals with abnormal vibration perception or 10-g monofilament tests compared with their counterparts. The present study suggests that liver fibrosis might be associated with DPN in individuals with type 2 diabetes.
非酒精性脂肪肝(NAFL)或肝纤维化与糖尿病周围神经病变(DPN)之间的关联尚未得到很好的研究。我们旨在研究 2 型糖尿病患者中 NAFL 或肝纤维化指数与 DPN 之间的关联。在这项观察性研究中,我们纳入了 264 名 2 型糖尿病患者,并计算了非酒精性脂肪性肝病(NAFLD)肝脂肪评分、NAFLD 纤维化评分和 Fibrosis-4(FIB-4)指数,以评估 NAFLD 或肝纤维化的状况。当密歇根神经病变筛查工具-体格检查评分≥2.5 时,诊断为 DPN。患有 DPN 的个体的 NAFLD 纤维化评分和 FIB-4 指数明显高于没有 DPN 的个体。Logistic 分析显示,在调整了协变量后,NAFLD 纤维化评分和 FIB-4 指数与 DPN 相关(调整后的优势比分别为 1.474 和 1.961)。在亚组分析中,这种关联仅在高 NAFLD 肝脂肪评分(> -0.640)组中具有统计学意义。与振动感觉异常或 10-g 单丝试验正常的个体相比,血清中肝分泌因子胎球蛋白-A 的水平在有异常振动感觉或 10-g 单丝试验的个体中降低。本研究提示,肝纤维化可能与 2 型糖尿病患者的 DPN 有关。