Li X, Yu X M, Li E H, Chen P H, Zheng L M, Zhang S
Anhui University of Science and Technology, Huainan 232001, China Department of Endocrinology and Metabolism, Fengxian District Central Hospital, Shanghai 201406, China.
Department of Endocrinology and Metabolism, Fengxian District Central Hospital, Shanghai 201406, China.
Zhonghua Nei Ke Za Zhi. 2023 Aug 1;62(8):987-992. doi: 10.3760/cma.j.cn112138-20220822-00614.
To investigate relationships between serum growth differentiation factor 15 (GDF15) and glycolipid metabolism in patients with metabolic associated fatty liver disease (MAFLD). The current investigation was a cross-sectional study. A total of 333 patients from the Fengxian District Central Hospital were recruited into the study after physical examination from February 2020 to February 2021. There were 107 patients with MAFLD and type 2 diabetes mellitus (T2DM), including 54 males and 53 females with a mean age of (57±11) years. There were 65 patients with simple MAFLD only, including 32 men and 33 women with a mean age of (49±5) years. There were 105 patients with T2DM only, including 53 men and 52 women, with a mean age of (56±10) years. A control group of 56 people without MAFLD or diabetes,28 male, 28 female, mean age (48±6) years, was also included in the study. Serum GDF15 was measured via enzyme-linked immunosorbent assays. IBM SPSS 26.0 was used for statistical analysis. Logistic regression was used to evaluate relationships between GDF15 and metabolic abnormalities in MAFLD patients. GDF15 progressively increased in the control [385 (296, 484) ng/L], nonobese MAFLD [388 (319, 435) ng/L], obese MAFLD [426 (354, 527) ng/L], T2DM [664 (483, 900) ng/L], and MAFLD+T2DM groups [770 (560, 1 074) ng/L](=113.82, =0.001). There was no significant difference in serum GDF15 between the simple MAFLD [406 (339, 524) ng/L] and control group (=1 505.50, =0.132). GDF15 was significantly higher in the MAFLD+T2DM group than in the T2DM-only group (=4 573.50, =0.019). In logistic regression analysis increased GDF15 was associated with increased risks of simple MAFLD [odds ratio ()=2.202], T2DM (=29.656), and MAFLD+T2DM(=58.197). In patients with MAFLD, serum GDF15 was higher in the FIB4 index>1.45 group [773 (534, 1 162) ng/L] than in the FIB4 index<1.45 group [527 (389, 787) ng/L] (=1 709.50, <0.001). Increased GDF15 was associated with an increased risk of advanced liver fibrosis (=2.388). In patients with simple MAFLD, GDF15 level was not significantly higher than in the control group. In the T2DM-only group and the MAFLD+T2DM group GDF15 was significantly higher than in the control group. Increased serum GDF15 was associated with increased risk and severity of MAFLD complicated with abnormal glucose and lipid metabolism. High GDF15 increased the risk of advanced fibrosis in MAFLD patients.
探讨代谢相关脂肪性肝病（MAFLD）患者血清生长分化因子15（GDF15）与糖脂代谢之间的关系。本研究为横断面研究。2020年2月至2021年2月，共有333名来自奉贤区中心医院的患者在体检后纳入本研究。其中，107例为MAFLD合并2型糖尿病（T2DM）患者，包括54例男性和53例女性，平均年龄为（57±11）岁。65例为单纯MAFLD患者，包括32例男性和33例女性，平均年龄为（49±5）岁。105例为单纯T2DM患者，包括53例男性和52例女性，平均年龄为（56±10）岁。研究还纳入了一个由56名无MAFLD或糖尿病的人组成的对照组，其中28例男性，28例女性，平均年龄（48±6）岁。采用酶联免疫吸附测定法检测血清GDF15。使用IBM SPSS 26.0进行统计分析。采用逻辑回归评估GDF15与MAFLD患者代谢异常之间的关系。GDF15在对照组[385（296，484）ng/L]、非肥胖MAFLD组[388（319，435）ng/L]、肥胖MAFLD组[426（354，527）ng/L]、T2DM组[664（483，900）ng/L]和MAFLD+T2DM组[770（560，1074）ng/L]中呈逐渐升高趋势（χ²=113.82，P=0.001）。单纯MAFLD组[406（339，524）ng/L]与对照组之间血清GDF15无显著差异（χ²=1505.50，P=0.132）。MAFLD+T2DM组的GDF15显著高于单纯T2DM组（χ²=4573.50，P=0.019）。在逻辑回归分析中，GDF15升高与单纯MAFLD风险增加[比值比（OR）=2.202]、T2DM（OR=29.656）和MAFLD+T2DM（OR=58.197）相关。在MAFLD患者中，FIB4指数>1.45组的血清GDF15[773（534，1162）ng/L]高于FIB4指数<1.45组[527（389，787）ng/L]（χ²=1709.50，P<0.001）。GDF15升高与晚期肝纤维化风险增加相关（OR=2.388）。在单纯MAFLD患者中，GDF15水平不显著高于对照组。在单纯T2DM组和MAFLD+T2DM组中，GDF15显著高于对照组。血清GDF15升高与MAFLD合并糖脂代谢异常的风险和严重程度增加相关。高GDF15增加了MAFLD患者晚期纤维化的风险。
