Huang Nan, Su Xianghui, Yu Ting, Wu Xiaodong, Lu Bing, Sun Weixia, Yao Liqin, Wang Maoyun, Wang Yao, Wu Wenxuan, Liu Yingzhao, Yang Ting, Gao Ruidong, Miao Congqing, Li Ling
Department of Endocrinology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.
Institute of Glucose and Lipid Metabolism, Southeast University, Nanjing, China.
Front Endocrinol (Lausanne). 2024 Nov 29;15:1420088. doi: 10.3389/fendo.2024.1420088. eCollection 2024.
In this cross-sectional study including patients with type 2 diabetes mellitus (T2DM) we aimed to explore the relationship between serum 25-hydroxy vitamin (25(OH)D) level and liver steatosis and fibrosis in the Chinese population.
Patients visiting 16 clinical centers with T2DM were recruited. Their liver steatosis and fibrosis status were then assessed using elastography. Factors associated with steatosis and fibrosis were explored using regression analysis. Correlations between serum 25(OH)D levels and other patient characteristics were analyzed using linear regression.
In total, 1,513 patients with T2DM were included in the study. The prevalence of steatosis and fibrosis was 69.7%, and 34.6%, separately. A lower level of 25(OH)D was detected in patients with liver steatosis compared to those without, although it was not an independent predictor of this condition. However, 25(OH)D level was independently associated with liver fibrosis even when adjusted for age, sex, body mass index, hemoglobin A1c, insulin, and homeostatic model assessment of insulin resistance (OR = 0.964 [0.935-0.993], = 0.015). When patients were separated into subgroups by sex, a correlation between 25(OH)D and fibrosis was identified in the male group (OR = 0.969 [0.940-0.998], = 0.038).
In conclusion, this multi-center, cross-sectional study in patients with T2DM showed that serum 25-hydroxy vitamin D level was strongly associated with liver fibrosis and this relationship was more pronounced in male patients.
https://clinicaltrials.gov/ct2/show/, identifier NCT05597709.
在这项纳入2型糖尿病（T2DM）患者的横断面研究中，我们旨在探讨中国人群血清25-羟基维生素（25(OH)D）水平与肝脏脂肪变性及纤维化之间的关系。
招募到16个临床中心就诊的T2DM患者。然后使用弹性成像评估他们的肝脏脂肪变性和纤维化状态。采用回归分析探索与脂肪变性和纤维化相关的因素。使用线性回归分析血清25(OH)D水平与其他患者特征之间的相关性。
本研究共纳入1513例T2DM患者。脂肪变性和纤维化的患病率分别为69.7%和34.6%。与无肝脏脂肪变性的患者相比，有肝脏脂肪变性的患者检测到的25(OH)D水平较低，尽管它不是这种情况的独立预测因素。然而，即使在调整年龄、性别、体重指数、糖化血红蛋白、胰岛素和胰岛素抵抗的稳态模型评估后，25(OH)D水平仍与肝脏纤维化独立相关（比值比=0.964[0.935 - 0.993]，P = 0.015）。当按性别将患者分为亚组时，在男性组中发现25(OH)D与纤维化之间存在相关性（比值比=0.969[0.940 - 0.998]，P = 0.038）。
总之，这项针对T2DM患者的多中心横断面研究表明，血清25-羟基维生素D水平与肝脏纤维化密切相关，且这种关系在男性患者中更为明显。
