Sun Yi, Huang Ping, Zhao Xiao-Qin, Tang Zhu-Qi, Xu Tong-Tong, Wang Xin-Wei, Qi Zong-Xian, Lin Wei-Rong, Li Min-You, Gu Yun-Juan
Department of Endocrinology and Metabolism, Affiliated Hospital of Nantong University, Nantong 226000, Jiangsu Province, China.
R&D Department, Guangzhou Jinde Biotech Company Limited, Guangzhou 510000, Guangdong Province, China.
World J Hepatol. 2025 Jun 27;17(6):104693. doi: 10.4254/wjh.v17.i6.104693.
Glucagon (GCG) plays an important role in both diabetes and metabolic dysfunction-associated steatotic liver disease (MASLD).
To investigate the relationship between GCG and the development of MASLD in patients with type 2 diabetes mellitus (T2DM) and the possible influencing factors.
A total of 212 T2DM patients were enrolled. GCG concentrations were measured using the chemiluminescence method. Fibro touch ultra sound attention parameter was used to determine the occurrence of MASLD. Multivariate logistic regression analyses were employed to assess the correlation between GCG levels and MASLD severity in T2DM patients.
The ultrasound attenuation parameter of T2DM patients was positively correlated with GCG, insulin (INS), C-peptide (CP), INS resistance, obesity related indicators (body mass index, waist circumference, percent body fat, basal metabolic rate, visceral fat area, fat free mass index, fat mass index, skeletal muscle index), liver cirrhosis related indicators [liver stiffness measurement (LSM), gamma glutamyl transpeptidase to platelet ratio, alanine aminotransferase], serum uric acid, diastolic blood pressure and triglyceride, while were negative correlated with age, fibrosis 4 score and high-density lipoprotein cholesterol (all < 0.05). According to the multivariate logistic regression model, the T2DM patients with fasting GCG concentrations above the cut-off value had a significant increased risk of MASLD (OR: 3.068; 95%CI: 1.333-7.064; = 0.008). Also, an increased concentration of fasting CP (OR: 1.965; 95%CI: 1.323-2.918; = 0.001) and LSM (OR: 1.422; 95%CI: 1.16-1.743; = 0.001) were significantly associated with a higher risk of MASLD in T2DM patients.
Fasting GCG, fasting CP and LSM are risk factors for MASLD in T2DM patients.
胰高血糖素（GCG）在糖尿病和代谢功能障碍相关脂肪性肝病（MASLD）中均起重要作用。
探讨2型糖尿病（T2DM）患者中GCG与MASLD发生的关系及可能的影响因素。
共纳入212例T2DM患者。采用化学发光法测定GCG浓度。使用Fibro Touch超声关注参数来确定MASLD的发生情况。采用多因素logistic回归分析评估T2DM患者GCG水平与MASLD严重程度之间的相关性。
T2DM患者的超声衰减参数与GCG、胰岛素（INS）、C肽（CP）、胰岛素抵抗、肥胖相关指标（体重指数、腰围、体脂百分比、基础代谢率、内脏脂肪面积、去脂体重指数、脂肪量指数、骨骼肌指数）、肝硬化相关指标[肝脏硬度值（LSM）、γ-谷氨酰转肽酶与血小板比值、丙氨酸氨基转移酶]、血清尿酸、舒张压和甘油三酯呈正相关，而与年龄、纤维化4评分和高密度脂蛋白胆固醇呈负相关（均P<0.05）。根据多因素logistic回归模型，空腹GCG浓度高于临界值的T2DM患者发生MASLD的风险显著增加（OR：3.068；95%CI：1.333-7.064；P=0.008）。此外，空腹CP浓度升高（OR：1.965；95%CI：1.323-2.918；P=0.001）和LSM升高（OR：1.422；95%CI：1.16-1.743；P=0.001）与T2DM患者发生MASLD的较高风险显著相关。
空腹GCG、空腹CP和LSM是T2DM患者发生MASLD的危险因素。
