Correlation Between Serum Osteocalcin Level And Non-alcoholic Fatty Liver Disease With Senile Diabetics

Background and objective:At present, the morbidity of non-alcoholic fatty liver disease (NAFLD) in the worldwide continued to rise rapidly.In the general population the morbidity of NAFLD is 20-30%,while the morbidity in the population of obesity or diabetes can be up to 70-90%.NAFLD has become an important cause of chronic liver disease. NAFLD can be used as a liver manifestation of metabolic syndrome, which is often accompanied by hyperglycemia or type 2 diabetes, hypertension, lipid metabolism abnormal and obesity, and has higher cardiovascular disease and type 2 diabetes risk.Osteocalcin (OCN) is a single chain polypeptide of osteoblast formation and specific secretion,which involve in the regulation of energy consumption, glucose metabolism and insulin secretion. OCN has an important relationship in the complex pathways between bone and energy metabolism.Molecular cell and animal experiments have both confirmed that OCN has the effect of improving liver fat deposition,the mechanism of it may be that OCN promote insulin secretion, improve insulin resistance, decrease triglyceride glycerol levels, reduce oxidative stress and inflammatory reaction. The purpose of this article aim to cross-sectional study the association between the serum osteocalcin and non-alcoholic fatty liver disease with elderly diabetics,which provide a new theoretical basis and methods for clinical disease prevention and treatment.Study Object and MethodsStudy objectFrom the 97 diabetics from June 2014 to April 2015 admitted to the Department of Geriatrics and Endocrinology in the First Affiliated Hospital of Zhengzhou University were participated into our study. A total of 47 T2DM patients (the diabetes mellitus group),50 senile diabetic patients with non-alcoholic fatty liver disease (the fatty liver group),30 healthy elderly were included as control group.MethodsThe anthropometric indices and biochemical parameters were determined using standard procedures. BMI、osteocalcin、fasting plasma glucose、fasting insulin、 HOMA-IR、HOMA-pHbA1c、total cholesterol、triglyceride、HDL-C and LDL-C were compared.Statistical processingThe SPSS version 20.0 statistical software were used to performe all calculations.By means of the Kolmogorov-Smirnov method to test whether all data is normally distributed. When the total variance was homogeneous, the single factor analysis of variance (ANOVA One-Way) was used to test and the LSD-t test was used to compare the two two groups. OCN and each index of correlation test using Pearson correlation analysis in the fat group.Multiple linear regression analysis was used to analyze the influencing factors of serum OCN level in T2DM patients with NAFLD.The risk factors for T2DM with NAFLD is evaluated by Logistic regression analysis.It was considered to be statistically significant that an adjusted value of P<0.05.Result:1.The fasting plasma glucoses fasting insulins HbA1c、total cholesterol、 triglyceride、LDL-C and HOMA-IR in the diabetes mellitus group and the fatty liver group are both higher than the control group,while HDL-C、HOMA-βand the osteocalcin are lower(P< 0.05).2.In the fatty liver group, the osteocalcin level negatively correlated with fasting plasma glucose、HbAlC、HOMA-IR、BMI, (r=-0.701,-0.442,-0.337,-0.543 P< 0.05),and positively with HOMA-β(r=0.341 P<0.05).3.The multiple linear regression was conducted in the fatty liver group,with the osteocalcin as the dependent variable.The results showed fasting plasma glucose is the independent factor (β=-1.57,P=0.018).4. Logistic regression analysis showed the higher serum ONC level is the protective factor of NAFLD in the middle of elder diabetes, the OR was 0.06.Conclusion:It has a significant reduction of serum osteocalcin level in non-alcoholic fatty liver disease with senile diabetes, and body mass index (BMI), fasting plasma glucose, glycated hemoglobin, insulin resistance index and insulin secretion index showed a linear correlation. High serum OCN may be is the protective factors of NAFLD in elderly patients with type 2 diabetes mellitus,monitoring serum OCN levels in senile patients with type 2 diabetes mellitus with NAFLD can provide new idea on prevention and treatment NAFLD in elderly patients with type 2 diabetes mellitus.