Studies Of Serum ADRP In Type 2 Diabetes Mellitus With Nonalcoholic Fatty Liver Disease

Objective:To investigate the relationship between serum adipophilin(ADRP)and type 2 diabetes mellitus(T2DM)with nonalcoholic fatty liver disease(NAFLD).First,to understand the clinical features of type 2 diabetes mellitus with nonalcoholic fatty liver disease,and to explore the relationship of insulin resistance between T2 DM and T2 DM with NAFLD;Second,by analyzing the association of ADRP and glucolipid metabolism,insulin resistance,liver function,this provided a certain theoretical basis for prevention andtreatment of diabetes and nonalcoholic fatty liver disease.Methods:The fasting serum ADRP levels were measured in 56 T2 DM patients(1999 WHO diagnostic standards)in our hospital endocrine department,including 28 diabetic patients without NAFLD(B group,16 males and 12 females,59.5±13.94 years old),28 diabetic patients with NAFLD(C group,15 males and 13 females,57.28±14.83 years old)and 28 healthy individuals(A group,12 males and 16 females,47.61±1.00 years old),in patients without diabetes,high blood pressure and cardio-cerebrovascular disease,history of chronic liver disease,chronic kidney disease.The patients were measured for height,weight,body mass index(BMI)was calculated,waist circumference(WC),hip circumference(HC),Waist to hipratiosystolic was calculated,blood pressure(SBP),diastolic blood pressure(DBP).Laboratory tests included glycosylated hemoglobin(HbA1C),blood glucose,insulin,homeostasis model assessment of insulin resistance(HOMA-IR)was calculated.Blood lipid indexes such as triglycerides(TG),cholesterol(TC),high-density lipoprotein(HDL-C),low density lipoprotein(LDL-C),liver function(alanine transaminase ALT,aspartate aminotransferase AST)were also measured and the determination of serum ADRP.Fixed special doctor examined the livers by color Doppler.Chemical immune method was used to detect fasting plasma insulin;The enzyme-linked immunosorbent assay was used to detect ADRP.Application SAS9.4 statistic software for data processing,analysis of variance(ANOVA)was used to show the difference between the three groups,SNK was used to show the difference between the two groups.The relationships between ADRP level and other clinical indexes were used by Spearman correlation analysis and logistic regression analysis.The difference was statistically significant if P<0.05.Results:1、Compared with patients in T2 DM and control group,the mean values levels of BMI、WC、HC、HOMA-IR、TG、TC were higher in T2 DM complicated with NAFLD group(P<0.05).Compared with the control group,the age,WHR,FBG,HbA1 C,HOMA-IR,TC in T2 DM group were higher,and HDL-C was lower,the difference was statistically significant(P<0.05).2、The trend test showed that ADRP level increased gradually in the control group,T2 DM and T2 DM combined with NAFLD group,the difference between every group had statistical significance(P<0.01).3 、 Linear correlation analysis showed that serum ADRP level was positively correlated with age,BMI,WC,WHR,FBG,HbA1 C,TG,TC,ALT,and negatively correlated with HDL-C(P<0.05).4、Multiple stepwise regression analysis showed that WC,FBG,TC and HDL-C were the risk factors of serum ADRP.Conclusion:1、Compared with patients with T2 DM,insulin resistance and glucose and lipid metabolism disorders in T2 DM combined with NAFLD was more serious,visceral adiposity was more obvious.2、The level of serum ADRP in patients with type 2 diabetes was significantly higher than control group,and compared with T2 DM group,the level of serum ADRP of patients in T2 DM with NAFLD group was higher,suggesting that ADRP may play a role in the occurrence and development of diabetes and NAFLD disease.3、The level of serum ADRP was closely related to age,central obesity,hyperglycemia,lipid disorder and elevated liver enzymes.WC,FBG,TC,HDL-C were independent risk factors for ADRP.