The Relationship Between The Levels Of Serum Ferritin And Syndrome Of Phlegm-dampness In Type 2 Diabetes Patients Mellitus With Nonalcoholic Fatty Liver Disease

Objective:The aim of this study is to investigate the relationship between serum ferritin(SF)levels and Type 2 diabetes mellitus(T2DM)with nonalcoholic fatty liver disease(NAFLD),in order to find new way for the diagnosis and trearment of Type 2 diabetes with nonalcoholic fatty liver disease.It also investigates the correlation between SF and sugar lipid metabolism index with phlegm dampness syndrome in type 2 diabetes with nonalcoholic fatty liver disease.This paper provides a new theoretical basis for the objectification of TCM syndromes of T2DM combined with NAFLD,and provide a reference for the study of TCM syndrome in thetreatment of T2DM with NAFLD.Methods:In this study,a total of 1,479 patients with type 2 diabetes were collected,370 patients were excluded Because drinking,anemia,tumor,acute infection and ketoacidosis,and 1109 patients were included finally.613 cases were divided into T2DM+NAFLD group and 496 cases in T2DM group.T2DM patients with NAFLD were divided into phlegm-dampness group(n=417)and non-phlegm-dampness group(n=196)according to the TCM dialectical classification.To collect all the basic information of the patients and the general clinical data SF?fasting blood glucose(FBG)?Homeostatic Model Assessment for Insulin Resistance(HOMA-IR)?fasting C peptide(FC-P)?fasting insulin(FINS)?Alanine aminotransferase(ALT)?Aspartate transaminase(AST)?total cholesterol(TC)?triglyceride(TG)?high-density lipoprotein cholesterol(HDL-C)?low density lipoprotein cholesterol(LDL-C)?apolipoprotein Al(ApoAl)?apolipoprotein E(ApoE)and lipoprotein(Lp-a)?transferrin(TRF)?fetal protein(AFP)?carcinoembryonic antigen(CEA)and carbohydrate antigen 125(CA 125)?carbohydrate antigen 125(CA 153)?carbohydrate antigen 199(CA 199),then calculate according to the height,weight,body mass index(BMI),calculate according to the fasting blood glucose,fasting insulin,insulin resistance index(HOMA-IR).omparison of SF,and all the indexes in T2DM group and T2DM with nonalcoholic fatty liver disease group,the phlegm wet group and non phlegmy wet in the group level,Analysis the relationship between SF?and age?gender?duration?body weight?WC?BMI?FBG?HOMA IR?FC-P?FINS?ALT?AST?TC?TG?HDL?LDL-C-C?ApoAl?ApoE?Lp-a?agency?AFP?CEA?CA 125?CA 153?CA 199?Logistic multiple regression analysis was used to analyze the risk factors of T2DM and non-alcoholic fatty liver disease and the risk factors of phlegm dampness syndromes.Results:(1)The level of SF in T2DM patients with NAFLD group was obviously higher than that of T2DM group(p<0.05),and age?weight?WC?BMI?HOMA IR?FBG?FC-P?FINS?AST?ALT?TC?TG?ApoE in T2DM+NAFLD group are higher than which in T2DM group(p?0.05),Age.duration?HDL-C?ApoAl?Lp-a and CEA are lower than that of T2DM group,difference had statistical significance(p<0.01).(2)The results showed that there was a positive correlation between the level SF of T2DM+NAFLD and body weight?FBG?FC-P?AST?ALT?TC?TG?LDL-C?ApoE?AFP?CA153?CA199(p?0.05),and there was a significant negative correlation between SF and female?age?duration?HDL-C?ApoAl?Lp-a(p?0.05).The results of partial correlation show that there was a positive correlation between the SF and weight?AST?TG?LDL-C?ApoAl?CA 153(p<0.05),and there was a negative correlation between SF and the women?duration?WC?FINS?HDL-C(p?0.05);(3)Logistic regression analysis results showed that SF?sex?duration?BMI?FC-P?TG?agency is a risk factor for T2DM combined NAFLD?female?age?course?TC?HDL-C for the protection of the merger of T2DM NAFLD factors(p<0.05).(4)The level of SF in patients with phlegm wet group was higher than the non phlegm dampness syndrome group(p?0.01),The levels of weight?WC?BMI?HOMA IR?FINS?HOMA IR?TC?TG?LDL-C were higher than in non phlegmy wet group(all p?0.05),and age?women?duration?Lp-a?below the the non phlegm dampness syndrome group(p?0.05).(5)The results showed that the level SF of the phlegm dampness syndrome group had a positive correlation with body weight?FBG?AST?ALT?TC?TG?ApoE?AFP?CEA?CA 125?CA 153?CA 125(p?0.05),and had significant negative correlation with the female?age?duration?BMI?HDL-C(p?0.05),and The results of partial correlation show that the SF had positive correlation with AST?TG?LDL-C?ApoAl?CA 153(p?0.05),and had significant negative correlation with age?duration?female?WC?FINS?agency has(p?0.05).(6)Logistic regression analysis results showed that SF?BMI is a risk factor for phlegm dampness syndromes(p?0.05).Conclusions:1.Compared with the normal group,_the T2DM+NAFLD group had high level of serum ferritin,suggest that the determination of SF may contribute to the diagnosis of NAFLD in T2DM patients.2.In T2DM+NAFLD group?SF was correlated with was related to the level of AST?TG?LDL-C?ApoAl?CA 153 and FINS?imply that SF closely related to disorder of glucose and lipid metabolism.3.The level SF is the risk factors for NAFLD in type 2 diabetes,and the level of SF may increase the risk of T2DM with NAFLD.4.The SF level of T2DM+ NAFLD patients with phlegm dampness syndrome was significantly higher than that in the non-phlegm group,suggesting that SF was a biological marker of phlegm dampness syndrome.so the relationship between SF and phlegm needs further study.