The Relationship Between Levels Of Serum Homocysteine And Cystain C In Type 2 Diabetic Patients With Nonalcoholic Liver Disease

Objectives By measuring serum homocysteine,Cystatin C,blood glucose,blood lipid and other indicator in type 2 diabetes mellitus patients with nonalcoholic fatty liver,and explore the relationship between homocysteine,Cystatin C,blood glucose and blood lipid in diabetic patients with nonalcoholic fatty liver disease.Provide the basis for early diagnosis and treatment of diabetes complicated with nonalcoholic fatty liver disease.Methods Select 179 cases of type 2 diabetes patients from October 2016 to October 2017 in the department of endocrinology of affiliated hospital of North China University of Science and Technology.According to results of abdominal ultrasound examination,the 179 samples were divided into two groups:121 cases who have type 2 diabetes mellitus complicated with nonalcoholic fatty liver(NAFLD group)and chose 58 cases who have diabetes without nonalcoholic fatty liver(DM group)as control group.NAFLD group included patients with type 2 diabetes mellitus with mild non alcoholic fatty liver group(mild NAFLD group)61 cases and type 2 diabetic patients with moderate and severe nonalcoholic fatty liver group(severe NAFLD group)60 cases.Record gender,age,course of the disease,height,body weight,systolic blood pressure(SBP),diastolic blood pressure(DBP),high-density lipoprotein cholesterol(HDL-C),low density lipoprotein(LDL-C),fasting venous blood glucose(FPG),glycosylated hemoglobin(HbAlc),fasting insulin(FINS),fasting C peptide(FC),total cholesterol(TC),triglyceride(TG),uric acid(UA),urine trace albumin(UAlb),homocysteine(HCY),Cystatin C(Cys-C)level of samples,and measure body mass index(BMI),the homa insulin-resistance(HOMAIR).Make questionnaire,collect data,analyse all the data with SPSS17.0 statistical software package.Measurement data is shown in the form of(x ±s).Count data is measured by chi-square test,measurement data comparison using t test between groups;The relationship between the probability of NAFLD and all indicators of interest is examined by the Logistic regression which indicates some statistically significant relationships with P<0.05.Pearson correlation correlation and multiple stepwise regression method are applied to observe the relationship between HCY,Cys-C and other indicators.Results 1 There was no significant difference in two gender between case group and control group by t tests(P > 0.05),indicating that the sex composition of this study was comparable.2 Case group and control group were tested by independent sample t test.The results showed that there was no significant difference in age,SBP,FPG,FC,TC,LDL-C between the two groups(P > 0.05).3 Case group and control group were subjected to independent sample t test.The results showed that there was a statistically significant difference in the duration of diabetes,BMI,DBP,HbA1 c,FINS,HOMA-IR,TG,HDL-C,UA and UA between the two groups(P< 0.05).4 The serum HCY level in group NAFLD was higher than that in group DM,and it increased with the increase of the severity of NAFLD in T2 DM,the difference was statistically significant.(P < 0.05).When the HCY exceeded the normal range,the risk of T2 DM in patients with nonalcoholic fatty liver disease increased 3.71 times.5 The level of serum Cys C in group NAFLD was higher than that in group DM,and it increased with the increase of the severity of NAFLD in T2 DM,the difference was statistically significant.(P < 0.05).When Cys C exceeded the normal range,the risk of nonalcoholic fatty liver disease in T2 DM patients increased by 7.74 times.6 Whether complicated with nonalcoholic fatty liver disease as the dependent variable,with t significant indicators as independent variables,to continue the multivariate non conditional Logistic regression analysis,results showed that duration,DBP,HbA1 c,UA,UAlb,HCY,Cys C was positively correlated T2 DM with NAFLD(OR > 1),and HDL-C is a negative correlation(OR < 1).7 The correlation analysis of serum HCY as the dependent variable showed that HCY was positively correlated with Cys C,TG and UA(P < 0.05),and the correlation with BMI was not significant(P=0.05).Taking serum HCY as the dependent variable,t test and chi-square test statistically significant variables as independent variables,and to continue the multivariate stepwise regression analysis.The results showed HCY was positively correlated with UA,Cys C and TG(P < 0.05).8 The correlation analysis of serum Cys C as a dependent variable showed that Cys C was positively correlated with HOMA-IR,BMI,TG and FINS(P < 0.05),and serum Cys C was negatively correlated with HDL-C(P<0.05).Taking serum Cys C as dependent variable,t test and chi-square test statistically significant variables as independent variables,to continue the multivariate stepwise regression analysis.The results showed Cys C was positively correlated with HCY,HOMA-IR and BMI(P < 0.05).Conclusions 1 The level of serum HCY in T2 DM patients with NAFLD increased,and with the increase of T2 DM and NAFLD severity,serum HCY level increased further.Serum HCY may be the risk factor of T2 DM with NAFLD.2 The level of serum Cys-C in T2 DM patients with NAFLD increased,and with the increase of T2 DM and NAFLD severity,serum Cys-C level increased further.Serum Cys-C may be the risk factor of T2 DM with NAFLD.