| Objective To explore the correlation between the controlled attenuation parameter(CAP)value of the liver in patients with type 2 diabetes mellitus(T2DM)and the level of 25-hydroxyvitamin D[25(OH)D] in the serum.Methods A total of 160 T2 DM patients(86 males and 74 females)who were treated in the department of Endocrinology,First Affiliated Hospital of Bengbu Medical College from May 2019 to July 2020 were selected and used Fibro Scan-502 Touch manufactured by Echosens Medical Technology in France The instrument detects the liver CAP value of the patients,and divides the patients into four groups according to the liver CAP value:(1)Non-alcoholic fatty liver(NAFLD)group:CAP<240d B/m,a total of 43 cases;(2)Mild NAFLD group: 240 d B/m≤CAP<265d B/m,a total of 35 cases;(3)moderate NAFLD group:265d B/m≤CAP<295d B/m,a total of 35 cases;(4)severe NAFLD group:CAP≥295d B/m,a total of 47 cases.All of the above patients used the Japanese Omron HDS-2000 Visceral Fat Detector to determine the content of visceral adipose tissue(VAT)and subcutaneous adipose tissue(SAT).All patients were tested for 25(OH)D,blood sugar,blood lipids and other biochemical indicators.Use analysis of variance for normal distribution,LSD-t test for pairwise comparison between groups;Kruskal-Wallis rank sum test for non-normal distribution,and Kruskal-Wallis pairwise comparison for pairwise comparison between groups;the risk factor indicators of NAFLD use Logistic regression analysis;the correlation test of the indicators uses Pearson or Spearman analysis;Use receiver operating characteristic curve(ROC)to analyze the optimal threshold of CAP for vitamin D deficiency in patients with T2 DM.Results 1.VAT and SAT in the non-NAFLD group were significantly lower than those in the mild NAFLD group,moderate NAFLD group and severe NAFLD group.The VAT and SAT in the mild NAFLD group were significantly lower than those in the severe NAFLD group(P<0.05).2.The 25(OH)D in the non-NAFLD group was significantly higher than the moderate NAFLD group,and at the same time significantly higher than the severe NAFLD group;the mild NAFLD group was significantly higher than the severe NAFLD group(P<0.05);the moderate NAFLD group 25(OH)D was significantly higher than the severe NAFLD group(P<0.05).3.Liver CAP of T2 DM patients was negatively correlated with 25(OH)D and HDL-C(r=-0.436,-0.193,all P<0.05),and was correlated with WHR,BMI,VAT,SAT,TC,TG,FINS,HOMA-IR,FFA,CRP,γ-GT,ALT were positively correlated(r=0.276～0.447,all P<0.05).4.Serum 25(OH)D of T2 DM patients is negatively correlated with CAP,VAT,FBG,TC,TG,FFA,HOMA-IR,ALT,CRP,γ-GT(r=-0.436～-0.156,all P<0.05).5.Logistic regression analysis found that 25(OH)D was a protective factor for NAFLD in T2 DM patients(P<0.05),and FFA was a risk factor for NAFLD(P<0.05).6.The ROC curve shows that taking CAP 265 d B/m as the diagnostic cut-off value,the sensitivity of predicting vitamin D deficiency in T2 DM patients is 0.776 and the specificity is 0.637.Conclusion 1.The liver fat content(LFC)of T2 DM patients is closely related to the content of VAT and SAT.2.Serum 25(OH)D level of T2 DM patients without NAFLD group was significantly higher than that of moderate and severe NAFLD group.CAP was negatively correlated with serum 25(OH)D,and 25(OH)D was a protective factor for T2 DM to develop NAFLD.3.Liver CAP of T2 DM patients has predictive value for vitamin D deficiency. |
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