| ObjectiveBy comparing the serum levels of homocysteine（Hcy）,cystatin C（Cys C）and uric acid in patients with type 2 diabetes mellitus combined with nonalcoholic fatty liver disease（T2DM+NAFLD group）and patients with pure type 2 diabetes mellitus（T2DM group）（UA）level,analyze the relationship between Hcy,Cys C and UA and T2 DM combined with NAFLD,explore the related factors affecting Hcy,Cys C and UA,and evaluate the diagnostic value of Hcy,Cys C and UA in T2 DM combined with NAFLD,which is T2 DM The diagnosis and treatment of combined NAFLD provide new ideas.MethodA total of 100 T2 DM patients from October 2020 to October 2021 in the Department of Endocrinology,Affiliated Central Hospital of Shenyang Medical College were selected and divided into 50 patients with simple T2DM（T2DM group）（24 males/26 females）according to whether they were combined with NAFLD or not.,50 patients with T2 DM and NAFLD（T2DM+NAFLD group）（27 males/23 females）.General information such as gender,age,and disease course of all enrolled patients were collected,height,weight,waist circumference and hip circumference were measured,and fasting blood glucose（FBG）,fasting insulin（FIns）,fasting C-peptide（C-peptide）,and glycosylated hemoglobin（Hb A1c）were detected.),aspartate aminotransferase（AST）,glutamate aminotransferase（ALT）,glutamyltransferase（GGT）,urea nitrogen（BUN）,creatinine（Cr）,triglyceride（TG）,Total cholesterol（TC）,low density lipoprotein cholesterol（LDL-C）,high density lipoprotein cholesterol（HDL-C）,homocysteine（Hcy）,cystatin（Cys C）,uric acid（UA）biochemical index.Body mass index（BMI）,waist-to-hip ratio（WHR）,β-cell function index（HOMA-β）,and insulin resistance index（HOMA-IR）were calculated.All data were collected,sorted,and analyzed using SPSS 23.0 statistical software.Result1.Compared with the pure T2 DM group,the BMI,waist-hip ratio,FBG,FIns,Hb A1 c,HOMA-IR,TC,TG,LDL-C,Hcy,Cys C,UA of the T2DM+NAFLD group were significantly increased,and C-peptide was significantly increased.,HDL-C were significantly decreased,and the differences were statistically significant（P<0.05）.There was no significant difference in gender,age,disease course,HOMA-β,ALT,AST,GGT,BUN,and Cr（P>0.05）.2.The Pearson correlation analysis and multiple linear stepwise regression analysis showed that: Cys C,UA and serum Hcy were positively correlated（r>0,P<0.05）,and were independent influencing factors（β>0,P<0.05）;Hcy,UA,BUN,Cr were positively correlated with serum Cys C（r>0,P<0.05）,and were independent influencing factors（β >0,P<0.05）;age,BMI,Hcy,Cys C,TC It was positively correlated with serum UA（r>0,P<0.05）,and was an independent factor（β >0,P<0.05）.3.Binary Logistic regression analysis showed that T2 DM combined with NAFLD was positively correlated with BMI,Hb A1 c,HOMA-IR,TG,TC,Hcy,Cys C,UA（OR>1）,and negatively correlated with HDL-C（OR< 1）.BMI,Hb A1 c,HOMA-IR,TG,TC,Hcy,Cys C,and UA were risk factors for T2 DM combined with NAFLD,and HDL-C was a protective factor for T2 DM combined with NAFLD.4.The ROC curve was used to analyze the diagnostic value of Hcy,Cys C and UA for T2 DM complicated with NAFLD.The results showed: Hcy（AUC=0.728,sensitivity 0.90,specificity 0.58）,Cys C（AUC=0.717,sensitivity 0.60,specificity）0.80),UA（AUC=0.852,sensitivity 0.82,specificity 0.78）.Conclusion1.The changes of serum Hcy,Cys C and UA levels have a certain correlation with T2 DM combined with NAFLD.And serum Hcy,Cys C,UA levels are risk factors affecting the occurrence of T2 DM combined with NAFLD.2.Serum Hcy,Cys C and UA in T2 DM combined with NAFLD are positively correlated with each other and are independent influencing factors,suggesting that Hcy,Cys C and UA may have a synergistic effect in the occurrence and development of T2 DM combined with NAFLD.3.Serum Hcy,Cys C and UA levels have certain reference value for the diagnosis of T2 DM combined with NAFLD. |
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