The Relation Between NAFLD And Abnormal Glucolipid Metabolism

1Background and ObjectiveNon-alcoholic fatty liver disease (NAFLD) and diabetes are common diseasesworldwide. The prevalence has significantly increased in recent decades. It wasestimated that there were approximately150million patients with NAFLD[1]inChina, and it has reached epidemic level. NAFLD related closely with metabolicsyndrome (MS), impaired glucose tolerance and diabetes. Evidence-based datashowed that NAFLD was a risk factor of type2diabetes and atherosclerosis relateddiseases, and approximately80%patients with T2DM had NAFLD, which isaggravating the liver and peripheral insulin resistance. It was the importantmechanism of diabetic progression and worsened[2]. Screening of non-alcoholic fattyliver disease will help predict the occurrence of T2DM and cardiovascular disease.And the prevention and treatment of NAFLD may effectively prevent T2DM.Currently, the most of the health examination people only concern about thefasting blood glucose (FBG) level. They may miss abnormal postprandial glucosewith normal FBG. This study surveyed the prevalence of NAFLD in the healthyexamination population in the Second Affiliated Hospital of Zhengzhou University.OGTT test and insulin release test in patients with normal fasting blood glucose hadbeen carried out. The prevalence of abnormal blood glucose metabolism, obesity,hypertension, hypertriglyceridemia, hypercholesterolemia and high LDL-C in patients with NAFLD was investigated. At the same time, this study explored the relationshipamong NAFLD, abnormal lipid metabolism and IR. It may help for the earlyintervention of diabetes.2Subjects and methods2.1GroupingThe study enrolled1000cases with normal FBG, ages from25to60, as theresearch subject. They are accepted health examination at the Second AffiliatedHospital of Zhengzhou University in2013from January to July. The patients withNAFLD in the health examination were screened out.122cases were assigned to theNAFLD group including70males and52females. The mean age was49.20±10.88years old.88cases in the non-fatty liver crowd were assigned to the control group.There were46cases male and42cases were female. The mean age of control groupwas48.02±9.63years old. Then122cases of NAFLD were divided into mild fattyliver group, moderate fatty liver group and severe fatty liver group according to thedegree of steatosis.2.2Observations2.2.1The prevalence of obesity, NAFLD, hypertension, hypertriglyceridemia,hypercholesterolemia, high LDL-C and hyperlipidemia in health examinationpopulation;2.2.2The prevalence of obesity, hypertension, hypertriglyceridemia,hypercholesterolemia in NAFLD group and non-NAFLD group;2.2.3The differences of abnormal glucose metabolism between NAFLD group andnormal control group;2.2.4The biochemical test results and general information in NAFLD group andnormal control group.2.3Statistical analysisSPSS17.0software package was used for statistical analysis. The measurementdata showed in x±s. The two groups were compared by t test. The count data werecompared by chi-square test. The test level is α=0.05. The relationship amongdifferent levels of fatty liver and indicators compared by pearson correlation analysis.3Result 3.1The prevalence of metabolic diseases respectively were hypertension34.0%,obesity12.0%, non-alcoholic fatty liver disease30.1%, hypertriglyceridemia25.4%,hypercholesterolemia15.5%, high LDL-C hyperlipidemia12.0%;3.2The prevalence of metabolic diseases was higher in the NAFLD group than that inthe non-NAFLD group. The prevalence of obesity was7.9%VS4.2%，hypertension47.6%VS25.7%，hypercholesterolemia22.6%VS18.0%，hypertriglyceridemia51.2%VS14.2%. There was significant difference between two groups (P <0.05).3.3Compared the prevalence of abnormal glucose metabolism between NAFLDgroup and control group.There were16cases (18.2%) with abnormal glucose metabolism in controlgroup, and50cases (41.0%) with abnormal glucose metabolism in NAFLD group,including15cases with diabetes (12.3%),30cases with impaired glucosetolerance(24.6%),5cases with impaired fasting glucose (4.0%). Comparison ofNAFLD group with control group was significant difference (P <0.05) in theprevalence of abnormal glucose metabolism.3.4Compared other biochemical indicators and general information between NAFLDgroup and control group.In NAFLD group, BMI, waist circumference, TG, HOMA-IR, FINS,2hINS,SBP,HbA1C, PBG average levels were significantly higher than that in the normalcontrol group, there was significant difference (P<0.05). the levels ofTC, LDL-C,HDL-C, WHR, DBP, hip in two NAFLD groups were no significant difference(P>0.05).3.5Different degree of fatty liver and the biochemical index correlation analysis.Different degree of fatty liver was positively correlated with HOMA-IR, BMI,TG, FINS,2hINS, waist circumference,HbA1C and PBG.4Conclusions4.1The prevalence in NAFLD group with obesity, hypertension, hypertriglyceridemia,hypercholesterolemia is higher than that in normal control group;4.2Compared with healthy people, patients with NAFLD have obvious insulinresistance and abnormal lipid metabolism;4.3The severity of NAFLD was positively correlated with HOMA-IR, BMI, TG, FINS,2hINS, waist circumference, HbA1C and PBG;4.4The patients with NAFLD should perform OGTT test.