| Objective: With the increasing prevalence of type 2 diabetes mellitus(T2DM),the detection rate of nonalcoholic fatty liver disease(NAFLD)in patients with T2 DM is also increasing.A foreign study showed that the prevalence of NAFLD in the general population was 5%,but in obese and T2 DM patients can be as high as 25% ~75%.Osteocalcin(OC)is a kind of structural protein which is synthesized by osteoblasts and has the properties of calcium regulatory proteins.It plays an important role in the regulation of bone mineralization,bone maturation and bone remodeling.However,the latest research suggests that osteocalcin may be involved in the regulation of energy metabolism,can reverse insulin resistance,high blood glucose and obesity.At the same time,it can reduce energy consumption.The aim of this study was to investigate the role of serum osteocalcin in the development of nonalcoholic fatty liver disease in patients with type 2 diabetes mellitus.Methods: 104 male patients with T2 DM were divided into NAFLD+T2DM group and T2 DM group.29 normal subjects were selected as normal control group.All the subjects were required to record the clinical data of hypoglycemic treatment,duration of diabetes,height,weight,serum osteocalcin concentration,fasting blood glucose(FBG),fasting insulin(FINS),glycosylated hemoglobin(HbA1c),triglyceride(TG),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),γ-glutamyl transpeptidase(gamma-GT),body mass index(BMI)and other indicators.The concentration of OC and the correlation between the three groups were compared,and the correlation between OC and the measured parameters was analyzed.Results: The level of TC,TG,LDL-C,FBG,BMI,HbA1 c,insulin resistance index(HOMA-IR),FINS and alanine aminotransferase(ALT)in NAFLD + T2 DM group were higher than that in T2 DM group(P <0.05),while HDL-C,25-OH-VitD3,OC concentration were lower than that in T2 DM group,the difference was statistically significant(P<0.05).There was a negative correlation between HOMA-IR,BMI,TC,and serum OC concentration in NAFLD+T2DM group,but there was no correlation obserbed in T2 DM group and normal control group.FBG and HbA1 c in group NAFLD+T2DM and group T2 DM were negatively correlated with serum OC level,but no correlation was found in normal control group.The negative correlation between OC and TG was found in all three groups,but the same correlation between FINS,HDL-C,LDL-C,ALT,γ-GT,HOMA-β was not be found;Multiple linear regression analysis showed that TG(β =-0.029,P=0.000),HbA1c(β=-0.282,P=0.006),FBG(β =-0.022,P=0.010)are independent factors affecting the level of OC;Logistic regression showed that OC(OR=0.681,95%CI:0.533 ~ 0.870)and 25-OH-VitD3(OR=0.904,95%CI:0.851 ~ 0.960)are protective factors of type 2diabetes mellitus with non-alcoholic fatty liver disease.Conclusion: The level of serum OC in patients with type 2 diabetes mellitus complicated by nonalcoholic fatty liver disease is significantly lower than that in type2 diabetes mellitus,and OC is the protective factor of type 2 diabetes mellitus with nonalcoholic fatty liver disease. |
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