Study On The Correlation Between CIMT FFA Resistin And NAFLD In T2DM Patients

In the past 30 years,the prevalence of diabetes mellitus(DM)in China has increased significantly.2010 survey results show that the prevalence of people over the age of 18 up to 11.6%.At the same time,the incidence and detection rate of nonalcoholic fatty liver disease(NAFLD)increased year by year.Epidemiological data show that about 34%-74% of type 2 diabetes(T2DM)patients combined with NAFLD.The common pathogenesis of T2 DM and NAFLD is IR.IR and lipid metabolism disorders are often found in T2 DM patients,lipid toxicity is one of its mechanism.Serum free fatty acid(FFA),an intermediate product of lipid metabolism,can induce or aggravate IR and impair the function of pancreatic ?-cell,and trigger or promote the occurrence of T2 DM when its level is increased or the content of intracellular fat is increased,and its main role in the liver,pancreas and muscle.Adipose tissue is not only the body's energy storage organs,but also the largest secretion organs.The adipokines secreted by adipose tissue(e.g.resistin and TNF-a)not only play a role in the regulation of inflammation and immunity,but also involved in the body's metabolic regulation.Recent studies show that there is a close relationship between resistin and IR.Resistin can cause IR by weakening the multiple aspects of insulin signaling cascade reaction.Resistin is involved in the pathogenesis of T2 DM and NAFLD.A large number of studies have shown that the increased risk of cardiovascular complications in T2 DM patients with NAFLD,and is independent of other risk factors.T2 DM and NAFLD are independent risk factors for atherosclerosis.Carotid artery is the most common site of early AS,and carotid intima media thickness(CIMT)is often used as the predictive factor of AS in clinical practice.Therefore,we analyzed the clinical data of 138 T2 DM patients to explore the relationship between CIMT,FFA,Resistin and NAFLD in T2 DM patients.Objective:To investigate the relationship between CIMT,FFA,Resistin and NAFLD in T2 DM patients by observing the differences,and provide clinical basis for them in the prevention and control strategy.Methods:143 patients of Chengde Medical College affiliated hospital from March 2015 to October 2015 were selected,of which 138 cases meet the inclusion criteria.The general data of the patients were measured,such as sex,age,blood pressure,height,weight,waist circumference(WC),etc.Take the venous blood of all patients in the overnight fasting,and sent to the laboratory for determination the biochemical indexes of triglyceride(TG),total cholesterol(TCH),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),glycosylated hemoglobin(HbA1c)and fasting blood glucose(FPG).Liver and carotid ultrasonography were performed in all patients.The body mass index was calculated.The subjects were divided into T2 DM with non-NAFLD group(A group,n=44),T2 DM with mild NAFLD group(B group,n=39)and T2 DM with moderate NAFLD group(C group,n=55)according to the results of ultrasound.Results:1 Comparison of general informationSingle factor analysis of variance showed that there were no significant difference in sex,age and blood pressure among the three groups(P>0.05).The value of WC,BMI of B group and C group were(92.77±5.86)cm,(95.69±5.86)cm and(26.25±3.01)kg/m2,(27.53±2.92)kg/m2,which were significantly higher than those of A group(88.02±6.78)cm,(24.60±2.51)kg/m2,the difference was statistically significant(P<0.05).2 Comparison of glucose and lipid metabolismSingle factor analysis of variance showed that there was no significant difference in TCH among the three groups(P>0.05),and the difference of FPG,HbA1 c,TG,HDL-C and LDL-C were statistically significant(P<0.05).Compared with TG(1.40 ± 0.51)mmol/L,FPG(8.84 ± 2.32)mmol/L,HDL-C(0.89 ± 0.13)mmol/L of A group,the TG(2.08 ± 0.69)mmol/L,FPG(10.16±3.21)mmol/L and TG(2.13±0.60)mmol/L,FPG(10.50±3.15)mmol/L of C group were higher,the HDL-C(0.82±0.15)mmol/L of B group and(0.81 ± 0.11)mmol/L of C group were lower,the difference was statistically significant(P<0.05).Compared with the LDL-C(2.05±0.75)mmol/L?HbA1c(9.03±1.56)% of B group,LDL-C(2.37±0.65)mmol/L,HbA1c(9.69±1.59)% of C group were higher,the difference was statistically significant(P<0.05).3 Comparison of FFA,resistin,CIMTSingle factor analysis of variance showed that the differences of FFA,resistin and CIMT among the three groups were statistically significant(P<0.05).Compared with FFA(513.57±238.02)ng/mL,resistin(24.56±8.39)ng/mL,CIMT(0.90 ± 0.17)mm of A group,the FFA(656.59 ±250.64)ng/mL,resistin(29.94±10.98)ng/mL,CIMT(1.03±0.17)mm of C group were increased,the difference was statistically significant(P<0.05).There were no significant difference between FFA(556.94±248.78)ng/mL,resistin(28.20±11.21)ng/mL and CIMT(0.94±0.16)mm of B group and those of A group and C group(P> 0.05).4 The correlation between NAFLD and each indexThe index of WC,BMI,FPG,HbA1 c,TG,LDL-C,CIMT,FFA,resistin were positively correlated with the NAFLD(r=0.459,0.403,0.208,0.305,0.438,0.231,0.309,0.244,0.198,P<0.05),and HDL-C was negative correlation with it(r=-0.252,P<0.01).Conclusion:Obesity and glycolipid metabolic disorders were more obvious,the levels of FFA,resistin were higher,and the CIMT was larger in T2 DM with NAFLD.What's more,they were more serious with the more severity of NAFLD.