Association Of CTRP13 Serum Levels And Liver Lipid Contents,Insulin Resistance,Metabolic Disorders In Patients Of Type 2 Diabetes Mellitus And Non-alcoholic Fatty Liver Disease

Objective:C1q/TNF-Related Protein-13(CTRP13)is the fat factor,newly discovered,which regulates metabolism.There is a little information concerning CTRP13 in the context of NAFLD and T2DM.We examined the serum levels of CTRP13 in healthy control and patients with T2DM,NAFLD and NAFLD+T2DM,and evaluated correlations between CTRP13 serum levels and clinical and subclinical features to discuss the relationships among serum levels of CTRP13 and glycolipid metabolism,insulin resistance and fatty liver.Methods:We randomly recruited T2DM,NAFLD,NAFLD and T2DM patients from Gansu Provincial Hospital from October 2017 to October 2018.Control subjects were randomly selected from the medical center in our hospital and did not have any metabolic disorder.Patients and controls had no significant differences in ethnicity.Circulating CTRP13and anthropometric and laboratory measurement were measured in 168 subjects(41 healthy control,IR and BMI.CTRP13 serum levels were measured by ELISA method,and the quantitative analysis of fatty liver ultrasound images were performed,which the results were compared between groups,and the correlation between variables was analyzed.Results:1.The serum CTRP13 level was significantly lower in three groups of T2DM,NAFLD,T2DM+NAFLD than in healthy subjects,and it was lowest in group of T2DM+NAFLD,which differences were statistically significant(P﹤0.01).2.There were no significant difference in serum CTRP13 levels between men and women(P﹥0.05).3.After the NAFLD group was divided into light,medium and heavy,thevariance analysis showed no difference(P﹥0.05).4.ANOVA showed that the serum CTRP13 level were significantly negatively correlated with FPG(r=-0.225、P=0.017)、HbA1c(r=-0.291、P=0.002)、HOMA-IR(r=-0.209、P=0.026).5.Multivariate regression models showed that BMI(β=-3.249、P=0.002)、FPG(β=-2.449、P=0.016)、HbA1c(β=-3.489、P=0.001)、HOMA-IR(β=-2.291、P=0.024)were the independent risk factor of serum CTRP13.6.Logistic analysis showed that CTRP13 was the protective factor of T2DM(OR=0.997、P=0.000)、NAFLD(OR=0.998、P=0.001)、T2DM+NAFLD(OR=0.998、P=0.000).Futher the ROC curve analysis showed that the cut-off value of T2DM,NAFLD,T2DM+NAFLD in serum CTRP13 were separately1012pg/ml,1022pg/ml,372pg/ml,the AUC was respectively 0.869(95%CI0.776,0.961,P<0.01),0.822(95%CI0.709,0.935,P<0.01),0.890(95%CI0.806,0.974,P<0.01).Conclusions:The serum level of CTRP13 in patients of T2DM+NAFLD is significantly lower than in T2DM and NAFLD,and CTRP13,which is closely related to glycolipid metabolism index,insulin resistance and BMI,is not only the protective factor of three diseases,but also likely can predict them when it~’s serum level drops to a certain degree.