Correlation Analysis Between The Level Of Plasma Amino Acids And Type 2 Diabetes Mellitus With Non-alcoholic Fatty Liver Disease

Background:Many studies have found that plasma amino acid levels are closely related to the risk of type 2 diabetes(T2DM),but there are few studies on the relationship between plasma amino acid levels and type 2 diabetes mellitus complicated with Nonalcoholic fatty liver disease(NAFLD).Objective:In this study,the plasma levels of 23 amino acids in patients with T2 DM combined with NAFLD group and T2 DM without NAFLD group were compared To exploring the influencing factors of T2 DM complicated with NAFLD,so as to deepen the understanding of NAFLD in patients with T2 DM,and provide new ideas for the diagnosis and treatment of NAFLD and T2 DM.Methods:A total of 187 patients with T2 DM were diagnosed in Second Affiliated Hospital of Dalian Medical University from January 2018 to November 2020 were enrolled.All patients were examined by abdominal ultrasonography.According to the diagnostic criteria of abdominal ultrasonography of NAFLD,all patients were divided into two groups: T2 DM with NAFLD group(n = 117)and only T2 DM group(as control group)(n = 70).2.General data such as age,sex,height,weight,systolic blood pressure and diastolic blood pressure were recorded,and BMI was calculated.General laboratory inspection such as alanine aminotransferase(ALT),aspartate aminotransferase(AST),γ-glutamyl transpeptidase(GGT),alkaline phosphatase(ALP),cholesterol,triglyceride,High density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),fasting blood glucose,fasting insulin,creatinine and uric acid were collected,and HOMA-IR was calculated.3.The plasma was detected by ultra-high performance liquid chromatography and electrospray ionization quadrupole time-of-flight mass spectrometry,and 23 kinds of amino acids were obtained.The levels of 23 kinds of plasma amino acids in the two groups were analyzed,and the data were analyzed by SPSS26 statistical software.Result:1.Compared with the control group,the levels of body weight,BMI,fasting blood glucose,fasting insulin,HOMA-IR,triglyceride,ALT,AST,GGT,creatinine and uric acid were significantly increased and HDL-C was significantly decreased in T2DM+NAFLD group(P <0.05),but there was no significant difference in sex,age,systolic blood pressure,diastolic blood pressure,cholesterol,LDL-C and ALP(P >0.05).2.Compared with the control group,the levels of alanine,asparagine,homocysteine,leucine,phenylalanine,proline,tyrosine and valine in T2DM+NAFLD group were significantly increased.There was no significant difference in other amino acids such as arginine,aspartic acid,citrulline and so on between the two groups.(P > 0.05).3.Alanine was positively correlated with HOMA-IR and triglyceride.Asparagine was positively correlated with BMI,triglyceride and was negatively correlated with HDL.Homocysteine was positively correlated with BMI,fasting insulin.HOMA-IR and was negatively correlated with HDL.Leucine was positively correlated with BMI and fasting blood glucose,and was negatively correlated with HDL.Phenylalanine was positively correlated with triglyceride and was negatively correlated with HDL.Tyrosine was positively correlated with fasting insulin and was negatively correlated with HDL.Valine was positively correlated with BMI,fasting blood glucose and triglyceride,but was negatively correlated with HDL.4.Univariate logistic regression analysis showed that body weight,BMI,fasting blood glucose,fasting insulin,HOMA-IR,triglyceride,HDL,ALT,AST,GGT,creatinine,uric acid,alanine,asparagine,homocysteine,leucine,phenylalanine,proline,tyrosine and valine were associated with T2 DM complicated with NAFLD.Multivariate logistic regression analysis showed that BMI,alanine,homocysteine and valine were independent risk factors for T2 DM complicated with NAFLD.5.The diagnostic value of BMI,alanine,homocysteine and valine in T2 DM complicated with NAFLD was analyzed by ROC curve.The results showed that BMI(AUC=0.770,the sensitivity was 0.786,the specificity was 0.657),alanine(AUC=0.715,the sensitivity was 0.590,the specificity was 0.743),homocysteine(AUC=0.774,the sensitivity was 0.632,the specificity was 0.843),valine(AUC=0.732,the sensitivity was 0.632,the specificity was 0.729).Conclusion:1.The levels of alanine,asparagine,homocysteine,leucine,phenylalanine,proline,tyrosine and valine were increased in patients with T2 DM complicated with NAFLD,suggesting that the changes of amino acid levels may be related to T2 DM complicated with NAFLD.2.Alanine,homocysteine and valine are independent risk factors for the occurrence of T2 DM complicated with NAFLD,suggesting that these three amino acids may have a predictive value for the occurrence of T2 DM complicated with NAFLD.3.Alanine,homocysteine and valine have a reference value in for the diagnosis of T2 DM complicated with NAFLD.