Serum CTRP9 Level In Patients With Type 2 Diabetes Mellitus And Non-alcoholic Fatty Liver Disease

Objective: C1q/TNF associated protein 9(CTRP9)is a newly discovered adipocytokine,which has the functions of regulating lipid metabolism,anti-inflammatory and anti-oxidation.Little research has been done in patients with type 2 diabetes mellitus(T2DM)and non-alcoholic fatty liver disease(NAFLD).This study aims to detect the changes of CTRP9 expression and its relationship with lipids in patients with type 2 diabetes mellitus(T2DM)and type 2 diabetes mellitus with non-alcoholic fatty liver disease(CTRP9).To explore the role and clinical significance of ctrp9 in the pathogenesis of the disease.Methods : In this study,151 patients hospitalized in the department of endocrinology of our hospital from September 2020 to September 2021 and healthy people in our hospital in the same period were selected.According to the existence of NAFLD and T2 DM,they were divided into three groups: control group,T2 DM group and T2 DM combined with NAFLD group.Collect the general clinical data of all subjects,measure the levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST),creatinine(Cr),uric acid(UA),triglyceride(TG),total cholesterol(TC),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),fasting plasma glucose(FPG),fasting insulin(FINS)and glycosylated hemoglobin A1c(Hb A1c)in peripheral blood,and calculate the insulin resistance index(HOMA-IR).The level of ctrp9 was determined by ELISA.Results:(1)The levels of age,diastolic blood pressure,BMI,systolic blood pressure,FBG,FINS,HOMA-IR,Hb A1 c and TG increased and HDL-C decreased in patients with T2 DM complicated with NAFLD.(2)The level of CTRP9 increased in patients with T2 DM and T2 DM complicated with NAFLD.(3)In all subjects,the level of CTRP9 was positively correlated with age,systolic blood pressure,diastolic blood pressure,TG,LDL-C,FPG,HOMA-IR,FINS and Hb A1c;The level of CTRP9 was negatively correlated with HDL-C.In all T2 DM patients,CTRP9 was positively correlated with body weight and negatively correlated with HDL-C level.(4)Regression equation between CTRP9 and other indicators: CTRP9 = Hb A1 c * 34.614-HDL-C* 61.087 +weight * 2.982-142.252.(5)In the univariate model,increased body weight,BMI,SDP,ALT,LDL-C,FINS,HOMA-IR,Hb A1 c and CTRP9 concentrations and decreased HDL-C levels were associated with a higher prevalence of T2 DM complicated with NAFLD.In the multivariate model,BMI,FINS,ALT and Hb A1 c were independently associated with a higher prevalence of T2 DM complicated with NAFLD.CTRP9 and other factors did not enter the final model.After correcting blood pressure and BMI,high-level CTRP9 was associated with T2 DM.After correcting blood pressure and BMI,CTRP9 was not associated with T2 DM complicated with NAFLD.Conclusions: The level of CTRP9 is related to metabolic parameters such as insulin resistance.Serum ctrp9 plays an important role in the development of insulin resistance or obesity in type 2 diabetes.The increase of CTRP9 in patients with type 2 diabetes and type 2 diabetes complicated with nonalcoholic fatty liver disease may be a compensatory response to the occurrence and development of the disease.