| Objective: This study is designed to investigate the relationship between the hypertriglyceridemic-waist circumference phenotype,liver fat content and visceral fat area in male patients with type 2 diabetes mellitus,and to analyze the correlation between LFC and VFA.Methods: Total 134 male patients with type 2 diabetes mellitus(aged20-64)were randomly recruited in the present study in First Hospital of Qin Huangdao during 2015.10-2016.8.The average age was 46.69±10.72 years old.All patients were in accordance with diabetes diagnostic criteria revised by the World Health Organization(WHO)in 2006.Base on whether plasma triglyceride concentration≥1.7mmol/L or not,waist circumference≥90cm or not,male patients with type 2 diabetes mellitus(n=134)were divided into four groups:normal waist circumference with normal triglyceride(group A),normal waist circumference with high triglyceride(group B),high waist circumference with normal triglyceride(group C)and hypertriglyceridemic-waist circumference phenotype(group HTWC).Take VFA ≥ 100cm2 as the boundary.Those subjects were excluded from study enrollment according to:1)Type 1 diabetes mellitus,special type of diabetes;2)A large number of long-term drinking history,alcohol intake≥ 140 g / week;3)Viral hepatitis,autoimmune liver disease and other causes of liver disease;4)Diabetic ketosis and ketoacidosis;5)The history of taking lipid-lowering drugs,malignant tumor,psychiatric disorders,and the recent of infection.The following information was collected from the subjects: age,height,weight,waist circumference(WC),VFA,LFC,triglyceride(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),low-density lipoproteincholesterol(LDL-C),alanine aminotransferase(ALT),aspartate aminotransferase(AST),platelet,albumin,fasting blood glucose(FBG),Hb A1 c.Then the body mass index(BMI)and NAFLD fibrosis score(NFS)were calculated.NFS=-1.675+0.037 * age(year)+0.094 * BMI(kg/m2)+1.13* impaired fasting glucose / diabetes(yes=1,no=0)+0.99 x AST/ALT-0.013 x platelet(x 109/L)-0.066 * albumin(g/L).VFA was measured by bioelectrical impedance method.LFC was measured by echo attenuation coefficient.All analyses were performed using the SPSS 17.0 statistical software.Analysis of normality and homogeneity of variance before analysis.Values were expressed as mean with standard deviation.The non normal distribution data were log transformed.The data of normal distribution between groups were compared by variance analysis(ANOVA),multiple comparisons were performed using the LSD test.Between the groups of non normal distribution measurement data using the Wilcoxon rank sum test(Kruskal-Wallis H).Single factor correlation analysis using Pearson correlation analysis and drawing scatter plot.Count data were compared using the Chi square test.Logistic regression analysis was used to screen the risk factors.P < 0.05 for the difference was statistically significant.Results:1 The average VFA of A,B,C,HTWC group were 72.50±12.07,91.15±18.89,97.11±15.57,121.75±20.2.The average VFA in group HTWC was significantly higher than that in group A,B and C(P = 0.00,0.00,0.00),the VFA in group C was significantly higher than that in group A(P = 0.00),the VFA in the group B was significantly higher than that in group A(P =0.006),there was no significant difference in VFA between group B and C(P =0.367);2 The average LFC of A,B,C,HTWC group were 12.22±2.16,23.16±5.75,23.53±5.07,32.39±6.78.The average LFC in group HTWC was significantly higher than that in group A,B and C(P = 0.00,0.031,0.025),the LFC in group C was significantly higher than that in group A(P = 0.004),the LFC in the group B was significantly higher than that in group A(P = 0.008),there was no significant difference in LFC between group B and C(P = 0.927);3 The average NFS in group HTWC was significantly higher than that in groups A,B and C(P = 0.002,0.033,0.029),the NFS in group C was significantly higher than that in group A(P = 0.009),the NFS in the group B was significantly higher than that in group A(P = 0.008),there was no significant difference in NFS between group B and C(P = 0.927);4 VFA was negatively correlated with HDL-C(r=-0.209,P < 0.05).VFA were positively correlated with WC(r=0.457,P < 0.05),BMI(r=0.323,P <0.05),LFC(r=0.812,P < 0.05),TG(r=0.251,P < 0.05),TC(r=0.200,P <0.05),LDL-C(r=0.225,P < 0.05).There was not any correlation between VFA and age,AST,ALT,FBG,Hb A1c;5 The detection rates of VFA ≥ 100cm2 in the four groups were 16.7%,44%,54.5%,and 74.4%.Take VFA as the dependent variable(no =0,yes=1).Take TG,TC,LDL-C,HDL-C,AST,ALT,BMI,WC,LFC,whether HTWC(triglyceride and waist circumference were normal =1,simple triglyceride high =2,Simple waist high =3,HTWC phenotype =4)as the independent variable.Perform a logistic regression analysis,the results showed that except LFC,the HTWC was a risk factor for VFA in patients with type 2 diabetes mellitus.After correction of TG,TC,LDL-C,HDL-C,AST,ALT,BMI,WC,LFC,the detection rate of VFA in group HTWC was 12.597 times higher than that in group A(OR=12.597,95%:1.359~116.730).Conclusions:1 The levels of VFA and LFC are significantly increase in young and middle-aged male type 2 diabetic patients with HTWC.HTWC is a risk factor for elevated VFA in young men with type 2 diabetes mellitus,it can be used as a simple indicator for screening VFA more than 100cm2.2 VFA is significantly positively correlated with LFC.Taking into account the the cost of measuring LFC by liver biopsy,proton magnetic resonance spectroscopy is high,it is difficult to promote.The measurement of liver echo attenuation coefficient is time-consuming.VFA is easy to operate and low cost by bioelectrical impedance measurement.VFA can be used to determine thelevel of LFC increase or decrease trend.3 The level of NFS in type 2 diabetic patients with HTWC is significantly higher than that of non HTWC in the young and middle-aged men,and it was more likely to develop liver fibrosis than the non HTWC. |
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