Study On Serum Levels Of IGF-1 And UA In Patients With Type 2 Diabetes Mellitus Complicated With Nonalcoholic Fatty Liver Disease

ObjectiveWith the improvement of living standards,the development of type 2 diabetes mellitus(T2DM)is also younger,and the incidence of various acute and chronic complications and comorbidities gradually increased,such as:diabetic ketoacidosis,diabetic nephropathy,diabetic cardio-cerebral vascular disease,Non-alcoholic fatty liver disease(NAFLD)Wait;,etc.;among these complications,NAFLD is one of the most common chronic comorbidities of T2DM;and,T2DM is as an independent risk factor for the development of NAFLD,NAFLD can continue to develop into cirrhosis and hepatocellular carcinoma,which poses a great threat to human health.Insulin growth factor-1(IGF-1)and uric acid(Uric acid,UA)are involved in the formation and progression of diseases such as T2DM and NAFLD as a variety of factors in cell biological function.Currently,IGF-1 and there are not many studies on the correlation of UA in T2DM and NAFLD.The purpose of this study was to investigate the expression of IGF-1 and UA in patients with T2DM and NAFLD.Method168 patients diagnosed with T2DM were divided into 4 groups according to the presence or absence of NAFLD and Hyperuricemia(HU A).1.T2DM combined with NAFLD group(group A)a total of 81 cases,divided into high uric acid(HUA)group(A1 group)47 cases(25 males,22 females);normal uric acid group(A2 group)34 cases(18males,16 females).2.A total of 87 patients in the T2DM group(group B)were divided into high uric acid(HUA)group(B1 group)36 cases(19 males and 17 females);normal uric acid group(B2 group)51(male 27)For example,24 women).3.Patients who eligible the enrollment were collected on an empty stomach at admission.The following indicators were detected by biochemical analyzer:Asperate aminotransferase(AST),Alanine aminotransferase(ALT),and valley Glutenyl transpeptidase(GGT),Triglyceride(TG),Total cholesterol(TC),High density lipoprotein cholesterol(HDL-C),Low density lipoprotein cholesterol(LDL-C),Uric acid(UA),Creatinine(Crin),Thyroid stimulating hormone(TSH),Triiodothyronine(T3),Thyroxine(T4),Fasting blood glucose(FBG),Fasting insulin(FIns),Fasting C peptide(C peptide),Glycated hemoglobin(HbAlc),Weight calculation Body mass index(BMI),Waist-to-hip ratio(Waist to hip ratio,WHR),Homeostasis model of assessment for insulin resistance index(HOMA-IR)4.Collect the whole blood sample of the patient and centrifuge at 1000×g for 10 minutes in a low-speed centrifuge(within 2 hours at room temperature);take the supernatant and store in the refrigerator at-80℃;use the enzyme in the central laboratory of the Affiliated Central Hospital of Shenyang Medical College.The instrument detects the concentration of IGF-1.Result1.Group A(T2DM combined with NAFLD)compared with group B(Simple T2DM),body weight,BMI,WHR,FBG,HbA1C,C peptide,FIns,HOMA-IR,GGT,ALT,TG,LDL-C,UA increased,IGF-1,HOMA-p,HDL-C decreased,the difference was statistically significant(P<0.05);creatinine,AST,TC had no significant difference(P>0.05).2.AI group(T2DM combined with NAFLD+HUA)compared with A2 group(T2DM combined with NAFLD+UA normal),body weight,BMI,WHR,FBG,HbAlC,C peptide,Flns,HOMA-IR,GGT,ALT,TG,LDL-C and UA increased,IGF-1,HOMA-β and HDL-C decreased,the difference was statistically significant(P<0.05).There was no significant difference in creatinine,AST and TC(P>0.05).3.B1 group(T2DM+HUA)compared with B2 group((T2DM+UA normal)),body weight,BMI,WHR,FBG,HbAlC,C peptide,FIns,HOMA-IR,GGT,ALT,TG,LDL-C and UA increased,IGF-1,HOMA-β,HDL-C decreased,the difference was statistically significant(P<0.05);creatinine,AST,TC had no significant difference(P>0.05).4.Group A1(T2DM combined with NAFLD+HUA)compared with B1 group(T2DM+HUA),body weight,BMI,WHR,FBG,HbAlC,C peptide,FIns,HOMA-IR,GGT,ALT,TG,LDL-C,UA increased,HOMA-P,IGF-1,HDL-C decreased,the difference was statistically significant(P<0.05);creatinine,AST,TC had no significant difference((P>0.05).5.A2 group(T2DM combined with NAFLD+UA normal)compared with B2 group(T2DM+UA normal)body weight,BMI,WHR,FBG,HbAlc,C peptide,FIns,HOMA-IR,GGT,ALT,TG,LDL-C,UA increased,HOMA-β,IGF-1,HDL-C decreased,the difference was statistically significant(P<0.05);creatinine,AST,TC had no significant difference(P>0.05).6.Correlation of IGF-1 with other biochemical indicators:IGF-1 is linearly negatively correlated with body weight,BMI,WHR,FBG,FIns,C peptide,HOMA-IR,TG,LDL-C,UA,GGT,ALT(P<0.05),positive correlation with HOMA-β and HDL-C(P<0.05);no significant correlation with age,height,TC,creatinine(P>0.05);further multivariate logistic regression analysis showed FBG,HOMA-IR,HOMA-β,UA,and C peptides had significant effects on serum IGF-1 levels.7.There were no significant differences in age,gender,height,and thyroid function(T3,T4,TSH)between the two groups(P>0.05).Conclusion1.Compared with T2DM alone,the prevalence of HUA in T2DM combined with NAFLD group increased.2.Compared with T2DM alone,the serum levels of IGF-1 were decreased in patients with T2DM and NAFLD.3.IGF-1 has a significant relationship with FBG,HOMA-IR,HOMA-β,UA,C peptide.Among them,the lower the IGF-1,the more severe the insulin resistance,and the lower the function of islet P cells.4.The common relationship between T2DM,NAFLD and HUA is IR,which is causal and mutually influential.IGF-1 acts as a protective factor for the three,which can improve insulin sensitivity and delay islet β cell failure.Improve T2DM with NAFLD and HUA.