Serum Spexin Levels And Related Factors In T2DM And NAFL Patients

Objective: This study was designed to detect serum Spexin levels in healthy control,patients with non-alcoholic fatty liver(NAFL),type 2diabetes mellitus(T2DM)and T2DM+NAFL.In addition,the study aim to investigate the correlation of Spexin with T2 DM,NAFL and Nonalcoholic fatty liver disease fibrosis score.Methods: There are 60 patients each group with T2 DM and T2DM+NAFL who met the inclusion criteria and were hospitalized in the Department of Endocrinology of our hospital from March 2019 to November 2020 were randomly selected.Meanwhile,60 normal healthy subjects with gender and BMI matching and 60 subjects with NAFL were selected from the physical examination center of our hospital.All the subjects signed the informed consent,and the name,gender,age and other basic information of each subject were recorded respectively.Fasting blood samples were collected from the subjects in the morning to determine blood glucose,blood lipid,liver and kidney function,glycosylated hemoglobin,fasting insulin,fasting C peptide,Spexin,TNF-α and IL-6 levels.Calculate body mass index,insulin resistance index and NAFLD fibrosis score.Statistical analysis was performed using the SPSS statistical software(Version 26.0),and P < 0.05 indicated statistically significant results.Results:1 Compared with healthy control group,serum Spexin levels were significantly decreased in NAFL,T2 DM and T2DM+NAFL group,with statistical significance(P < 0.01);However,there was no significant difference in serum Spexin levels among NAFL,T2 DM and T2DM+NAFL groups.2 Serum Spexin expression levels among different subgroups:Compared with the normal weight group,the serum Sepxin level in the overweight and obesity group was significantly lower,and the Sepxin level in the obesity group was much lower than the overweight group(P < 0.01).However,there was no statistical distinction in serum Spexin level between the genders(P > 0.05).3 Correlation analysis showed that serum Spexin was negatively correlated with IL-6,TNF-α,BMI,SBP,DBP,TG,FBG,Hb A1 c,and positively correlated with HDL-C.Further multivariate stepwise regression analysis showed that BMI and Hb A1 c were the independent risk factors of serum Spexin(P < 0.01).4 ROC curve analysis showed that the cut-off value of serum Spexin in predicting the occurrence of NAFL,T2 DM and T2DM+NAFL were2347.50pg/ml,2647.50pg/ml and 2645.00pg/ml respectively,and the AUC were 0.777,0.740 and 0.795 respectively.Conclusion:1 Compared with healthy control group,serum Spexin level was significantly decreased in NAFL,T2 DM and T2DM+NAFL group,and was closely correlated with glycolipid metabolism and BMI;2 BMI and Hb A1 c were independent factors affecting Spexin;3 The decrease of serum Spexin is a risk factor for the occurrence of NAFL,T2 DM and T2DM+NFAL.