| Objective:By studying the levels of serum fetuin A and adiponectin in patients with type 2 diabetes mellitus(T2DM)complicated with metabolically associated fatty liver disease(MAFLD),the risk factors of T2 DM complicated with MAFLD were explored,and the value of serum fetuin A and adiponectin in the diagnosis of T2 DM complicated with MAFLD was analyzed.Methods:A total of 206 patients with T2 DM who were admitted to the Department of Endocrinology,Cangzhou People ’s Hospital from November 01,2021 to October 31,2022 and met the inclusion criteria were selected.According to whether they were combined with metabolic associated fatty liver disease,they were divided into group A(T2DM+MAFLD)116 cases and group B(simple T2DM)90 cases.At the same time,80 healthy subjects who met the inclusion criteria were used as group C(control).The general data of gender,age,height and weight of the three groups were recorded.The routine biochemical indexes(glucose and lipid metabolism indexes)of the case group and the control group were carefully recorded.The level of fetuin A was quantitatively detected by enzyme-linked immunosorbent assay,and the level of adiponectin(latex-enhanced immunoturbidimetry)was quantitatively detected by Roche automatic biochemical analyzer.Spearman correlation analysis was used to analyze the correlation between fetuin A,adiponectin and other observation indexes.The related influencing factors of T2 DM combined with MAFLD were analyzed by binary logistic regression analysis.ROC curve was used to analyze whether fetuin A and adiponectin had auxiliary diagnostic value for T2 DM combined with MAFLD.Results:1.Comparison of serum fetuin A and adiponectin in three groups of subjectsThe levels of fetuin A in group A(T2DM+MAFLD)and group B(T2DM)were significantly higher than those in group C(healthy control)(763.72 ±81.00vs718.74±81.82vs634.06±84.49),and the levels of adiponectin were lower than those in group C(2.31(1.98,2.76)vs3.54(3.07,4.31)vs5.25(4.27,6.69))(P<0.001).The levels of fetuin A and adiponectin in the three groups were compared between groups,and there were also statistical differences(P<0.001),and the level of fetuin A was group A>group B>group C,and the level of adiponectin was group C>group B>group A.2.Correlation analysis of fetuin A,adiponectin and other indicatorsSpearman correlation analysis showed that fetuin A was positively correlated with BMI(r=0.420),waist circumference(r=0.413),fasting plasma glucose(r=0.359),fasting insulin(r=0.193),insulin resistance index(r=0.312),glycosylated hemoglobin(r=0.337),triglyceride(r=0.242)and lipoprotein a(r=0.146)(P<0.05),and negatively correlated with high density lipoprotein cholesterol(r=-0.216)and adiponectin(r=-0.445)(P<0.05).Adiponectin was negatively correlated with BMI(r=-0.586),waist circumference(r=-0.620),fasting plasma glucose(r=-0.641),fasting insulin(r=-0.243),insulin resistance index(r=-0.503),glycosylated hemoglobin(r=-0.503),triglyceride(r=-0.393),lipoprotein a(r=-0.155)and fetuin A(r=-0.445)(P<0.05),and positively correlated with high density lipoprotein cholesterol(r=0.373)(P<0.05),the differences were statistically significant.3.Logistic regression analysis resultsAccording to the results of single factor Logistic regression analysis,the influential indicators were included for multivariate binary Logistic regression analysis.The results showed that the increase of BMI(OR=1.590,95%CI1.149-2.201),the increase of fasting plasma glucose(OR=2.352,95%CI1.069-5.172),the increase of fetuin A(OR=1.011,95%CI 1.003-1.018)and the decrease of adiponectin(OR=0.030,95%CI 0.008-0.107)were independently correlated with the occurrence of T2 DM combined with MAFLD(P<0.05).4.ROC curve analysis resultsThe results of ROC curve analysis showed that the areas under the curve of fetuin A,adiponectin and their ratio in the diagnosis of T2 DM with MAFLD were 0.657,0.917 and 0.926,respectively.The optimal cut-off values were755.27 μ g/m L,2.93 μ g/m L and 251.94,respectively.The sensitivity was58.6%,82.8% and 81.9%,respectively,and the specificity was 74.4%,85.6%and 88.9%,respectively.Conclusions:1.The level of fetuin A in T2 DM patients and T2 DM patients with MAFLD was significantly higher than that in healthy people,while the level of adiponectin was significantly lower than that in healthy people;patients with MAFLD had higher fetuin A and lower adiponectin than those with simple T2 DM.2.The increase of BMI,fasting plasma glucose,fetuin A and the decrease of adiponectin were independent risk factors of T2 DM combined with MAFLD.3.Fetuin A and adiponectin have certain auxiliary diagnostic value for T2 DM combined with MAFLD,and the ratio of fetuin A to adiponectin is more valuable than single index. |
PDF Full Text Request