The Research Of The Relationship Between Nesfatin-1 And Insulin Resistance In Type 2 Diabetes Patients With Nonalcoholic Fatty Liver

Objective:To explore the change of serum Nesfatin-1 and insulin resistance in healthy people, type 2 diabetes, non alcoholic fatty liver, and type 2 diabetes complicated with non alcoholic fatty liver. To research the relationship between the both and the type 2 diabetes meliitus as well as non alcoholic fatty liver.To explore the possible relationship between serum Nesfatin-1 and insulin resistance.Methods:108 cases, who were outpatients, hospitalized patients and healthy physical examina in the First Affiliated Hospital of Nanchang University from April 2014 to January 2015, were involved in this research according to the inclusion criteria. All the patients were newly-diagnosed. They were divided into 4 groups: normal control group(group NC) with 28 cases, simple type 2 diabetes mellitus group(DM group)with 26 cases, simple non alcoholic fatty liver group(NAFLD group) with 27 cases,type 2 diabetes mellitus complicated with non alcoholic fatty liver group(DM+NADLD group) with 27 cases. The data of cases, such as sex, age, height, body weight, blood pressure, waist circumference, hip circumference were recorded, and calculated the body mass index(BMI) and the waist hip ratio(WHR).Fasting serum concertations of nesfatin-1 were messured using an enzyme-linked immunosorbent assay(ELISA) method. The serum levels of fasting blood glucose(FBG),hemoglobin A1c(Hb A1c), fasting plasma insulin(FINS), body lipid were also tested.The insulin resistance index(HOMA-IR) of all the cases was calculated by the method of homeostasis model assessment: HOMA-IR=FBG×FINS/22.5. All data were statistically analyzed : the data were statistically analyzed by t-test, ANOVA,linear correlation and multiple linear regression analysis.Results:Serum nesfatin-1 concentrations in DM+NAFLD group were significantly lowerthan NC group, DM group,and NAFLD group(2.15±0.95ng/m L, 3.71±0.98ng/m L,3.53±0.93ng/m L, 3.00±0.66ng/m L, respectively, and P<0.01). The serum levels of nesfatin-1 in NAFLD group is significantly lower than the NC group(P<0.01). The serum levels of nesfatin-1 in DM group shows a decreased tendency compared with NC group, but has no statistical difference(P > 0.05). In NAFLD group, serum nesfatin-1 concentrations were lover when compared with DM group, and the diffreences were statistically significant(P<0.05). Using the person correlation analysis shows the serum nesfatin-1 level is negatively correlated with weight, BMI,waistline, WHR, TC, TG, LDL-C, FPG, HOMA-IR and Hb A1C(r=-0.286、r=-0.304、r=-0.325、r=-0.243、r=-0.213、r=-0.273、r=-0.316、r=-0.391、r=-0.462、r=-0.284).While it has no significant correlation with gender, SBP, DBP, HDL-C, ALT and AST.Establish the multiple linear stepwise regression model in which weight, BMI,waistline, WHR, TC, TG, LDL-C, FPG, HOMA-IR and Hb A1 C as the dependent variable and the serum nesfatin- 1 level as independent variable.The result shows HOMA-IR is the independent factor influencing serum Nesfatin-1(r2=0.213,P=0.00).Conclusions:The levels of serum Nesfatin-1 have no significant statistical difference between simple type 2 diabetes mellitus and healthy people. Nesfatin-1 levels in patients with simple NAFLD is lower than healthy controls and simple type 2 diabetes mellitus,and it further reduced in type 2 diabetes mellitus patients combined with NAFLD.Insulin resistance is increased significantly in type 2 diabetes mellitus and NAFLD patients. The serum nesfatin-1 levels is negatively correlated with HOMA-IR, and HOMA-IR is the independent factor affecting serum Nesfatin–1. The results indicate that Nesfatin-1 and insulin resistance may have a significant role in type 2 diabetes mellitus and NAFLD.