Correlation Between Sonographic Hepatorenal Ratio And Serological Indicators In Patients With Type 2 Diabetes Mellitus

Objective To explore the the difference of hepatorenal ratio and its correlation with serological indicators in crowd echoes with multiple status of glucose metabolism.Methods(1)A total of 217 subjects(55 normal, 42 patients with impaired glucose regulation and 120 patients with type 2 diabetes mellitus) were selected in this study.( 2) All subjects were fasting for 8 hours, then conventional two-dimensional ultrasound were performed in the supine and left lateral decubitus position. Intercostal and subcostal scans for liver-kidney sagittal images, exporting and choosing the better quality images for offline analysis.(3)The average grey scale value in the region of interest were calculated using software NIHimage, and the sonographic hepatorenal ratio which was able to predict liver fat content were calculated.( 4) Within 24 hours after the ultrasound for blood tests, gathering blood biochemical indexes of blood lipid and liver function and renal function.(5)At last, we analysed the correlation between hepatorenal ratio and serological indicators in people with different status of glucose metabolism.Results1. The mean values of hepatorenal ratio in three groups: patients with IGR > patients with T2 DM > normal population, and the difference was statistically significant(F=5.571,P=0.004).2. Normal population: ①There is no correlation between hepatorenal ratio and BMI as well as age(P > 0.05); ②Hepatorenal ratio have positive correlation with TG、ALT、SUA(P < 0.05), and have negative correlation with HDL; ③ Multivariate linear regression analysis was calculated, in which hepatorenal ratio was dependent variable while TG, TC, HDL, LDL, ALT, AST, γ-GT, ALP, SUA were independent variables,and the results showed that TG and SUA entried the equation and the equation was Y)=0.867+0.001×SUA+0.043×TG(R2=0.411,n=45,P=0.000).3.Patients with IGR: ①There is no correlation between hepatorenal ratio and BMI as well as age(P > 0.05); ② There is no correlation between hepatorenal ratio andserological indicators.4. Patients with T2DM: ①There is no correlation between hepatorenal ratio and BMI as well as age(P > 0.05); ②Hepatorenal ratio have positive correlation with TG,ALT, AST, γ-GT, LDL, GHb(P < 0.05), while no correlation with HDL, LDL, ALP and blood uric acid(P > 0.05); ③Multivariate linear regression analysis was calculated, in which hepatorenal ratio was dependent variable while TG, TC, HDL, LDL, ALT, AST, γ-GT, ALP, SUA were independent variables, and the results showed that only TG entried the equation Y)=1.245+0.062×TG(R2=0.210, n=120, P=0.000); ④ The mean of hepatorenal ratio in patients with abnormally increased TG(> 1.92mmol/L) was(1.559 ±0.470), and the 95% confidence interval was(1.417-1.699); The receiver operating characteristic curve was constructed which showed that the best critical value of hepatorenal ratios for TG abnormality was 1.236 and that the area under curve(AUC)was 0.677 while the sensitivity, specificity was 86.7%, 45.3%, respectively.Conclusion1. The sonographic hepatorenal ratio is a reliable index for predicting liver fat content;2. The sonographic hepatorenal ratio is higher in patients with IGR than patients with T2 DM, more attention and early treatment are needed in clinical;3. TG and SUA are important factors of the hepatorenal ratio in normal people, and TG and SUA should be regularly monitored to prevent occurrence of NAFLD;4.The TG concentration is an important factor of the hepatorenal ratio in patients with T2 DM, and should be regularly monitored to reduce the occurrence of NAFLD.