Association Between Serum Adropin And Osteocalcin Levels In Type 2 Diabetes Mellitus With Nonalcoholic Fatty Liver Disease

Objective: To investigate the association between serum adropin and osteocalcin levels in type 2 diabetes mellitus with nonalcoholic fatty liver disease.Methods: According to the inclusion criteria and exclusion criteria,170 inpatients in Affiliated Hospital of Zunyi Medical College from April 2017 to January 2018 were selected as the subjects.According to the 1999 WHO diagnostic criteria for diabetes and "nonalcoholic fatty liver disease diagnosis and treatment guidelines(2010 Revised Edition)",the subjects are divided into 4 groups: 42 cases of normal control group(NC group),32 cases of newly diagnosed type 2 diabetic group(T2DM group),46 cases of newly diagnosed nonalcoholic fatty liver disease group(NAFLD group),and 50 cases of newly diagnosed type 2 diabetic patients with nonalcoholic fatty liver disease group(T2DM+NAFLD group).Collected the general clinical data of all objects,tested the fasting blood glucose,fasting plasma insulin,glycosylated hemoglobin,alanine aminotransferase,aspartate aminotransferase,gamma glutamyl transferase,total cholesterol,triglyceride,high density lipoprotein cholesterol,low density lipoprotein cholesterol of all objects,calculated the body mass index,waist hip ratio and insulin resistance index.Enzyme-linked immunosorbent assay was uesd to test serum adropin and serum undercarboxylated Osteocalcin concentration;the SPSS22.0 statistical software for data processing and analysis: analysis of variance or Kruskal-Wallis H test were used in the four groups.Mann-Whitney U test was used among the two groups;Pearson or spearman correlation analysis,multiple linear stepwise regression analysis and logistic regression analysis were used to determine the relationship,P < 0.05 was statistically significant.Results:(1)The four groups in gender and age had no significant difference;(2)Compared with the NC group,the levels of WHR,FPG,Hb A1 c,HOMA-IR,TG and LDL-C in the T2 DM group were significantly increased(P < 0.05),and the levels of HDL-C,adropin and uc OC were significantly decreased(P < 0.05);Compared with the NC group,the levels of BMI,WHR,FPG?FIns,HOMA-IR,ALT,GGT,TG and LDL-C in the NAFLD group were significantly increased(P < 0.05),and the levels of AST/ALT,HDL-C,adropin and uc OC were significantly decreased(P < 0.05);Compared with the NC group,the levels of BMI,WHR,FPG,FIns,Hb A1 c,HOMA-IR,ALT,AST,GGT and TG in the T2DM+NAFLD group were significantly increased(P < 0.05),the levels of AST/ALT,HDL-C,adropin and uc OC were significantly decreased(P < 0.05);(3)Compared with the T2 DM group,the levels of ALT in the NAFLD group was significantly increased(P < 0.05),the levels of WHR,FPG,Hb A1 c,HOMA-IR and AST/ALT were significantly decreased(P < 0.05);Compared with the T2 DM group,the levels of BMI,WHR,Hb A1 c,HOMA-IR,ALT,AST and GGT in the T2DM+NAFLD group were significantly increased(P < 0.05),the levels of FPG,AST/ALT and adropin were significantly decreased(P < 0.05).(4)Compared with the NAFLD group,the levels of WHR,FPG,Hb A1 c and HOMA-IR in the T2DM+NAFLD group were significantly increased(P < 0.05),the levels of HDL-C and adropin were significantly decreased(P <0.05).(5)The level of serum adropin were negatively related with the level of WHR,FPG,Hb A1 c,HOMA-IR,GGT and TG;and it was positively correlated with HDL-C and uc OC;the level of uc OC was negatively correlated with the level of WHR,FPG,Hb A1 c,HOMA-IR,ALT,GGT and TG,and positively correlated with the level of AST/ALT,HDL-C and serum adropin.(6)FPG and GGT are the influencing factors of serum adropin,FPG and AST/ALT are the influencing factor of serum uc OC.(7)HOMA-IR,GGT and adropin are the influencing factors of NAFLD in T2 DM patients.Conclusion: Adropin is associated with nonalcoholic fatty liver disease in patients with type 2 diabetes,and low levels of adropin may be a risk factor for non-alcoholic fatty liver disease;Osteocalcin may not be associated with nonalcoholic fatty liver disease in type 2diabetic patients.