Relationship Between Vitamin D Levels And Liver Fat Content And Carotid Ather-Osclerosis In Type 2 Diabetic Patients With Non-alcoholic Fatty Liver Disease

Objectives: 1.To investigate the relationship between vitamin D levels and liver fat content in type 2 diabetes(T2DM)patients with NAFLD,and to analyze the possible risk factors affecting liver fat content and NAFLD.2.To investigate the relationship between vitamin D level and carotid atherosclerosis in patients with T2 DM and NAFLD,and to understand the possible risk factors for carotid atherosclerosis in patients with T2 DM and NAFLD.To provide reference for the prevention of NAFLD and atherosclerosis in clinically diabetic patients.Methods: Select T2 DM patients admitted to the First Affiliated Hospital of Guangxi Medical University from November 2015 to December 2017.The patient's general information,biochemical indicators were collected,and liver fat content and carotid intima-media thickness were calculated by ultrasound and other techniques.(1)188 patients with T2 DM were divided into NAFLD group and non-NAFLD group according to the presence or absence of NAFLD.and the course of disease,age,Serum uric acid(SUA),25-hydroxyvitamin D(25(OH)D),glycated hemoglobin A1c(HbA1c),fasting plasma glucose(FPG),postprandial 2-hour blood glucose(2hPG),total cholesterol(T-CHO),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),glutamyl transpeptidase(GGT),aspartate aminotransferase(AST),glutamic acid aminotransferase(ALT),liver fat content(LFC)were compared.(2)Patients were divided into Q1,Q2,and Q3 groups according to the liver three-point position,and vitamin D was compared among the three groups.(3)Patients with T2 DM combined with NAFLD were divided into two groups: sclerosis group and non-sclerosis group,Age,duration,25(OH)D,HbA1 c,fasting blood glucose,2hPG,T-CHO,TG,HDL-C,LDL-C,etc.were compared.Results:(1)The TG,GGT,FPG,HbA1 c and prevalence of combined hyperlipidemia in NAFLD group was higher than that in non-NAFLD group(P<0.05).There was no significant difference in 25(OH)D between the two groups(P>0.05).(2)According to the three points of liver fat content,there was no significant difference in 25(OH)D between groups(P>0.05).(3)Correlation analysis revealed that liver fat content was negatively correlated with disease duration,positively correlated with BMI,TG,AST,ALT,GGT,fasting blood glucose,and HbA1c(P<0.05),and had no correlation with 25(OH)D(rs= 0.009,P>0.05).(4)Stepwise linear regression analysis was performed with liver fat content as the dependent variable.The results showed that BMI and TG entered the regression equation(P<0.05).Using logistic regression analysis with or without NAFLD as the dependent variable,BMI,TG,and HbA1 c entered the regression equation(P<0.05).(5)In patients with T2 DM and NAFLD,the age of the sclerosis group was higher than that of the non-sclerosis group,and the 25(OH)D was lower than that of the non-sclerosis group.The difference was statistically significant(P<0.05).(6)Correlation analysis showed that carotid atherosclerosis was positively correlated with age and negatively correlated with 25(OH)D(P<0.01).Logistic regression analysis showed that age and 25(OH)D entered the regression equation(P< 0.01).Conclusion:(1)This study did not find that the occurrence of NAFLD in patients with T2 DM was related to the presence of vitamin D,and no correlation was found between liver fat contend and vitamin D.(2)BMI,TG,and HbA1 c are risk factors for NAFLD in patients with type 2 diabetes.(3)BMI and TG are risk factors affecting liver fat content.(4)Age is a risk factor for atherosclerosis in patients with T2 DM and NAFLD.25(OH)D is a protective factor.