| ObjectiveNonalcoholic fatty liver disease(NAFLD)is a common metabolic disease of the liver that is closely related to type 2 diabetes mellitus(T2DM)and exacerbates the progression of related diseases.Recently,Cardiometabolic index(CMI),a novel index is proposed and researches show that CMI has predictive value in diabetes mellitus,atherosclerosis,ischemic stroke,hypertension,left ventricular and renal dysfunction.There is no research on the association between CMI and NAFLD.Therefore,this study intends to investigate the risk assessment and prediction value of CMI for NAFLD in patients with T2 DM.MethodsA total of 501 patients with T2 DM who were admitted to the department of endocrinology of our hospital from May 2018 to March 2020 were selected and their clinical indicators were measured.According to the results of ultrasound examination,the patients were divided into NAFLD group and non-NAFLD group and the clinical indicators between the groups were compared.The patients were divided into three groups according to the tertiles of CMI: T1(CMI < 0.765),T2(CMI 0.765~1.375)and T3(CMI ≥ 1.375)groups.The prevalence of NAFLD and clinical indicators was compared among three groups.The correlation between CMI and various indicators was analyzed,and the correlation between CMI and risks of NAFLD was discussed.The predictive value of CMI for NAFLD was analyzed by receiver operating characteristic curve(ROC)method and subgroup analysis.Results(1)Compared with the non-NAFLD group,NAFLD group had higher proportion of hypertension.Diastolic blood pressure(DBP),body mass index(BMI),waist circumference(WC),visceral fat area(VFA),subcutaneous fat area(SFA),visceral-tosubcutaneous fat area ratio(VSR),alanine aminotransferase(ALT),aspartate transaminase(AST),gamma-glutamyl transpeptidase(GGT),serum uric acid(SUA),total triglyceride(TG),total cholesterol(TC),fast c-peptide(FC-P),fast insulin(FIns)and homeostasis model-insulin resistance(HOMA-IR)were significantly higher in NAFLD groups compared to the non-NAFLD group,whereas high density lipoprotein cholesterol(HDL-C)levels were significantly lower(P < 0.05).The CMI value of the NAFLD group was significantly higher than that of the non-NAFLD group(P < 0.01).(2)From T1 to T3 group,the BMI,VFA,SFA,VSR,GGT,FC-P,FIns and HOMA-IR showed gradually increasing trend.The prevalence of NAFLD in the three groups was 46.1%,70.1%,and 85.0%,respectively,with statistically significance among the groups(P < 0.01).(3)CMI was positively correlated with DBP,BMI,VFA,SFA,VSR,ALT,GGT,SUA,TC,fasting plasma glucose(FPG),FC-P,FIns,HOMA-IR(P < 0.01)and AST(P < 0.05).(4)Logistic regression analysis showed that CMI was an independent risk factor for NAFLD(OR=2.053,95%CI: 1.422~2.964,P <0.01).Compared with T1 group,the risk of NAFLD in T2 and T3 groups was 2.735 and 6.639(P < 0.01),respectively.(5)The ROC analysis showed that the area under the curve(AUC)predicted by CMI for NAFLD was 0.738(95%CI: 0.691~0.784,P < 0.01),and the optimal critical value was 0.692,with sensitivity and specificity of 83.6% and 51.5%,respectively.Subgroup analysis showed that CMI had high sensitive in the non-overweight/obese T2 DM subgroup.Conclusions(1)CMI is a useful new index,reflecting the disorder of glucose and lipid metabolism in T2 DM patients.(2)Our results indicated that CMI has a good predictive value for NAFLD in T2 DM patients,especially in the non-overweight/obese subjects.CMI can be used as a predictor of NAFLD in T2 DM patients. |
