The Related Research Of Iron Metabolism And Insulin Resistance In Male Patients With Type 2 Diabetes Mellitus Patients Complicated With Nonalcoholic Fatty Liver Disease In Qinghai Area

Objective:To investigate the changes of iron metabolism and the effect on insulin resistance in patients with type 2 diabetes mellitus complicated with non-alcoholic fatty liver in Qinghai.Methods:The study subjects selected 200 male patients from the Affiliated Hospital of Qinghai University from October 2018 to October 2020 who met the inclusion and exclusion criteria,aged 22-82 years.Including 100 patients in type 2 diabetes mellitus complicated with non-alcoholic fatty liver and 100 patients in a simple type 2 diabetes mellitus group,50 healthy people who underwent physical examination in our hospital at the same time were selected as the control group.The general information of the candidates was recorded.The indexes of iron metabolism,biochemical indexes,fasting insulin,fasting C-peptide,glycosylated hemoglobin and blood routine were collected.All the selected subjects were examined by liver color ultrasound,and the data were statistically analyzed.Results:①There was no significant difference in age,height,waistline and blood pressure among the three groups(P>0.05),but the body weight and body mass index in type 2 diabetes mellitus complicated with non-alcoholic fatty liver group were higher than those in simple diabetes group and healthy control group(P<0.05).②The level of triglyceride in type 2 diabetes mellitus complicated with non-alcoholic fatty liver group was higher than that in simple diabetes group and healthy control group(P<0.05),but there was no significant difference between simple diabetes group and healthy control group(P>0.05).Uric acid in type 2 diabetes mellitus complicated with non-alcoholic fatty liver group was higher than that in simple diabetes group(P<0.05).③The level of serum ferritin in type 2 diabetes mellitus complicated with non-alcoholic fatty liver group was significantly higher than that in simple diabetes group and healthy control group(P<0.05),The simple diabetes group is higher than the healthy control group(P<0.05).The total iron binding capacity in type 2 diabetes mellitus complicated with non-alcoholic fatty liver group was higher than that in simple diabetes group and healthy control group(P<0.05),but there was no significant difference between simple diabetes group and healthy control group(P>0.05).There was no significant difference in serum iron,unsaturated iron binding capacity and transferrin saturation among the three groups(P>0.05).④Fasting insulin,insulin resistance index and fasting C-peptide in type 2 diabetes mellitus complicated with non-alcoholic fatty liver group were higher than those in simple diabetes group and healthy control group.Fasting blood glucose in type 2 diabetes complicated with non-alcoholic fatty liver group was higher than that in healthy control group,but there was no significant difference between type 2 diabetes complicated with non-alcoholic fatty liver group and simple diabetes group(P>0.05).The insulin resistance index in type 2 diabetes mellitus complicated with non-alcoholic fatty liver group was higher than that in simple diabetes group and healthy control group(P<0.05).⑤The levels of alanine aminotransferase and glutamyl transpeptidase in type 2 diabetes mellitus complicated with non-alcoholic fatty liver group were higher than those in simple diabetes group and healthy control group(P<0.05),but there was no significant difference between simple diabetes group and healthy control group(P>0.05).There was no significant difference in aspartate aminotransferase,Alkaline Phosphatase and total bilirubin,direct bilirubin and indirect bilirubin among the three groups(P>0.05).⑥The hemoglobin and hematocrit in type 2 diabetes mellitus complicated with non-alcoholic fatty liver group were higher than those in simple diabetes group and healthy control group(P<0.05).There was no significant difference in Mean Corpuscular Volume,Mean Corpuscular Hemoglobin,Mean Corpuscular Hemoglobin Concentration among the three groups(P>0.05).⑦The correlation analysis showed that there was a correlation between type 2 diabetes mellitus complicated with non-alcoholic fatty liver group(there was no correlation between iron metabolism index and insulin resistance in simple diabetes group):there was a positive correlation between serum ferritin and insulin resistance rs=0.549,(P<0.001).There was a negative correlation between unsaturated iron binding capacity and insulin resistance rs=-0.246,(P<0.05).There was a negative correlation between total iron binding capacity and insulin resistance rs=-0.197,(P<0.05).There was a positive correlation between transferrin saturation and insulin resistance rs=0.213,(P<0.05).There was no significant correlation between serum iron and insulin resistance(P>0.05).Conclusions:①Type 2 diabetic patients complicated with non-alcoholic fatty liver had higher levels of serum ferritin,total iron binding capacity,fasting blood glucose,fasting insulin and insulin resistance.②There was a correlation between iron metabolism and insulin resistance index in patients with type 2 diabetes mellitus complicated with non-alcoholic fatty liver.It is suggested that iron metabolism may be involved in insulin resistance.③Alanine aminotransferase and glutamyl transpeptidase increased in patients with type diabetes mellitus complicated with fatty liver,suggesting that type 2 diabetes mellitus complicated with non-alcoholic fatty liver is easy to cause abnormality of liver enzyme index and damage of liver function.