Correlation Between Nonalcoholic Fatty Liver Disease And Arteriosclerosis In Type 2 Diabetes Patients

Objective:Analyze the effect of NAFLD on arteriosclerosis and explore the risk factors of arteriosclerosis in T2DM patients.To investigate the predictive value of controlled attenuation parameter(CAP)on arteriosclerosis in people with T2DM.Methods:166 patients with T2DM were selected from the Department of Endocrinology and Metabolism of Changzhou Second People’s Hospital from December 2020 to October 2021.They were divided into T2DM group(n=36)and T2DM combined with NAFLD group(n=130)by CAP measured by Fibrotouch.T2DM combined with NAFLD group was further divided into mild,moderate and severe groups(n=32,n=59,n=39).Arteriosclerosis was diagnosed by carotid media thickness()and brachio-ankle pulse wave velocity(ba PWV).General data,biochemical and noninvasive indexes,and the morbidity of arteriosclerosis in each group were compared.Fibrotouch indexes of liver include CAP and Liver Stiffness Measurement(LSM).Liver fibrosis indexes include FIB4,APRI and NFS,and Liver inflammation index is FibroAST,which are calculated by the formula in relevant literature;Spearman correlation analysis was used for univariate correlation analysis,and logistic regression analysis was used for multivariate correlation analysis.The diagnostic efficacy of CAP and FIB4 on arteriosclerosis in T2DM population was tested by the working characteristic curve(ROC)of subjects.Results:1.The prevalence of NAFLD in 166 T2DM patients included in this cohort was 78.31%.There was no significant difference between DM group and DM+NAFLD group in gender,age,systolic blood pressure,and course of disease Diastolic blood pressure,BMI,waist circumference,visceral and subcutaneous fat area in DM+NAFLD group were higher than those in DM group(P<0.05).2.DM+NAFLD group showed significantly higher levels of AST,ALT,γ GT,TG,TC,FINS,HOMA-IR,CAP,LSM and FAST DM group(P<0.05).There was significant difference in ba PWV and ABI between the two groups(P<0.05).3.Univariate correlation analysis showed that age,diastolic blood pressure,systolic blood pressure,course of disease,ba PWV,CIMT,CAP,LSM,FIB4,FAST were positively correlated with the morbidity of arteriosclerosis in T2DM population(P<0.05).4.Regression analysis showed that CAP and FIB4 were independent predictors of arteriosclerosis in T2DM patients(P<0.05).5.The morbidity of arteriosclerosis in DM+NAFLD group(83.8%)was significantly higher than that in DM group(66.7%)(P<0.05).The morbidity of arteriosclerosis in T2DM patients combined with mild,moderate and severe nonalcoholic fatty liver disease was 68.8%,88.1% and 89.7%.There was a significant difference in the morbidity of arteriosclerosis between T2DM patients with mild NAFLD and those with moderate and severe NAFLD(P<0.05).6.Divided by the severity of NAFLD,the differences in age,diastolic blood pressure,systolic blood pressure,BMI,waist circumference,visceral fat area,subcutaneous fat area,AST,ALT,r GT,TG,TC,HDL,UA,FINS,FCP,HOMA-IR,CAP,LSM,FAST,APRI were statistically significant(P<0.05).7.We utilized ROC curves to explore whether CAP could act as diagnostic markers to identify arteriosclerosis in T2DM patients.We found CAP provided a reliable discrimination effect with an area under the curve(AUC)of 0.676.Importantly,when combined with FIB-4,the value of the ROC curve was further improved,with an AUC of 0.749.Conclusions:1.Waist circumference,BMI,blood pressure,visceral and subcutaneous fat area,TG,TC,LSM,hepatic function disorder and insulin resistance were higher in T2DM.2.CAP and FIB4 are independent predictors of arteriosclerosis in T2DM.The predictive efficiency of CAP is 67.6%,which can reach 74.9% combined with FIB4.3.T2DM and NAFLD patients are more likely to develop arteriosclerosis than T2DM patients.The morbidity of arteriosclerosis rise as NAFLD progressed.