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The Risk Factor Analysis for Type 2 Diabetes Mellitus Patients with Nonalcoholic Fatty Liver Disease and Positive Correlation with Serum Uric Acid

Abstract

Recent years, we has witnessed a sharp increase in the complications of Type 2 diabetes mellitus (T2DM) with nonalcoholic fatty liver disease (NAFLD). Here we aimed to determine the risk factors for T2DM patients with NAFLD and the relationship of serum uric acid (SUA) in these complications. We performed retrospective analysis of 300 T2DM patients admitted into our hospital from April 2010 to January 2014. We divided the T2DM patients into two groups based on whether the patients also had NAFLD or not, Group A (without NAFLD, 155 cases) and Group B (with NAFLD, 145 cases). General information of the patients was collected and analyzed statistically. Meanwhile, we detected and compared the blood biochemistry, glucose, and fasting insulin (FINS), and further performed Logistic regression analysis and determined the risk factors in T2DM patients with NAFLD. Significantly higher BMI, waist circumference, hip circumference, WHR, systolic, and diastolic blood pressure were observed in T2DM patients with NAFLD than the patients without NAFLD, which were statistically different (P < 0.05). There were also significant higher levels of TC, TG, ALT, AST, GGT, and SUA in T2DM patients with NAFLD than those in patients without NAFLD, which were statistically different (P < 0.05). Significantly higher levels of FPG, FINS, and HOMA-IR were observed in the T2DM patients with NAFLD than those without, which were statistically significant (P < 0.05). Logistic regression analysis also showed high BMI, WHR, TG, and SUA were independent risk factors in T2DM patients with NAFLD (P < 0.05). Meanwhile, SUA levels were positively correlated with BMI, W, H, WHR, hip circumference, waist circumference, TG, ALT, AST, GGT, FPG, FINS, and HOMA-IR, which were statistically significant (P < 0.05). The risk factors for T2DM patients with NAFLD are mainly BMI, WHR, TG, and SUA. Our findings provide clinical implications for the prevention and early diagnosis of T2DM patients with NAFLD.

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References

  1. Samuel, V. T., Liu, Z. X., Qu, X., Elder, B. D., Bilz, S., Befroy, D., et al. (2004). Mechanism of hepatic insulin resistance in non-alcoholic fatty liver disease. Journal of Biological Chemistry, 279, 32345–32353.

    CAS  PubMed  Article  Google Scholar 

  2. Angulo, P. (2002). Nonalcoholic fatty liver disease. New England Journal of Medicine, 346, 1221–1231.

    CAS  PubMed  Article  Google Scholar 

  3. Sertoglu, E., Ercin, C. N., Celebi, G., Gurel, H., Kayadibi, H., Genc, H., et al. (2014). The relationship of serum uric acid with non-alcoholic fatty liver disease. Clinical Biochemistry, 47, 383–388.

    CAS  PubMed  Article  Google Scholar 

  4. Lee, Y. J., Lee, H. R., Lee, J. H., Shin, Y. H., & Shim, J. Y. (2010). Association between serum uric acid and non-alcoholic fatty liver disease in Korean adults. Clinical Chemistry and Laboratory Medicine, 48, 175–180.

    CAS  PubMed  Google Scholar 

  5. Sirota, J. C., McFann, K., Targher, G., Johnson, R. J., Chonchol, M., & Jalal, D. I. (2013). Elevated serum uric acid levels are associated with non-alcoholic fatty liver disease independently of metabolic syndrome features in the United States: Liver ultrasound data from the National Health and Nutrition Examination Survey. Metabolism, 62, 392–399.

    CAS  PubMed Central  PubMed  Article  Google Scholar 

  6. Kumashiro, N., Erion, D. M., Zhang, D., Kahn, M., Beddow, S. A., Chu, X., et al. (2011). Cellular mechanism of insulin resistance in nonalcoholic fatty liver disease. Proceedings of the National Academy of Sciences USA, 108, 16381–16385.

    CAS  Article  Google Scholar 

  7. Wang, Z., Yao, T., Pini, M., Zhou, Z., Fantuzzi, G., & Song, Z. (2010). Betaine improved adipose tissue function in mice fed a high-fat diet: A mechanism for hepatoprotective effect of betaine in nonalcoholic fatty liver disease. American Journal of Physiology. Gastrointestinal and Liver Physiology, 298, G634–G642.

    CAS  PubMed Central  PubMed  Article  Google Scholar 

  8. Lomonaco, R., Ortiz-Lopez, C., Orsak, B., Webb, A., Hardies, J., Darland, C., et al. (2012). Effect of adipose tissue insulin resistance on metabolic parameters and liver histology in obese patients with nonalcoholic fatty liver disease. Hepatology, 55, 1389–1397.

    CAS  PubMed  Article  Google Scholar 

  9. Ying, X., Jiang, Y., Qian, Y., Jiang, Z., Song, Z., & Zhao, C. (2012). Association between insulin resistance, metabolic syndrome and nonalcoholic fatty liver disease in chinese adults. Iranian Journal of Public Health, 41, 45–49.

    CAS  PubMed Central  PubMed  Google Scholar 

  10. Valenti, L., Mendoza, R. M., Rametta, R., Maggioni, M., Kitajewski, C., Shawber, C. J., et al. (2013). Hepatic notch signaling correlates with insulin resistance and nonalcoholic fatty liver disease. Diabetes, 62, 4052–4062.

    CAS  PubMed Central  PubMed  Article  Google Scholar 

  11. Kalra, S., Vithalani, M., Gulati, G., Kulkarni, C. M., Kadam, Y., Pallivathukkal, J., et al. (2013). Study of prevalence of nonalcoholic fatty liver disease (NAFLD) in type 2 diabetes patients in India (SPRINT). Journal of the Association of Physicians of India, 61, 448–453.

    PubMed  Google Scholar 

  12. Park, S. K., Seo, M. H., Shin, H. C., & Ryoo, J. H. (2013). Clinical availability of nonalcoholic fatty liver disease as an early predictor of type 2 diabetes mellitus in Korean men: 5-year prospective cohort study. Hepatology, 57, 1378–1383.

    CAS  PubMed  Article  Google Scholar 

  13. Birkenfeld, A. L., & Shulman, G. I. (2014). Nonalcoholic fatty liver disease, hepatic insulin resistance, and type 2 diabetes. Hepatology, 59, 713–723.

    PubMed Central  PubMed  Article  Google Scholar 

  14. Bonapace, S., Valbusa, F., Bertolini, L., Pichiri, I., Mantovani, A., Rossi, A., et al. (2014). Nonalcoholic fatty liver disease is associated with aortic valve sclerosis in patients with type 2 diabetes mellitus. PLoS One, 9, e88371.

    PubMed Central  PubMed  Article  Google Scholar 

  15. Targher, G., & Byrne, C. D. (2013). Clinical review: Nonalcoholic fatty liver disease: a novel cardiometabolic risk factor for type 2 diabetes and its complications. Journal of Clinical Endocrinology and Metabolism, 98, 483–495.

    CAS  PubMed  Article  Google Scholar 

  16. Shibata, M., Kihara, Y., Taguchi, M., Tashiro, M., & Otsuki, M. (2007). Nonalcoholic fatty liver disease is a risk factor for type 2 diabetes in middle-aged Japanese men. Diabetes Care, 30, 2940–2944.

    CAS  PubMed  Article  Google Scholar 

  17. Trojak, A., & Idzior-Walus, B. (2012). Nonalcoholic fatty liver disease as a risk factor of macroangiopahty in patients with type 2 diabetes. Przeglad Lekarski, 69, 1276–1279.

    PubMed  Google Scholar 

  18. Ismail, M. H. (2011). Nonalcoholic fatty liver disease and type 2 diabetes mellitus: the hidden epidemic. American Journal of the Medical Sciences, 341, 485–492.

    PubMed  Article  Google Scholar 

  19. Gronbaek, H., Thomsen, K. L., Rungby, J., Schmitz, O., & Vilstrup, H. (2008). Role of nonalcoholic fatty liver disease in the development of insulin resistance and diabetes. Expert Review of Gastroenterology and Hepatology, 2, 705–711.

    CAS  PubMed  Article  Google Scholar 

  20. Hwang, I. C., Suh, S. Y., Suh, A. R., & Ahn, H. Y. (2011). The relationship between normal serum uric acid and nonalcoholic fatty liver disease. Journal of Korean Medical Science, 26, 386–391.

    CAS  PubMed Central  PubMed  Article  Google Scholar 

  21. Nakanishi, N., Okamoto, M., Yoshida, H., Matsuo, Y., Suzuki, K., & Tatara, K. (2003). Serum uric acid and risk for development of hypertension and impaired fasting glucose or Type II diabetes in Japanese male office workers. European Journal of Epidemiology, 18, 523–530.

    CAS  PubMed  Article  Google Scholar 

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Correspondence to Muhuyati Wulasihan.

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Li, Yl., Xie, H., Musha, H. et al. The Risk Factor Analysis for Type 2 Diabetes Mellitus Patients with Nonalcoholic Fatty Liver Disease and Positive Correlation with Serum Uric Acid. Cell Biochem Biophys 72, 643–647 (2015). https://doi.org/10.1007/s12013-014-0346-1

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  • DOI: https://doi.org/10.1007/s12013-014-0346-1

Keywords

  • NAFLD
  • T2DM
  • SUA
  • WHR