Metabolic characteristics of non-obese and obese metabolic dysfunction-associated fatty liver disease in type 2 diabetes mellitus and its association with diabetic peripheral neuropathy and diabetic retinopathy.
Metabolic characteristics of non-obese and obese metabolic dysfunction-associated fatty liver disease in type 2 diabetes mellitus and its association with diabetic peripheral neuropathy and diabetic retinopathy.
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DOI：
10.3389/fmed.2023.1216412
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发表时间：
2023
影响因子：
3.9
通讯作者：
Xu, Jing
中科院分区：
文献类型：
--
作者：
Dang, Si-Wen;Gao, Lei;Li, Yu-Jun;Zhang, Ruo;Xu, Jing
关键词：
评估非肥胖代谢功能障碍相关脂肪肝病 (MAFLD) 与肥胖 MAFLD 相比的代谢特征，以及 MAFLD 与 2 型糖尿病 (T2DM) 患者糖尿病周围神经病变和糖尿病视网膜病变的关系。数据来自 536 名 T2DM 患者（355 名女性，181 名男性；年龄 58.2±12.0 岁）。我们探讨了T2DM患者中肥胖MAFLD（体重指数≥25kg/m2）和非肥胖MAFLD（体重指数<25kg/m2）的临床特征差异。单因素方差分析（ANOVA）用于比较连续变量的均值，卡方检验用于比较分类变量的频率差异。采用逻辑回归模型来计算优势比。据计算，中国住院 T2DM 患者中 MAFLD 的患病率为 42.7%。与相同体重组中未患MAFLD的参与者相比，肥胖和非肥胖MAFLD患者的体重指数（BMI）、腰围、甘油三酯、丙氨酸转氨酶、天冬氨酸转氨酶、γ-谷氨酰转移酶水平较高，年龄较小，高脂血症患病率较高，T2DM病程较短，糖尿病视网膜病变发生率较低。仅在非肥胖受试者中尿酸水平与 MAFLD 风险呈正相关，而在肥胖受试者中则不然。在非肥胖 T2DM 患者中，MAFLD 患病率与糖尿病视网膜病变之间呈负相关。即使在非肥胖的 T2DM 患者中，BMI 也被发现是 MAFLD 的独立危险因素。这些发现支持一种更加结构化、基于风险因素的 MAFLD 管理方法，特别是对于 T2DM 患者。非肥胖MAFLD在代谢特征以及与糖尿病视网膜病变、糖尿病周围神经病变的相关性方面具有独特的结果，值得进一步探讨。
To assess the metabolic characteristics of non-obese metabolic dysfunction-associated fatty liver disease (MAFLD) compared with obese MAFLD and the relationship of MAFLD with diabetic peripheral neuropathy and diabetic retinopathy in patients with Type 2 diabetes mellitus (T2DM). Data were obtained from 536 T2DM patients (355 women, 181 men; age 58.2 ± 12.0 years). We explored the difference in clinical characteristics between obese MAFLD (body mass index ≥25 kg/m2) and non-obese MAFLD (body mass index <25 kg/m2) in T2DM patients. One-way analysis of variance (ANOVA) was used to compare the means of continuous variables, and the Chi-squared test was used to compare the differences in frequencies of categorical variables. Logistic regression models were adopted to calculate odds ratios. The prevalence of MAFLD in hospitalized Chinese T2DM patients was calculated to be 42.7%. Both obese and non-obese MAFLD patients had higher levels of body mass index (BMI), waist circumfere nce, triglyceride, alanine aminotransferase, aspar tate aminotransferase, γ-glutamyltransferase, you nger age, higher prevalence of hyperlipidemia and shorter duration of T2DM and lower incidence of diabetic retinopathy, compared with participants with out MAFLD in the same weight group. Uric acid levels were positively correlated with the risk of MAFLD only in non-obese subjects but not in obese subjects. In non-obese patients with T2DM, a negative correlation was found between the prevalence of MAFLD and diabetic retinopathy. Even in non-obese patients with T2DM, BMI was found to be an independent risk factor for MAFLD. These findings support a more structured, risk-factor-based approach to MAFLD management, particularly in patients with T2DM. Non-obese MAFLD has unique results in metabolic characteristics and the correlation with diabetic retinopathy and diabetic peripheral neuropathy, which should be further explored.
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