Influencing factors for hepatic fat accumulation in patients with type 2 diabetes mellitus

doi:10.12998/wjcc.v9.i26.7717

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World Journal of Clinical Cases

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Retrospective Study

World J Clin Cases. Sep 16, 2021; 9(26): 7717-7728
Published online Sep 16, 2021. doi: 10.12998/wjcc.v9.i26.7717

Table 1 Comparison of clinical and laboratory characteristics among the three groups

Variable	Normal weight group	Overweight group	Obese group	P value
Cases	127	123	79	-
Age (yr)	54.72 ± 13.40^c	55.98 ± 15.03^c	46.41 ± 16.25^a^,^b	< 0.001
Height (cm)	164.66 ± 8.36^c	165.78 ± 8.09^c	169.32 ± 9.37^a^,^b	0.001
Weight (cm)	60.00 (13.00)^b^,^c	71.00 (10.00)^a^,^c	87.00 (16.00)^a^,^b	< 0.001
BMI (kg/m^b)	21.97 (2.63)^b^,^c	25.81 (1.80)^a^,^c	29.76 (3.47)^a^,^b	< 0.001
WC (cm)	83.18 ± 7.81^b^,^c	92.43 ± 6.47^a^,^c	103.73 ± 9.20^a^,^b	< 0.001
HC (cm)	91.52 ± 7.41^b^,^c	98.96 ± 6.51^a^,^c	106.89 ± 8.18^a^,^b	< 0.001
WHR	0.91 (0.06)^b^,^c	0.95 (0.07)^a^,^c	0.97 (0.06)^a^,^b	< 0.001
HFF (%)	7.02 (2.39)^b^,^c	8.51 (4.91)^a^,^c	13.03 (11.69)^a^,^b	< 0.001
FPG (mmol/L)	6.42 (3.55)^b^,^c	7.59 (2.73)^a^,^c	8.44 (3.74)^a^,^b	< 0.001
HbA_1c(%)	9.64 ± 2.23	9.38 ± 2.10	9.48 ± 2.11	0.639
FINS (uU/mL)	9.55 (9.70)^b^,^c	11.80 (8.40)^a	12.10 (8.60)^a	0.014
FCP (ng/mL)	0.85 (0.90)^b^,^c	1.20 (1.10)^b^,^c	1.60 (1.50)^a^,^b	< 0.001
FGC (pg/mL)	104.50 (51.90)	96.50 (51.40)	97.50 (54.90)	0.239
HOMA-IR	2.62 (3.11)^b^,^c	4.05 (3.31)^a	4.57 (3.01)^a	< 0.001
ALT (U/L)	18.80 (12.30)^c	22.10 (14.50)^c	36.80 (43.00)^a^,^b	< 0.001
AST (U/L)	18.10 (6.40)^c	20.40 (8.70)^c	27.00 (22.30)^a^,^b	< 0.001
DBIL (mmol/L)	3.90 (1.90)	3.90 (2.50)	4.50 (2.10)	0.078
IBIL (mmol/L)	9.60 (4.70)^c	10.30 (6.00)	10.60 (5.50)^a	0.018
TBIL (mmol/L)	13.30 (6.10)^c	14.10 (8.10)	15.50 (8.20)^a	0.031
LPS (U/L)	30.20 (16.70)^c	29.60 (10.60)^c	27.10 (9.50)^a^,^b	0.045
HBDH (U/L)	30.20 (16.70)	29.60 (10.60)	27.10 (9.50)	0.786
ALP (U/L)	82.70 (33.30)	82.40 (34.30)	81.40 (29.30)	0.487
LDH (U/L)	165.00 (39.00)^c	169.00 (43.00)	179.00 (53.00)^a	0.027
CK (U/L)	70.70 (44.40)	75.50 (58.10)	77.60 (51.70)	0.230
GGT (U/L)	20.80 (17.50)^b^,^c	26.30 (33.10)^a^,^c	37.70 (39.60)^a^,^b	< 0.001
ALB (g/L)	41.40 (5.30)^c	42.20 (3.90)^c	43.20 (4.00)^a^,^b	0.007
GLB (g/L)	25.70 (5.20)	26.30 (4.60)	26.50 (4.50)	0.379
A/G	1.60 (0.40)	1.60 (0.40)	1.60 (0.30)	0.206
UA (μmol/L)	280.00 (109.00)^b^,^c	334.00 (94.00)^a^,^c	384.00 (137.00)^a^,^b	< 0.001
Cr (μmol/L)	56.00 (21.00)^b	61.00 (19.00)^a	59.00 (20.00)	0.016
TC (mmol/L)	4.40 ± 0.85	4.58 ± 1.32	4.64 ± 1.18	0.273
TG (mmol/L)	1.06 (0.64)^b^,^c	1.45 (1.13)^a^,^c	1.86 (1.46)^a^,^b	< 0.001
LDL-C (mmol/L)	2.46 (0.95)^c	2.66 (1.15)	2.89 (1.05)^a	0.006
HDL-C (mmol/L)	1.31 (0.42)^b^,^c	1.14 (0.27)^a	1.12 (0.36)^a	< 0.001
CRP (mg/L)	1.07 (2.60)^b^,^c	1.59 (2.30)^a	2.16 (3.00)^a	< 0.001
TSH (mIU/L)	2.19 (1.58)	2.50 (1.88)	2.21 (1.60)	0.127
FT3 (pmol/L)	2.42 ± 0.42	2.49 ± 0.48	2.56 ± 0.46	0.109
FT4 (pmol/L)	1.15 ± 0.29	1.12 ± 0.29	1.10 ± 0.26	0.463

^aP < 0.05 compared with the normal weight group.

^bP < 0.05 compared with the overweight group.

^cP < 0.05 compared with the obese group. BMI: Body mass index; WHR: Waist to hip ratio; HFF: Hepatic fat fraction; FPG: Fasting plasma glucose; HbA_1c: Glycosylated hemoglobin; FINS: Fasting insulin; FCP: Fasting C-peptide; FGC: Fasting glucagon; HOMA-IR: Homeostasis assessment of insulin resistance; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; DBIL: Direct bilirubin; IBIL: Indirect bilirubin; TBIL, Total bilirubin; LPS: Lipase; HBDH: Hydroxybutyrate dehydrogenase; ALP: Alkaline phosphatase; LDH: Lactate dehydrogenase; CK: Creatine kinase; GGT: γ-glutamyl transpeptidase; ALB: Albumin; GLB: Globulin; A/G: Albumin to globulin ratio; UA: Uric acid; Cr: Creatinine; TC: Total cholesterol; TG: Triglyceride; LDL-C: Low-density lipoprotein cholesterol; HDL-C: High-density lipoprotein cholesterol; CRP: C-reactive protein; TSH: Thyroid stimulating hormone; FT3: Free triiodothyronine; FT4: Free thyroxine.

Table 2 Spearman correlation analysis of hepatic fat fraction with other variables

Variable	r	P value
Age	0.136	0.013
BMI	0.493	< 0.001
WHR	0.227	< 0.001
FPG	0.281	< 0.001
FINS	0.133	0.016
FCP	0.385	< 0.001
HOMA-IR	0.247	< 0.001
UA	0.305	< 0.001
ALT	0.459	< 0.001
AST	0.385	< 0.001
DBIL	0.154	0.005
IBIL	0.251	< 0.001
TBIL	0.234	< 0.001
LDH	0.126	0.022
GGT	0.413	< 0.001
ALB	0.217	< 0.001
TC	0.193	< 0.001
TG	0.478	< 0.001
LDL-C	0.269	< 0.001
HDL-C	-0.251	< 0.001
CRP	0.251	< 0.001
FT3	0.157	0.005

BMI: Body mass index; WHR: Waist to hip ratio; FPG: Fasting plasma glucose; FINS: Fasting insulin; FCP: Fasting C-peptide; HOMA-IR: Homeostasis assessment of insulin resistance; UA: Uric acid; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; DBIL: Direct bilirubin; IBIL: Indirect bilirubin; TBIL, Total bilirubin; LDH: Lactate dehydrogenase; GGT: γ-glutamyl transpeptidase; ALB: Albumin; TC: Total cholesterol; TG: Triglyceride; LDL-C: Low-density lipoprotein cholesterol; HDL-C: High-density lipoprotein cholesterol; CRP: C-reactive protein; FT3: Free triiodothyronine.

Table 3 Multivariate linear regression analysis of hepatic fat fraction with other variables in type 2 diabetes mellitus patients

Variable	B	SE	β	t	P value	95%CI
ALT	0.080	0.008	0.437	9.455	< 0.001	0.063-0.096
BMI	0.409	0.083	0.246	4.925	< 0.001	0.246-0.573
LDL-C	1.040	0.380	0.121	2.737	0.007	0.292-1.788
UA	0.008	0.003	0.108	2.253	0.025	0.001-0.014
ALB	0.135	0.065	0.091	2.070	0.039	0.007-0.263

ALT: Alanine aminotransferase; BMI: Body mass index; LDL-C: Low-density lipoprotein cholesterol; UA: Uric acid; ALB: Albumin; CI: Confidence interval.

Table 4 Multivariate binary logistic regression analysis of independent influencing factors for moderate to severe fatty liver in type 2 diabetes mellitus patients

Variable		B	SE	Wald	P value	OR	95%CI
BMI	< 24
	24-27.99	0.830	0.329	6.361	0.012	2.294	1.203-4.373
	≥ 28	1.615	0.379	18.121	< 0.001	5.027	2.390-10.572
ALT		0.028	0.007	15.643	< 0.001	1.029	1.014-1.043
ALB		0.099	0.036	7.480	0.006	1.105	1.029-1.186
LDL-C		0.537	0.185	8.389	0.004	1.710	1.189-2.459

BMI: Body mass index; ALT: Alanine aminotransferase; ALB: Albumin; LDL-C: Low-density lipoprotein cholesterol; CI: Confidence interval.

Citation: Wu MJ, Fang QL, Zou SY, Zhu Y, Lu W, Du X, Shi BM. Influencing factors for hepatic fat accumulation in patients with type 2 diabetes mellitus. World J Clin Cases 2021; 9(26): 7717-7728
URL: https://www.wjgnet.com/2307-8960/full/v9/i26/7717.htm
DOI: https://dx.doi.org/10.12998/wjcc.v9.i26.7717