摘要
Objective: To study the relationship between serum osteocalcin level and glucose and lipid metabolism in patients with type 2 diabetes mellitus complicated with nonalcoholic fatty liver disease. Methods: The clinical data of 180 type 2 diabetes mellitus patients in Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China from February 2017 to January 2018 were retrospectively analyzed, including 90 cases of nonalcoholic fatty liver disease patients (group A) and 90 cases of nonalcoholic fatty liver disease-free patients (group B), meanwhile another 100 healthy subjects were selected as the control group. Then various indexes were compared between groups, including serum osteocalcin, alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), prothrombin activity (PTA), fasting blood glucose (FBG), glycated hemoglobin (HbA1c), triglyceride (TG), total cholesterol (TC), low density lipoprotein (LDL), high density lipoprotein (HDL), fasting insulin (FINS), fasting C peptide (FCP), HOMA insulin resistance index (HOMA-IR), HOMA β-cell function (HOMA-β). Results: The serum osteocalcin and PTA in group A were significantly lower than those in group B and the control group (P<0.05). ALT, AST, and ALP were significantly higher than those in group B and the control group (P<0.05). The FBG and HbA1c in group A were significantly higher than those in group B and the control group (P<0.05). The TG, TC, LDL, and HDL of group A and group B were significantly higher than those of the control group (P<0.05). The FINS, FCP, and HOMA-IR in group A were significantly higher than those in group B and the control group (P<0.05). HOMA-βwas significantly lower than group B and the control group (P<0.05). Pearson correlation analysis showed that the serum osteocalcin was not correlated with ALT, AST, ALP, PTA, HbA1c, TG, TC, LDL, HDL and FINS (P>0.05), but negatively correlated with FBG and HOMA-IR (P<0.05), and positively correlated with FCP and HOMA-β (P<0.05). With serum osteocalcin as the dependent variable, and ALT, AST, ALP, PTA, FBG, HbA1c, TG, TC, LDL, HDL, FINS, FCP, HOMA-IR and HOMA-β as independent variables, multiple stepwise regression analysis showed that the FBG, HOMA-IR and HOMA-β were independent risk factors for osteocalcin. Conclusions: Patients with type 2 diabetes mellitus complicated with nonalcoholic fatty liver disease have lower serum osteocalcin level, which is susceptible to FBG, HOMA-IR, HOMA-β, and other factors.
