DA、CARM1、25-(OH)-D 3在糖尿病患者外周血中的表达及与NAFLD发生的关系

Expression of DA,CARM1 and 25-(OH)-D 3 in peripheral blood of diabetic patients and their relationship with the occurrence of NAFLD

目的探讨多巴胺(DA)、共激活剂相关精氨酸甲基转移酶1(CARM1)、25-羟维生素D 3[25-(OH)-D 3]在糖尿病患者外周血中的表达及与非酒精性脂肪肝(NAFLD)发生的关系。方法选取2021年5月至2023年2月在该院治疗的2型糖尿病(T2DM)合并NAFLD患者70例作为T2DM合并NAFLD组,同时选取单纯T2DM患者66例作为T2DM组,选取体检健康者70例作为健康组,比较各组外周血DA、CARM1、25-(OH)-D 3水平,同时分析T2DM合并NAFLD组不同血糖控制、严重程度患者外周血DA、CARM1、25-(OH)-D 3水平。采用Pearson相关分析外周血DA、CARM1、25-(OH)-D3水平与糖化血红蛋白(HbA1c)、受控衰减参数(CAP)的相关性,受试者工作特征曲线分析外周血DA、CARM1、25-(OH)-D 3诊断重度NAFLD的价值。结果T2DM合并NAFLD组外周血DA和25-(OH)-D 3水平明显低于T2DM组和健康组(P<0.05),而CARM1水平明显高于T2DM组和健康组(P<0.05);T2DM组外周血DA和25-(OH)-D 3水平明显低于健康组(P<0.05),而CARM1水平明显高于健康组(P<0.05)。T2DM合并NAFLD组血糖控制差者DA和25-(OH)-D 3水平明显低于血糖控制好者(P<0.05),而CARM1水平明显高于血糖控制好者(P<0.05)。重度患者DA和25-(OH)-D 3水平明显低于轻中度患者(P<0.05),而CARM1水平明显高于轻中度患者(P<0.05)。外周血DA、25-(OH)-D 3水平与HbA1c、CAP呈负相关(P<0.05),CARM1水平与HbA1c、CAP呈正相关(P<0.05)。CARM1、25-(OH)-D 3、DA诊断重度NAFLD的曲线下面积分别为0.858(95%CI 0.768~0.948)、0.922(95%CI 0.856~0.989)、0.571(95%CI 0.427~0.715)。结论DA和25-(OH)-D 3水平在T2DM患者外周血中降低,而CARM1水平升高,尤其在T2DM合并NAFLD患者中变化更加明显;DA、CARM1、25-(OH)-D 3水平与血糖控制、NAFLD严重程度存在相关性,其中CARM1、25-(OH)-D 3水平在诊断重度NAFLD方面有一定应用价值。

Objective To investigate the expression of dopamine(DA),coactivator associated arginine methyltransferase 1(CARM1)and 25-hydroxyvitamin D 3[25-(OH)-D 3]in peripheral blood of diabetic patients and their relationship with the occurrence of non-alcoholic fatty liver disease(NAFLD).Methods A total of 70 patients with type 2 diabetes mellitus(T2DM)combined with NAFLD treated in this hospital from May 2021 to February 2023 were selected as T2DM with NAFLD group,66 patients with simple T2DM were selected as T2DM group,and 70 healthy people were selected as healthy group.The levels of DA,CARM1 and 25-(OH)-D 3 in peripheral blood of each group were compared,and the levels of DA,CARM1 and 25-(OH)-D 3 in peripheral blood of T2DM combined with NAFLD patients with different blood glucose control and severity were analyzed.Pearson correlation analysis was used to analyze the correlation between peripheral blood DA,CARM1,25-(OH)-D 3 levels and glycosylated hemoglobin A1c(HbA1c),controlled attenuation parameter(CAP).Receiver operating characteristic curve was used to analyze the value of peripheral blood DA,CARM1,25-(OH)-D 3 in the diagnosis of severe NAFLD.Results The levels of DA and 25-(OH)-D 3 in T2DM with NAFLD group were significantly lower than those in T2DM group and healthy group(P<0.05),while the level of CARM1 in T2DM with NAFLD group was significantly higher than that in T2DM group and healthy group(P<0.05).The levels of DA and 25-(OH)-D 3 in T2DM group were significantly lower than those in healthy group(P<0.05),while the level of CARM1 in T2DM group was significantly higher than that in healthy group(P<0.05).The levels of DA and 25-(OH)-D 3 in T2DM with NAFLD patients with poor blood glucose control were significantly lower than those in patients with good blood glucose control(P<0.05),while the level of CARM1 was significantly higher than that in patients with good blood glucose control(P<0.05).The levels of DA and 25-(OH)-D 3 in patients with severe were significantly lower than those in patients with mild-to-moderate(P<0.05),while the level of CARM1 was significantly higher than that in patients with mild-to-moderate(P<0.05).The levels of DA and 25-(OH)-D 3in peripheral blood were negatively correlated with HbA1c and CAP,and the level of CARM1 was positively correlated with HbA1c and CAP(P<0.05).The area under curve of CARM1,25-(OH)-D 3 and DA were 0.858(95%CI 0.768-0.948),0.922(95%CI 0.856-0.989)and 0.571(95%CI 0.427-0.715),respectively.Conclusion The levels of DA and 25-(OH)-D 3 are decreased in peripheral blood of T2DM patients,while the level of CARM1 is increased,especially in T2DM patients with NAFLD.DA,CARM1 and 25-(OH)-D 3 levels are correlated with blood glucose control and the severity of NAFLD.CARM1 and 25-(OH)-D 3 levels have certain application value in the diagnosis of severe NAFLD.