关键词: 非酒精性脂肪性肝病, 2型糖尿病, 进展性肝纤维化, 抵抗素, 三酰甘油葡萄糖指数, 诊断

Abstract: Objective The purpose of this study was to investigate the changes of serum resistin and triacylglycerol glucose (TyG) index in patients with type 2 diabetes mellitus (T2DM) and concomitant non-alcoholic fatty liver diseases (NAFLD) to predict progressive liver fibrosis. Methods A total of 204 patients with T2DM and NAFLD were encountered in our hospital between March 2019 and February 2022, and the progressive liver fibrosis was evaluated by NAFLD fibrosis score (NFS). Serum resistin levels were detected by ELISA, and blood triacylglycerol and gl ucose levels were obtained routinely and the TyG index werecalculated. The multivariate Logistic regression analysis was applied to reveal the risk factors for the occurrence of progressive liver fibrosis in T2DM and NAFLD.The area under the receiver operating characteristic curves (AUC) was applied to evaluate the predictive performance of serum resistin and TyG index on the occurrence of progressive liver fibrosis in patients with T2DM and NAFLD. Results Out of the 204 patients with T2DM and NAFLD, the progressive liver fibrosis was found in 31 cases(15.2%); the age, disease history of diabetes, HOMA-IR , serum resistin level and TyG index in patients with progressive liver fibrosis were significantly higher or longer than in patients without(P＜0.05), while the estimated glomerular filtration rate(eGFR) was significantly lower than in those without (P＜0.05); the multivariate Logistic regression analysis showed that the age (OR=2.901, 95%CI: 1.042-5.238), serum resistin level (OR=3.404, 95%CI:1.874-9.435) and the TyG index (OR=2.965, 95%CI:1.258-6.439) were all the independent risk factors for the occurrence of progressive liver fibrosis in patients with T2DM and NAFLD(P＜0.05); the ROC analysis demonstrated that the sensitivities were 71.0%, 74.2% and 71.0%(P>0.05), and the specificities were 76.3%, 78.2% and 96.5% (P<0.05) when serum resistin level, the TyG index or the combination of the two parameters was applied to predict the existence of progressive liver fibrosis. Conclusion Serum resistin levels and TyG index are related to the occurrence of progressive liver fibrosis in patients with T2DM and NAFLD, and the combination of the two parameters might be used to predict severe liver fibrosis in this setting and help clinicians to make decisions for early management.

Key words: Non-alcoholic fatty liver diseases, Type 2 diabetes, Progressive liver fibrosis, Resistin, Triacylglycerol glucose index, Diagnosis