Abstract: Objective The aim of this study was to investigate the efficacy of fenofibrate at base of calorie restriction diet in treatment of patients with non-alcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (T2DM) and serum human cartilage glycoprotein-39 (HCGP39), adiponectin (APN) and asymmetric dimethylarginine (ADMA) level changes. Methods 128 patients with NAFLD complicated by T2DM were randomly divided into control (n=64) and observation group (n=64), receiving calorie-restricted diet or oral fenofibrate at the basis of calorie-restricted diet, respectively for 12 weeks. Serum glycated hemoglobin (HbA1c) levels were detected by immunochromatography, serum fasting blood glucose (FPG) and postprandial 2 hour blood glucose (2 h PPG) level were detected by glucose oxidase method, serum fasting insulin (FINS) level was detected by microparticle chemiluminescence method, by which the insulin resistance (IR) index was calculated, and serum HCGP39, APN and ADMA levels were detected by ELISA. Results At the end of 12 week observation, serum alanine aminotransferase level in the observation group was (39.4±5.3) U/L, significantly lower than , serum aspartate aminotransferase level was (46.3±4.4) U/L, significantly lower than , and serum glutamyl transferase level was (40.7±14.6) U/L, significantly lower than in the control; serum FBG level was (5.9±1.9) mmol/L, significantly lower than , serum 2 h PPG level was (7.4±2.2) mmol/L, significantly lower than , and IR level was (4.1±0.4), significantly lower than that【(4.7±0.5), P<0.05】 in the control; serum total cholesterol level was (1.5±0.2) mmol/L, significantly lower than , serum triacylglycerol level was (4.0±0.7 ) mmol/L, significantly lower than , serum low-density lipoprotein level was (2.1±0.5) mmol/L, significantly lower than , while serum high density lipoprotein level was (1.6±0.5) mmol/L, significantly higher than in the control; serum HCGP39 level was (61.4±7.5) ng/mL, significantly lower than , serum ADMA level was (1.8±0.3) μmol/mL, significantly lower than [(2.2±0.5) μmol/mL, P<0.05】, while serum APN level was (14.6±6.2) ng/mL, significantly higher than in the control.Conclusion The administration of fenofibrate at base of calorie restriction diet in treating patients with NAFLD and T2DM could reduce serum HCGP39 and ADMA levels and elevate serum APN levels, which might reduce liver injury, improve insulin resistance, and thus improve liver function, and glucose and lipid metabolism.

Key words: Nonalcoholic fatty liver disease, Type 2 diabetes mellitus, Fenofibrate, Calorie restricted diet, Adiponectin, Human cartilage glycoprotein-39, Asymmetric dimethylarginine