Abstract: Objective The aim of this study was to explore the implication of serum homocystein (HCY), fibroblast growth factor-21 (FGF21) and nuclear factor-κB (NF-κB) levels in patients with non-alcoholic fatty liver diseases (NAFLD) and type 2 diabetes mellitus (T2DM). Methods A total of 192 patients with NAFLD and 106 patients with NAFLD and T2DM were enrolled in our hospital between May 2020 and March 2022. Serum HCY, FGF-21 and NF-κB levels were detected by ELISA. The fasting plasma glucose (FPG) and glycosylated hemoglobin (HbA1c) were detected by glucose oxidase and high performance liquid chromatography, respectivley. The patients with NAFLD and T2DM were divided into simple fatty liver (SFL) in 76 cases, nonalcoholic steatohepatitis (NASH) in 21 cases and cirrhosis in 9 cases. All patients underwent liver stiffness measurement (LSM) by FibroTouch, and the liver fibrosis stage S0-S1 was found in 75 cases and stage S2-S4 in 31 cases. Results Serum LDL-C, FPG and HbA1c levels in patients with NAFLD and T2DM were (3.9±0.7)mmol/L, (8.6±1.3)mmol/L and (8.1±1.7)%, all significantly higher than [(3.1±0.6) mmol/L, (5.2±1.1)mmol/L and (5.7±1.0)%, P<0.05], while serum HDL-C level was (1.0±0.2)mmol/L, significantly lower than [(1.4±0.2)mmol/L, P<0.05] in patients with NAFLD; serum HCY, FGF21 and NF-κB levels in patients with NAFLD and T2DM were (17.8±2.3)μmol/L, (315.2±32.5) pg/ml and (4.1±0.8)pg/mL, significantly higher than [(14.1±1.9)μmol/L, (278.9±30.7)pg/ml and (2.8±0.5)pg/mL, respectively, P<0.05] in patients with NAFLD; serum HCY and NF-κB levels in patients with cirrhosis were (20.3±2.1)μmol/L and (5.0±1.0)pg/mL, both significantly higher than [(18.9±1.9)μmol/L and (4.5±0.7)pg/mL, P<0.05] in patients with NASH or [(16.2±1.6)μmol/L and (3.9±0.6)pg/mL, P<0.05] in patients with SFL, while serum FGF21 level was (284.7±30.5)pg/ml, significantly lower than [(337.8±25.1)pg/ml, P<0.05] in patients with NASH or [(312.5±28.3)pg/ml, P<0.05] in patients with SFL; serum HCY and NF-κB levels in patients with liver fibrosis staging S2-S4 were (20.9±1.8)μmol/L and (5.1±1.1)pg/mL, both significantly higher than [(17.2±2.1)μmol/L and (3.9±0.8)pg/mL, P<0.05] in patients with staging S0-S1, while serum FGF21 level was (291.1±26.7) pg/ml, significantly lower than [(319.8±28.3)pg/ml, P<0.05] in patients with staging S0-S1. Conclusion Serum HCY, FGF21 and NF-κB levels significantly increase in patients with NAFLD and T2DM, which might be related to clinical catalogues of NAFLD and the severity of liver fibrosis.

Key words: Non-alcoholic fatty liver diseases, Type 2 diabetes mellitus, Homocystein, Fibroblast growth factor-21, Nuclear factor-κB