Influencing factors for hepatic fat accumulation in patients with type 2 diabetes mellitus

BACKGROUND Non-alcoholic fatty liver disease has become the most common chronic liver disease worldwide, which originates from the accumulation of triglyceride(TG) in the liver. Patients with type 2 diabetes mellitus(T2 DM) are considered to have a predisposition to hepatic steatosis. However, the influencing factors for hepatic fat accumulation in T2 DM patients remain unclear.AIM To investigate the influencing factors for hepatic fat accumulation in T2 DM patients.METHODS We enrolled 329 T2 DM patients admitted to the Endocrinology Department of the First Affiliated Hospital of Soochow University, who underwent MR m DIXONQuant examination to quantify the hepatic fat fraction(HFF). According to body mass index(BMI), the patients were divided into normal weight, overweight, and obese groups. The differences in general statistics, biochemical parameters, islet function, and HFF were compared among the three groups. The associations between HFF and other parameters and the influences of various parameters on the severity of hepatic fat accumulation were analyzed.RESULTS The HFF of T2 DM patients gradually increased in the normal weight, overweight, and obese groups(P < 0.05). Spearman correlation analysis showed that in T2 DM patients, HFF was negatively correlated with age and high-density lipoprotein cholesterol(P < 0.05), whereas it was positively correlated with BMI, waist-hip ratio, fasting plasma glucose, alanine aminotransferase(ALT), aspartate aminotransferase, bilirubin, glutamyl transpeptidase, lactate dehydrogenase, albumin(ALB), uric acid(UA), total cholesterol, TG, low-density lipoproteincholesterol(LDL-C), C-reactive protein, free triiodothyronine, fasting insulin, fasting C-peptide, and homeostasis model assessment of insulin resistance(P < 0.05). Multiple linear regression analysis showed significant positive influences of BMI, ALT, LDL-C, UA, and ALB on HFF in T2 DM patients(P < 0.05). Binary logistic regression analysis showed that BMI, ALT, ALB, and LDL-C were independent risk factors for moderate to severe fatty liver in T2 DM patients, and obesity increased the risk of being complicated with moderate to severe fatty liver by 4.03 times(P < 0.05).CONCLUSION The HFF of T2 DM patients increases with BMI. Higher BMI, ALT, ALB, and LDLC are independent risk factors for moderate to severe fatty liver in T2 DM patients.