تقييم بعض المعايير الفسلجيه والكيموحيويه في مرضى السكري النوع الثاني المرتبط بمرض الكبد الدهني غير الكحولي

Evaluation of some physiological and biochemical Markers in patients with Diabetic Mellitus Type 2 associated with Non-alcoholic fatty liver disease

Summary
Metabolic diseases, including non-alcoholic fatty liver disease(NAFLD), metabolic syndrome, and type 2 diabetes, have widespread health impacts. Early identification and treatment of metabolic syndrome and related fatty liver disease can improve metabolic markers and prevent liver and cardiovascular complications.
The current study included 108 blood samples whom aged 35 to 77 years old. From October 2023 to April 2024, 70 blood samples were collected from patients with type 2 diabetes and fatty liver disease, 30 males and 40 females from the consulting clinics of Al-Hindiyah General Hospital and Imam Al-Hassan Hospital in Karbala Governorate. The control group included 38 healthy 16 males and 22 females, blood samples of the same age and gender. (Alcoholism, malignancy, gastrointestinal surgery, and liver disorders such as chronic hepatitis C, autoimmune liver disease, and Wilson’s disease that may cause fatty liver were excluded). Blood was drawn from veins post 8-12 hours of fasting after agreement with patients. Glucose, insulin serum, Homeostasis Model Assessment of Insulin Resistance(HOMA-IR), Alanine Transaminase(ALT), Aspartate Transaminase (AST), triglycerides(TG), cholesterol, Low density lipoprotein (LDL), Very low density lipoprotein (VLDL), High density lipoprotein (HDL), Platelets(PLT), vitamin D, albumin, and uric acid levels were examined, and Asprosin and Adiponectin serum levels were measured. The mean alanine aminotransferase levels (22.21 ±10.1 U/L), in the patient group were significant higher than the mean level of the control group (7.63±3.29 U/L). The mean aspartate aminotransferase in the patient group was (31.46±14.25 U/L), significantly higher than the control group (22.12±5.23 U/L). The diabetic group with fatty liver had significantly higher mean cholesterol (212.81±101.3mg/dl) and triglyceride levels (279.96±124.76mg/dl) than the control group (172.78±77.52mg/dl and 171.57±46.21 mg/dl respectively).
The patients had significantly higher insulin levels and insulin resistance than the controls indicating metabolic abnormalities in type 2 diabetes, insulin resistance leads to increased blood sugar and the body’s inability to use insulin effectively, which increases metabolic disturbances. As for Asprosin and Adiponectin Hormones, the patient group had a significantly higher mean level (150.56 ± 61.6 ng/ml) than the control group (127.64±46.9 ng/ml), and patients had higher Adiponectin (5.27±2.6 µg/ml) than the control group (4.18±2.08 µg/ml). Liver enzymes, especially alanine, were non-significant moderate negatively correlation with Asprosin and weak with Adiponectin. The data indicates a strong correlation between Asprosin, low-density lipoprotein, and insulin resistance. Lipid profile parameters indicated modest to moderate positive relationships between cholesterol, triglycerides, high-density lipoprotein, very low-density lipoprotein and Asprosin, with a negative correlation observed only for low-density lipoprotein.
Age, Body mass index(BMI), and disease duration had significant relationships and associations with the biomarkers. The results showed that these associations may be weak, moderate, or strong. Liver enzymes have a negative relationship with age, lipid profile has a positive relationship with age, insulin, sugar and liver fibrosis index have a positive relationship with age and body mass.
The study concludes that insulin resistance and elevated Asprosin levels can be used as biomarkers to predict type 2 diabetes and fatty liver, as well as a non-invasive test for metabolic-related NAFLD, since the basis of NAFLD is insulin resistance. Adiponectin has superior effectiveness compared to Asprosin in distinguishing between sick and healthy persons.