Serum iron is closely associated with metabolic dysfunction-associated fatty liver disease in type 2 diabetes: A real-world study

Abstract

AimsThere is still a debate about the relationship between serum iron and metabolic dysfunction-associated fatty liver disease (MAFLD). Furthermore, few relevant studies were conducted in type 2 diabetes mellitus (T2DM). Therefore, this study aimed to explore the association of serum iron levels with MAFLD in Chinese patients with T2DM.MethodsThis cross-sectional, real-world study consisted of 1,467 Chinese T2DM patients. MAFLD was diagnosed by abdominal ultrasonography. Based on serum iron quartiles, the patients were classified into four groups. Clinical characteristics were compared among the four groups, and binary logistic analyses were used to assess the associations of serum iron levels and quartiles with the presence of MAFLD in T2DM.ResultsAfter adjusting for gender, age, and diabetes duration, significantly higher prevalence of MAFLD was found in the second (45.7%), third (45.2%), and fourth (47.0%) serum iron quartiles than in the first quartiles (26.8%), with the highest MAFLD prevalence in the fourth quartile (p < 0.001 for trend). Moreover, increased HOMA2-IR (p = 0.003 for trend) and decreased HOMA2-S (p = 0.003 for trend) were observed across the serum iron quartiles. Fully adjusted binary logistic regression analyses indicated that both increased serum iron levels (OR: 1.725, 95% CI: 1.427 to 2.085, p < 0.001) and quartiles (p < 0.001 for trend) were still closely associated with the presence of MAFLD in T2DM patients even after controlling for multiple confounding factors.ConclusionsThere is a positive correlation between the presence of MAFLD and serum iron levels in T2DM patients, which may be attributed to the close association between serum iron and insulin resistance. Serum iron levels may act as one of the indicators for evaluating the risk of MAFLD in T2DM individuals.

Blood lactate levels are associated with an increased risk of metabolic dysfunction-associated fatty liver disease in type 2 diabetes: a real-world study

“…Notably, a meta-analysis demonstrated that MAFLD was more prevalent in T2DM patients (51.83%) than in non-diabetics (30.76%) ( 7 ). In the present real-world study, the prevalence of MAFLD in T2DM inpatients was 41.0%, which was close to the recent findings reported by our team (41.2%) ( 23 ).…”

“…All T2DM subjects were diagnosed based on the WHO diagnostic criteria as our recent study ( 21 ). Based on the international expert consensus statement in 2020, the diagnosis of MAFLD in T2DM patients was consistent with our recent study ( 1 , 23 ). The definition of obesity, smoking status and alcohol use referred to our recent studies ( 19 , 20 ).…”

Decreased Serum Osteocalcin is an Independent Risk Factor for Metabolic Dysfunction-Associated Fatty Liver Disease in Type 2 Diabetes

“… 36 Likewise, the present study showed that the MAFLD prevalence in T2DM subjects was 49.5%, which was close to the prevalence (52.6%) of NAFLD reported in our previous study. 25 Like other studies including our recent studies, 24–26 , 33 , 37 , 38 the current study also showed negative correlations of the MAFLD prevalence with age and DD in T2DM patients. One possible explanation for this phenomenon was that early and young T2DM patients had a greater degree of hyperinsulinemia, which led to the uptake of free fatty acids in hepatocytes.…”

“…For detection of hepatic steatosis, abdominal ultrasound examination was conducted in each participant, which was in accordance with our previous reports. 26 , 32 Based on our recent study, 33 since all participants in the current study had T2DM, subjects with the evidence of liver steatosis on abdominal ultrasonography were diagnosed as MAFLD according to the definition of MAFLD. 9 …”

Epidemiological and transcriptome data identify potential key genes involved in iron overload for type 2 diabetes

“…IO status in the liver can lead to many diseases [ 10 ], such as non-alcohol fatty liver disease and liver insulin resistance. Previous epidemiological studies reported that IO increases the risk of insulin resistance, indicating the linkage between IO and diabetes [ 11 ]. Although previous studies confirmed that IO is a risk factor for diabetes, the associated pathological mechanism is not clear.…”