Serum Retinol-Binding Protein Levels Are Associated with Nonalcoholic Fatty Liver Disease in Chinese Patients with Type 2 Diabetes Mellitus: A Real-World Study

Abstract

Background:The association of serum retinol-binding protein (RBP) levels with nonalcoholic fatty liver disease (NAFLD) remains controversial. Furthermore, few studies have investigated their relationship in type 2 diabetes mellitus (T2DM) patients. Therefore, the aim of the present study was to explore the association between serum RBP levels and NAFLD in Chinese inpatients with T2DM. Methods: This cross-sectional, real-world study included 2,263 Chinese T2DM inpatients. NAFLD was diagnosed by abdominal ultrasonography. The subjects were divided into four groups based on RBP quartiles, and clinical characteristics were compared among the four groups. The associations of both RBP levels and quartiles with the presence of NAFLD were also analyzed. Results: After adjustment for sex, age, and diabetes duration, there was a significant increase in the prevalence of NAFLD from the lowest to the highest RBP quartiles (30.4%, 40.0%, 42.4%, and 44.7% for the first, second, third, and fourth quartiles, respectively, P<0.001 for trend). Fully adjusted multiple logistic regression analysis revealed that both increased RBP levels (odds ratio, 1.155; 95% confidence interval, 1.012 to 1.318; P=0.033) and quartiles (P=0.014 for trend) were independently associated with the presence of NAFLD in T2DM patients. Conclusion: Increased serum RBP levels were independently associated with the presence of NAFLD in Chinese T2DM inpatients. Serum RBP levels may be used as one of the indicators to assess the risk of NAFLD in T2DM patients.

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

“…Moreover, a recent meta-analysis estimated that T2DM patients had a higher risk developing MAFLD than the general population, with a prevalence of 55.5%–70% ( 7 , 8 ). In our recent studies, the prevalence of MAFLD was 39.4%–52.6% in patients with T2DM, which was also higher than that in the general population ( 9 – 11 ). Given the high prevalence of MAFLD in T2DM, early identification and intervention of risk factors associated with MAFLD will be beneficial in reducing the occurrence of MAFLD in T2DM subjects.…”

“…This cross-sectional, real-world study included T2DM patients hospitalized in the Department of Endocrinology and Metabolism, the Sixth People’s Hospital of Shanghai Jiao Tong University from January 2006 to December 2012, and some of the patient data were from our recent studies ( 11 , 24 – 26 ). The hospital ethical review committee approved this study [approved number: 2018-KY-018(K)], with written consent obtained from all participants.…”

“…The following data were collected at admission as previously described: hypertension history, diabetes duration (DD), alcohol intake, smoking habits, use of lipid-lowering drugs (LLDs), metformin, insulin sensitizers, insulin or insulin analogs (IIAs), and physical data including height, waist and hip circumference, weight, and blood pressure ( 10 , 11 ). Specifically, the definitions of hypertension, obesity, smoking, and alcohol status were described in our previous studies ( 11 , 25 ).…”

“…Serum iron was determined using colorimetric assay by a LAbOSPECT 008AS automatic biochemical analyzer (Hitachi, Japan) ( 27 ), and serum ferritin level was measured using chemiluminescence immunoassay by a cobas e 602 module (Roche Diagnostics, Germany) ( 28 ). Other laboratory parameters such as blood glucose, lipids, insulin, C-peptide, kidney function, and urine tests were measured as described previously ( 10 , 11 , 25 ). The homeostasis model assessment of insulin resistance (HOMA2-IR) and the homeostasis model assessment of sensitivity (HOMA2-S) were estimated using HOMA2 Calculator version 2.2.3 ( 11 ).…”

“…Other laboratory parameters such as blood glucose, lipids, insulin, C-peptide, kidney function, and urine tests were measured as described previously ( 10 , 11 , 25 ). The homeostasis model assessment of insulin resistance (HOMA2-IR) and the homeostasis model assessment of sensitivity (HOMA2-S) were estimated using HOMA2 Calculator version 2.2.3 ( 11 ). The estimated glomerular filtration rate (eGFR) was calculated according to the formula recommended for the Chinese population [175×(serum creatinine) −1.234 × (age) −0.179 (×0.79, if female)] ( 25 ).…”