Objective To explore the predictive value of serum uric acid(SUA)for metabolic associated fatty liver disease(MAFLD)and liver fibrosis in the patients with type 2 diabetes mellitus(T2DM).Methods A total of 240 newly diagnosed T2DM patients were divided into groups of B(T2DM combined with MAFLD,150 cases)and A(without MAFLD,90 cases)according to the results of abdominal ultrasound examination.According to the fibrosis score of non-alcoholic fatty liver disease(NFS),group B was subdivided into groups of B1(NFS＜-1.455 points,38 cases),B2(NFS-1.455-0.676 points,95 cases)and B3(NFS＞0.676 points,17 cases).The general data and serological indexes of the patients were analyzed.Multivariate logistic regression analysis was used to analyze the influencing factors for MAFLD and liver fibrosis in T2DM patients.ROC curve was used to evaluate the predictive efficiency of SUA in MAFLD and progressive liver fibrosis in T2DM patients.Results The male proportion,BMI,ALT,AST,glutamyltransferase,ALP,SCr,SUA,TG,FIns,fasting C-peptide and HOMA-IR were higher,while AST/ALT ratio,25-hydroxyvitamin D[25(OH)D]and HDL-C were lower in group B than those in group A(P＜0.05).Higher BMI,SUA and HOMA-IR were the independent risk factors for MAFLD in T2DM patients,and higher 25(OH)D was the protective factor(P＜0.05).The AUC of SUA in predicting MAFLD in T2DM patients was 0.755.Taking 273.50 μmol/L as the cut-off value,the sensitivity and specificity were 84.67％and 55.56％,respectively.Compared with group B1,the age was older,AST/ALT ratio and HOMA-IR were higher,and Plt,Alb and ALT were lower in groups of B2 and B3,and fasting plasma glucose and SUA were higher in group B3(P＜0.05).The T2DM patients combined with MAFLD with higher HOMA-IR and SUA had more severe liver fibrosis,while those with higher ALT had lighter liver fibrosis(P＜0.05).The AUC of SUA predicting progressive liver fibrosis in T2DM patients combined with MAFLD was 0.684.When the optimal cut-off value was 355.50 μmol/L,the sensitivity and specificity were 82.35％and 54.89％,respectively.Conclusion SUA is the influencing factor for MAFLD and liver fibrosis in T2DM patients,and has certain predictive value.
Type 2 diabetes mellitusMetabolic associated fatty liver diseaseLiver fibrosisUric Acid
NETL
NSTL
万方数据
