[Associations between serum GDF15 and glycolipid metabolism disorder in metabolic associated fatty liver patients].

X Li, X M Yu, E H Li, P H Chen, L M Zheng, S Zhang
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Abstract

Objective: To investigate relationships between serum growth differentiation factor 15 (GDF15) and glycolipid metabolism in patients with metabolic associated fatty liver disease (MAFLD). Methods: The current investigation was a cross-sectional study. A total of 333 patients from the Fengxian District Central Hospital were recruited into the study after physical examination from February 2020 to February 2021. There were 107 patients with MAFLD and type 2 diabetes mellitus (T2DM), including 54 males and 53 females with a mean age of (57±11) years. There were 65 patients with simple MAFLD only, including 32 men and 33 women with a mean age of (49±5) years. There were 105 patients with T2DM only, including 53 men and 52 women, with a mean age of (56±10) years. A control group of 56 people without MAFLD or diabetes,28 male, 28 female, mean age (48±6) years, was also included in the study. Serum GDF15 was measured via enzyme-linked immunosorbent assays. IBM SPSS 26.0 was used for statistical analysis. Logistic regression was used to evaluate relationships between GDF15 and metabolic abnormalities in MAFLD patients. Results: GDF15 progressively increased in the control [385 (296, 484) ng/L], nonobese MAFLD [388 (319, 435) ng/L], obese MAFLD [426 (354, 527) ng/L], T2DM [664 (483, 900) ng/L], and MAFLD+T2DM groups [770 (560, 1 074) ng/L](H=113.82, P=0.001). There was no significant difference in serum GDF15 between the simple MAFLD [406 (339, 524) ng/L] and control group (U=1 505.50, P=0.132). GDF15 was significantly higher in the MAFLD+T2DM group than in the T2DM-only group (U=4 573.50, P=0.019). In logistic regression analysis increased GDF15 was associated with increased risks of simple MAFLD [odds ratio (OR)=2.202], T2DM (OR=29.656), and MAFLD+T2DM(OR=58.197). In patients with MAFLD, serum GDF15 was higher in the FIB4 index>1.45 group [773 (534, 1 162) ng/L] than in the FIB4 index<1.45 group [527 (389, 787) ng/L] (U=1 709.50, P<0.001). Increased GDF15 was associated with an increased risk of advanced liver fibrosis (OR=2.388). Conclusion: In patients with simple MAFLD, GDF15 level was not significantly higher than in the control group. In the T2DM-only group and the MAFLD+T2DM group GDF15 was significantly higher than in the control group. Increased serum GDF15 was associated with increased risk and severity of MAFLD complicated with abnormal glucose and lipid metabolism. High GDF15 increased the risk of advanced fibrosis in MAFLD patients.

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[代谢性脂肪肝患者血清GDF15与糖脂代谢紊乱的关系]。
目的:探讨代谢相关性脂肪肝(MAFLD)患者血清生长分化因子15 (GDF15)与糖脂代谢的关系。方法:本研究为横断面研究。在2020年2月至2021年2月期间,来自奉贤区中心医院的333名患者在体检后被招募到研究中。合并2型糖尿病(T2DM)患者107例,其中男性54例,女性53例,平均年龄(57±11)岁。单纯性MAFLD患者65例,其中男性32例,女性33例,平均年龄(49±5)岁。仅T2DM患者105例,其中男性53例,女性52例,平均年龄(56±10)岁。对照组56例无MAFLD或糖尿病患者,男28例,女28例,平均年龄(48±6)岁。采用酶联免疫吸附法测定血清GDF15。采用IBM SPSS 26.0进行统计分析。采用Logistic回归评估GDF15与MAFLD患者代谢异常之间的关系。结果:GDF15在对照组[385 (296,484)ng/L]、非肥胖MAFLD [388 (319, 435) ng/L]、肥胖MAFLD [426 (354,527) ng/L]、T2DM组[664 (483,900)ng/L]、MAFLD+T2DM组[770 (560,1 074)ng/L]中逐渐升高(H=113.82, P=0.001)。单纯性MAFLD患者血清GDF15 [406 (339, 524) ng/L]与对照组比较差异无统计学意义(U=1 505.50, P=0.132)。MAFLD+T2DM组GDF15明显高于T2DM组(U=4 573.50, P=0.019)。在logistic回归分析中,GDF15升高与单纯性MAFLD[比值比(OR)=2.202]、T2DM(OR= 29.656)和MAFLD+T2DM(OR=58.197)的风险增加相关。在MAFLD患者中,血清GDF15在FIB4指数>1.45组[773 (534,1 162)ng/L]高于FIB4指数组(1 709.50,POR=2.388)。结论:单纯性MAFLD患者GDF15水平不显著高于对照组。T2DM组和MAFLD+T2DM组GDF15明显高于对照组。血清GDF15升高与MAFLD并发糖脂代谢异常的风险和严重程度增加相关。高GDF15增加了MAFLD患者晚期纤维化的风险。
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