空腹C肽与糖尿病病程比值与2型糖尿病合并代谢相关脂肪性肝病的相关性研究

Background  Type 2 diabetes mellitusT2DM is the most common type of diabetes. The incidence of metabolic associated fatty liver diseaseMAFLD in T2DM patients is higher than that in non - diabetic patients. Thereforeit is of great significance to find effective indicators for predicting the occurrence of MAFLD in T2DM patients. Objective  This study aims to explore the predictive value of the ratio of fasting C-peptide to diabetes durationFCP/DD for the occurrence of MAFLD in patients with Type 2 Diabetes MellitusT2DMproviding a potential indicator for the early prevention and management of MAFLD. Methods  This study enrolled 532 patients diagnosed with Type 2 Diabetes MellitusT2DM at the Department of EndocrinologyHebei General Hospitalbetween September 2018 and December 2021. Demographic data were collectedand fasting blood samples were obtained to assess biochemical parameters. The fasting C-peptide to diabetes durationFCP/DD ratio was computed using a predefined formula. Participants were stratified into MAFLDn=359and non MAFLDn=173 groups based on the presence or absence of Metabolic Associated Fatty Liver DiseaseMAFLD. Further classification into low FCP/DDn=266 and high FCP/DDn=266 groups was performed according to the median FCP/DD ratio. The relationship between the FCP/DD ratio and MAFLD incidence in T2DM patients was examined using Spearman rank correlation and logistic regression analyses. The predictive efficacy of the FCP/DD ratio for MAFLD was evaluated by constructing receiver operating characteristicROC curves and calculating the area under the curveAUC. Results  The FCP/DD in the MAFLD group was higher than that in the non-MAFLD groupP<0.05. The incidence of MAFLD in the high FCP/DD group was higher than that in the low FCP/DD groupP<0.05. The Spearman rank correlation analysis results showed that in patients with T2DM and MAFLDFCP/DD was negatively correlated with age and high-density lipoprotein cholesterolHDL-Cand positively correlated with BMIfasting blood glucoseFBGglycated hemoglobinHbA1ctotal cholesterolTCtriglyceridesTGlow-density lipoprotein cholesterolLDL-Cserum uric acidSUAaspartate aminotransferaseASTalanine aminotransferaseALTand triglyceride-glucose indexTyGP<0.05. The results of multivariate Logistic regression analysis showed that after adjusting for confounding factorsa high level of FCP/DD was an independent risk factor for the occurrence of MAFLD in T2DM patientsP<0.05. The ROC curve results showed that the AUC of FCP/DD for predicting the occurrence of MAFLD in T2DM patients was 0.8290.791-0.867the AUC of FCP was 0.75895%CI=0.711-0.805the AUC of HbA1c was 0.5250.471-0.578and the AUC of TyG was 0.73395%CI=0.689-0.778.Conclusion  The level of FCP/DD was significantly increased. T2DM patients with high levels of FCP/DD had a higher risk of developing MAFLD. FCP/DD ratio has better predictive value than FCPHbA1cTyG for combined MAFLD in T2DM patients.