engleski

Although adiponectin and HDL are closely related to fatty liver, cystatin C is more important in the prediction of diabetic nephropathy

Methods: Adiponectin (ApN), C-reactive protein (CRP), fibrinogen (FIB), homocysteine, interleukin-6, cystatin C (Cys C), sialic acid (SA), creatinine clearance, albumin excretion rate (AER), C-peptide, waist circumference (WC), waist/hip ratio (WHR), fasting plasma glucose (fPG), glycated haemoglobin (HbA1c), liver tests, lipids, ferritin, uric acid (UA) and leucocytes (WBC) were determined in 288 DM2 patients divided according to AER (<30 ; 30-300 ; >300) and fatty liver index (FLI) (≤60 ; >60). FLI was calculated using BMI, WC, triglycerides (Tg) and gamma-glutamyl transpeptidase (GGT) to estimate the presence of FL. Insulin resistance was calculated using estimated glucose disposal rate (eGDR). Statistically significant differences between the variables according to FLI were determined using Student's t test and Mann Whitney test. Levels of statistical significance were at p<0.05. Results: After stepwise regression for AER as a dependent variable, the best model in DM2 included Cys C (R2=0.292). In view of the importance of sex in ApN prediction, stepwise regression was performed separately for women and men: the best model included (R2=0.862) AER, CRP, high-density lipoprotein (HDL), aspartate amino-transferase (AST), alanine amino-transferase (ALT) and FLI in women, and ALT and FLI in men (R2=0.454). ANOVA revealed significant differences (p<0.05) according to AER in CysC (F=9.56), HDL (F=3.97) and Tg (F=4.2). CRP, ferritin and C-peptide were significantly increased, and HDL was decreased in patients with FLI>60. If FLI was increased, ApN decreased significantly regardless of the AER category. ApN correlated significantly with HDL (r=0.47), FLI (r=-0.35), ALT (r=-0.47), ferritin (r=-0.36), C-peptide (r=-0.35) and eGDR (r=0.34). FLI correlated significantly with ApN (r=-0.35), CRP (r=0.35), ALT (r=0.43), ferritin (r=0.39), and eGDR (r=-0.45). AER correlated significantly with Cys C (r=0.33). Conclusion: This study pointed to the connection between ApN, eGDR, HDL and FLI, but Cys C emerged as a factor important in the prediction of nephropathy. FLI could be considered to be more important than AER in the determination of ApN level.

adiponectin ; Fetty liver ; diabetic mephropathy

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