中文｜English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 39 Issue 1
Jan.  2023
Turn off MathJax
Article Contents
Article Navigation >  Journal of Clinical Hepatology  > 2023  >  39(1): 83-88

Association between serum alkaline phosphatase and type 2 diabetes mellitus with nonalcoholic fatty liver disease

DOI: 10.3969/j.issn.1001-5256.2023.01.013

  • Department of Endocrinology, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu 212000, China

Research funding:

National Natural Science Foundation of China (81870548);

Natural Science Foundation of Jiangsu Province (BK20191222);

Social Development Project of Jiangsu Province (BE2018692)

More Information
  • Corresponding author: YUAN Guoyue, yuanguoyue@ujs.edu.cn (ORCID: 0000-0003-0822-6066)
  • Received Date: 2022-06-19
  • Accepted Date: 2022-09-13
  • Published Date: 2023-01-20
    Abstract
  •   Objective  To investigate the association between serum alkaline phosphatase (ALP) and type 2 diabetes mellitus (T2DM) with nonalcoholic fatty liver disease (NAFLD).  Methods  A total of 599 patients with T2DM who were hospitalized in Department of Endocrinology, Affiliated Hospital of Jiangsu University, from July 2016 to December 2018 were enrolled as subjects. According to the presence or absence of NAFLD, the patients were divided into NAFLD group with 286 patients and non-NAFLD group with 313 patients, and according to the results of abdominal ultrasound, the patients with NAFLD were divided into mild group with 111 patients, moderate group with 105 patients, and severe group with 70 patients. General clinical data were compared between groups. The independent samples t- test was used for comparison of normally distributed continuous data between two groups, and an analysis of variance was used for comparison between three groups; the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups, and the Kruskal-Wallis H test was used for comparison between three groups; the chi-square test was used for comparison of categorical data between groups. Pearson correlation analysis and Spearman correlation analysis were used to investigate the correlation between ALP and clinical indices, and a logistic regression analysis was used to investigate the influencing factors for NAFLD.  Results  Compared with the non-NAFLD group, the NAFLD group had significantly higher proportion of patients with history of hypertension (χ2=7.864, P < 0.05), systolic blood pressure (t=-2.226, P < 0.05), diastolic blood pressure (t=-3.800, P < 0.05), body mass index (BMI) (t=-11.842, P < 0.05), waist circumference (WC) (t=-9.150, P < 0.05), fasting insulin (FINS) (Z=-6.173, P < 0.05), fasting C-peptide (t=-5.419, P < 0.05), serum uric acid (t=-4.957, P < 0.05), low-density lipoprotein cholesterol (t=-2.702, P < 0.05), triglyceride (Z=-9.376, P < 0.05), total cholesterol (TC) (t=-3.016, P < 0.05), Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) (Z=-5.794, P < 0.05), alanine aminotransferase (ALT) (Z=-6.737, P < 0.05), aspartate aminotransferase (AST) (Z=-4.389, P < 0.05), gamma-glutamyl transpeptidase (GGT) (Z=-7.764, P < 0.05), and ALP (t=-2.833, P < 0.05), as well as significantly lower age (t=2.184, P < 0.05) and high-density lipoprotein cholesterol (Z=-5.273, P < 0.05). The severity of NAFLD (mild, moderate or severe) was positively correlated with age (rs=0.140, P < 0.05), BMI (rs=0.239, P < 0.05), WC (rs=0.222, P < 0.05), FINS (rs=0.191, P < 0.05), HOMA-IR (rs=0.218, P < 0.05), ALT (rs=0.188, P < 0.05), AST (rs=0.279, P < 0.05), GGT (rs=0.202, P < 0.05), and ALP (rs=0.361, P < 0.05). In the patients with T2DM and NAFLD, ALP was positively correlated with HbAlc (r=0.149, P < 0.05), fasting plasma glucose (r=0.146, P < 0.05), HOMA-IR (rs=0.132, P < 0.05), TC (r=0.151, P < 0.05), ALT (rs=0.210, P < 0.05), AST (rs=0.192, P < 0.05), and GGT (rs=0.297, P < 0.05). The logistic regression analysis showed that ALP was an influencing factor for NAFLD in patients with T2DM (odds ratio=1.013, 95% confidence interval: 1.004-1.023, P < 0.05).  Conclusion  Elevated serum ALP is a risk factor for T2DM with NAFLD and is closely associated with hyperglycemia, insulin resistance, and hyperlipemia, and ALP may play a role in the development and progression of T2DM and NAFLD.

     

    • FullText(HTML)
  • loading
    • References(17)
  • [1]
    STEFAN N, CUSI K. A global view of the interplay between non-alcoholic fatty liver disease and diabetes[J]. Lancet Diabetes Endocrinol, 2022, 10(4): 284-296. DOI: 10.1016/S2213-8587(22)00003-1.
    [2]
    National Workshop on Fatty Liver and Alcoholic Liver Disease, Chinese Society of Hepatology, Chinese Medical Association; Fatty Liver Expert Committee, Chinese Medical Doctor Association. Guidelines of prevention and treatment for nonalcoholic fatty liver disease: A 2018 update[J]. J Clin Hepatol, 2018, 34(5): 947-957. DOI: 10.3969/j.issn.1001-5256.2018.05.007.

    中华医学会肝病学分会脂肪肝和酒精性肝病学组, 中国医师协会脂肪性肝病专家委员会. 非酒精性脂肪性肝病防治指南(2018年更新版)[J]. 临床肝胆病杂志, 2018, 34(5): 947-957. DOI: 10.3969/j.issn.1001-5256.2018.05.007.
    [3]
    YOUNOSSI ZM, GOLABI P, DE AVILA L, et al. The global epidemiology of NAFLD and NASH in patients with type 2 diabetes: A systematic review and meta-analysis[J]. J Hepatol, 2019, 71(4): 793-801. DOI: 10.1016/j.jhep.2019.06.021.
    [4]
    XIONG T, ZHONG C, SUN G, et al. Early maternal circulating alkaline phosphatase with subsequent gestational diabetes mellitus and glucose regulation: a prospective cohort study in China[J]. Endocrine, 2019, 65(2): 295-303. DOI: 10.1007/s12020-019-01954-5.
    [5]
    World Health Organization. Definition, diagnosis and classification of diabetes mellitus and its complications. Report of a WHO consultation, part 1: diagnosis and classification of diabetes mellitus[R]. Geneva: WHO, 1999: 50.
    [6]
    National Workshop on Fatty Liver and Alcoholic Liver Disease, Chinese Society of Hepatology, Chinese Medical Association. Guidelines of clinical diagnosis and treatment for nonalcoholic fatty liver disease[J]. Chin Hepatol, 2006, 11(1): 68-70. DOI: 10.3969/j.issn.1008-1704.2006.01.032.

    中华医学会肝病学分会脂肪肝和酒精性肝病学组. 非酒精性脂肪性肝病诊疗指南[J]. 肝脏, 2006, 11 (1) : 68-70. DOI: 10.3969/j.issn.1008-1704.2006.01.032.
    [7]
    HUANG CW, WU TH, HSU HY, et al. Reappraisal of the role of alkaline phosphatase in hepatocellular carcinoma[J]. J Pers Med, 2022, 12(4): 518. DOI: 10.3390/jpm12040518.
    [8]
    BARTLETT CL, CAVE EM, CROWTHER NJ, et al. A new perspective on the function of Tissue Non-Specific Alkaline Phosphatase: from bone mineralization to intra-cellular lipid accumulation[J]. Mol Cell Biochem, 2022, 477(8): 2093-2106. DOI: 10.1007/s11010-022-04429-w.
    [9]
    CHIRAMBO GM, VAN NIEKERK C, CROWTHER NJ. The role of alkaline phosphatase in intracellular lipid accumulation in the human hepatocarcinoma cell line, HepG2[J]. Exp Mol Pathol, 2017, 102(2): 224-229. DOI: 10.1016/j.yexmp.2017.02.007.
    [10]
    CAVE E, CROWTHER NJ. Tissue non-specific alkaline phosphatase mediates the accumulation of cholesterol esters in the murine Y1 adrenal cortex cell line[J]. Ann Anat, 2020, 227: 151420. DOI: 10.1016/j.aanat.2019.151420.
    [11]
    ZHANG Y, ZHOU C, LI J, et al. Serum alkaline phosphatase levels and the risk of new-onset diabetes in hypertensive adults[J]. Cardiovasc Diabetol, 2020, 19(1): 186. DOI: 10.1186/s12933-020-01161-x.
    [12]
    MA HL, QUAN L, JIANG S. Analysis of clinical characteristics and risk factors in patients with nonal-coholic fatty liver disease complicated with type 2 diabetes mellitus[J]. China Med Herald, 2022, 19(21): 70-73, 82. https://www.cnki.com.cn/Article/CJFDTOTAL-YYCY202221016.htm

    马海林, 权莉, 蒋升. 非酒精性脂肪性肝病合并2型糖尿病患者的临床特征及危险因素分析[J]. 中国医药导报, 2022, 19(21): 70-73, 82. https://www.cnki.com.cn/Article/CJFDTOTAL-YYCY202221016.htm
    [13]
    LOOMBA R, FRIEDMAN SL, SHULMAN GI. Mechanisms and disease consequences of nonalcoholic fatty liver disease[J]. Cell, 2021, 184(10): 2537-2564. DOI: 1016/j.cell.2021.04.015.
    [14]
    ARMANDI A, ROSSO C, CAVIGLIA GP, et al. Insulin resistance across the spectrum of nonalcoholic fatty liver disease[J]. Metabolites, 2021, 11(3): 155. DOI: 10.3390/metabo11030155.
    [15]
    SCORLETTI E, CARR RM. A new perspective on NAFLD: Focusing on lipid droplets[J]. J Hepatol, 2022, 76(4): 934-945. DOI: 10.1016/j.jhep.2021.11.009.
    [16]
    WANG N, WANG Y, ZHANG W, et al. C-peptide is associated with NAFLD inflammatory and fibrotic progression in type 2 diabetes[J]. Diabetes Metab Res Rev, 2020, 36(2): e3210. DOI: 10.1002/dmrr.3210.
    [17]
    LI YY, ZHAO L, DENG X, et al. Relationship between cardiometabolic index and risk of nonalcoholic fatty liver disease in patients with type 2 diabetes mellitus[J]. Chin Gen Pract, 2021, 24(15): 1883-1888. DOI: 10.12114/j.issn.1007-9572.2021.00.433.

    李彦彦, 赵丽, 邓霞, 等. 2型糖尿病患者心脏代谢指数与非酒精性脂肪性肝病的关系研究[J]. 中国全科医学, 2021, 24(15): 1883-1888. DOI: 10.12114/j.issn.1007-9572.2021.00.433.
    • Relative Articles
    • Supplements(0)
    • Cited By
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Tables(4)

    Get Citation
    PDF
    XML

    Article Metrics

    Article views (1774) PDF downloads(114) Cited by()
    Proportional views
    Related
        

    The first journal specializing in hepatobiliary and pancreatic diseases in China

    Supervisor：Ministry of Education of the People's Republic of China

    Sponsor：Jilin University

    Academic Support: Chinese Society of Hepatology，Chinese Medical Association

    Address: 461 Xinjiang Road, Changchun

    Submit：0431-88782044

    Peer review：0431-88783542

    Email：lcgdb@vip.163.com

    About Journal

    Submission Guideline

    Journal Online

    Hepatobiliary College

    Guidelines

    YesterdayIP[]YesterdayPV[]TodayIP[]TodayPV[]Online[]

    Website Design © 2020 Editorial Board of Journal of Clinical Hepatology 吉ICP备10000617号-1 Supported by: Beijing Renhe Information Technology Co. Ltd  

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return