Relationship between serum protein kinase Cε activity and insulin resistance in elderly patients with concurrent type 2 diabetes mellitus and non-alcoholic fatty liver disease / 中华老年医学杂志

ABSTRACT

Objective:To investigate the association of serum protein kinase Cε(PKCε)activity with insulin resistance in elderly patients with concurrent type 2 diabetes mellitus(T2DM)and non-alcoholic fatty liver disease(NAFLD).Methods:Clinical data of 229 patients with T2DM admitted to the Department of Geriatric Endocrinology of the Second Affiliated Hospital of Xi'an Jiaotong University from October 2017 to October 2018 were retrospectively analyzed.Patients were divided into the T2DM group(T2DM patients without NAFLD, n=112)and the T2DM+ NAFLD group(T2DM patients with NAFLD, n=117). Healthy elderly subjects who underwent physical examination during the same period served as the control group(n=110). Clinical data and laboratory results were compared between the three groups.Serum PKCεactivity was measured by enzyme-linked immunosorbent assay, and the correlation between serum PKCεactivity and insulin resistance was analyzed statistically.Results:Serum PKCεactivity and HOMA-IR were higher in the T2DM+ NAFLD group than in the T2DM group and the control group[PKCε (195.5±62.1) μg/L vs.(188.7±61.2 )μg/L and (89.1±20.2 )μg/L, F=9.76, P=0.010; HOMA-IR 12.5±7.9 vs. 14.1±5.7 and 5.8±4.1, F=10.21, P=0.010]. Pearson correlation analysis revealed that serum PKCεactivity, HOMA-IR and TG were positively correlated with T2DM+ NAFLD( r=0.339, P=0.01; r=0.305, P=0.01; r=0.329, P=0.01)and that serum PKCεactivity was positively correlated with HOMA-IR and triglyceride( r=0.339, 0.305 and 0.329, P=0.01). Logistic regression analysis showed that serum PKCε activity, HOMA-IR and triglycerides were risk factors in the T2DM+ NAFLD group, and the regression coefficients were 0.849, 0.022 and 0.710, respectively.Increased serum PKCεactivity was an independent influencing factor for T2DM+ NAFLD. Conclusions:Elevated serum PKCεactivity is positively correlated with insulin resistance in elderly T2DM patients with NAFLD.Reducing serum PKCεactivity and improving insulin sensitivity will help to delay or reverse the development of T2DM and NAFLD.