Fetuin-B links nonalcoholic fatty liver disease to type 2 diabetes via inducing insulin resistance: Association and path analyses.
Cytokine
; 108: 145-150, 2018 08.
Article
em En
| MEDLINE
| ID: mdl-29609136
ABSTRACT
OBJECTIVE:
Laboratory models suggested that Fetuin-B impaired insulin action in myotubes and hepatocytes and caused glucose intolerance in mice. We aimed to explore the independent associations and pathways among serum Fetuin-B, nonalcoholic fatty liver disease (NAFLD) and type 2 diabetes (T2D).METHODS:
A cross-sectional study of 1318 obese adults who underwent serum Fetuin-B test and hepatic ultrasonography scanning was conducted in Xiamen, China. Multivariable logistic regression was used to calculate adjusted odds ratio (OR) and 95% confidence intervals (CI) of serum Fetuin-B level and NAFLD for T2D in different models with adjustment for potential confounders. Structural equation modeling (SEM) was used to examine the paths among NAFLD, serum Fetuin-B, metabolic/insulin resistance syndrome and T2D.RESULTS:
Subjects with T2D or NAFLD showed significantly increased serum Fetuin-B levels compared to their controls (4.25⯱â¯1.35 vs. 4.08⯱â¯1.38⯵g/ml for diabetes; and 4.26⯱â¯1.41 vs. 4.07⯱â¯1.33⯵g/ml for NAFLD; both p-valuesâ¯<â¯0.05). NAFLD and higher serum Fetuin-B were significantly associated with higher risk of T2D with adjustment for sociodemographic and lifestyle habits; and the adjusted ORs (95%CIs) were 2.90 (2.17-3.87, pâ¯<â¯0.001) and 1.16 (1.01-1.32, pâ¯=â¯0.032), respectively. With further adjustment for metabolic/insulin resistance syndrome (BMI, systolic and diastolic BP, triglyceride, total cholesterol, HDL- and LDL-cholesterol, HOMA-IR and serum uric acid), NAFLD but not serum Fetuin-B was significantly associated with increased risk of T2D (ORs (95%CIs) 1.58 (1.12-2.21, pâ¯=â¯0.009) and 1.07 (0.92-1.23, pâ¯=â¯0.384), respectively). A one pathway model by using SEM fitted well (χ2â¯=â¯497.92, pâ¯<â¯0.001; CFIâ¯=â¯0.965; TLIâ¯=â¯0.926; and RMSEAâ¯=â¯0.097) and showed that NAFLD increased serum Fetuin-B and elevated Fetuin-B increased fasting insulin level, which in turn induced insulin resistance and T2D. Besides, NAFLD increased the risk of T2D directly in addition to its indirect effects of inducing metabolic/insulin resistance syndrome which in turn increased the risk of T2D.CONCLUSIONS:
Fetuin-B links NAFLD to T2D via inducing insulin resistance, and NAFLD contributes to the pathogenesis of T2D via multiple mechanisms.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Resistência à Insulina
/
Diabetes Mellitus Tipo 2
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Fetuína-B
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Hepatopatia Gordurosa não Alcoólica
Tipo de estudo:
Etiology_studies
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Observational_studies
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Prevalence_studies
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Risk_factors_studies
Limite:
Female
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Humans
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Male
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Middle aged
País como assunto:
Asia
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article