Diabetes Metab J.  2022 Jan;46(1):129-139. 10.4093/dmj.2020.0222.

Serum Retinol-Binding Protein Levels Are Associated with Nonalcoholic Fatty Liver Disease in Chinese Patients with Type 2 Diabetes Mellitus: A Real-World Study

• Zhang ZH
• Ke JF
• Lu JX
• Liu Y
• Wang AP
• Li LX

• KMID: 2525132
• DOI: http://doi.org/10.4093/dmj.2020.0222

Abstract

Background
The association of serum retinol-binding protein (RBP) levels with nonalcoholic fatty liver disease (NAFLD) remains controversial. Furthermore, few studies have investigated their relationship in type 2 diabetes mellitus (T2DM) patients. Therefore, the aim of the present study was to explore the association between serum RBP levels and NAFLD in Chinese inpatients with T2DM.
Methods
This cross-sectional, real-world study included 2,263 Chinese T2DM inpatients. NAFLD was diagnosed by abdominal ultrasonography. The subjects were divided into four groups based on RBP quartiles, and clinical characteristics were compared among the four groups. The associations of both RBP levels and quartiles with the presence of NAFLD were also analyzed.
Results
After adjustment for sex, age, and diabetes duration, there was a significant increase in the prevalence of NAFLD from the lowest to the highest RBP quartiles (30.4%, 40.0%, 42.4%, and 44.7% for the first, second, third, and fourth quartiles, respectively, P<0.001 for trend). Fully adjusted multiple logistic regression analysis revealed that both increased RBP levels (odds ratio, 1.155; 95% confidence interval, 1.012 to 1.318; P=0.033) and quartiles (P=0.014 for trend) were independently associated with the presence of NAFLD in T2DM patients.
Conclusion
Increased serum RBP levels were independently associated with the presence of NAFLD in Chinese T2DM inpatients. Serum RBP levels may be used as one of the indicators to assess the risk of NAFLD in T2DM patients.

Keyword

Diabetes mellitus, type 2; Nonalcoholic fatty liver disease; Retinol-binding protein

Figure

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  Fig. 1. Prevalence of nonalcoholic fatty liver disease (NAFLD) in the subjects. (A) Overall prevalence of NAFLD in the subjects and comparison of the NAFLD prevalence between men and women (P=0.004). (B) Comparison of the NAFLD prevalence among subjects stratified by age after controlling for sex and diabetes duration (DD) (P<0.001 for trend). (C) Comparison of the NAFLD prevalence among subjects stratified by DD after controlling for gender and age (P=0.013 for trend).

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  Fig. 2. Comparisons of nonalcoholic fatty liver disease (NAFLD) prevalence among the retinol-binding protein (RBP) quartile groups. (A) Comparisons of the prevalence of NAFLD across the RBP quartile groups after controlling for sex, age, and diabetes duration (P<0.001 for trend). (B) Comparisons of serum RBP levels between type 2 diabetes mellitus patients with and without NAFLD (P<0.001).

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  Fig. 3. Correlations between serum retinol-binding protein (RBP) levels and metabolic parameters. All results were obtained after adjusting for sex, age, and diabetes duration. (A) Correlation between serum RBP levels and fasting C-peptide (FCP; P<0.001). (B) Correlation between serum RBP levels and 2-hour postprandial C-peptide (PCP; P<0.001). (C) Correlation between serum RBP levels and homeostasis model assessment of insulin resistance (HOMA2-IR; P<0.001). (D) Correlation between serum RBP levels and triglycerides (TG; P<0.001).

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