Decreased Serum Osteocalcin is an Independent Risk Factor for Metabolic Dysfunction-Associated Fatty Liver Disease in Type 2 Diabetes

Abstract

Purpose

The association between serum osteocalcin (OCN) levels and metabolic dysfunction-associated fatty liver disease (MAFLD) is still controversial. Moreover, few studies have explored their relationship in type 2 diabetes mellitus (T2DM) patients so far. The present study aimed to investigate the association of serum OCN levels with MAFLD in Chinese T2DM patients.

Methods

This cross-sectional, real-world study included 1889 Chinese T2DM inpatients. MAFLD was diagnosed by abdominal ultrasonography. Participants were divided into four groups according to serum OCN quartiles, among which the clinical characteristics were compared. The association of serum OCN levels with the presence of MAFLD was also analyzed in subjects.

Results

After controlling for sex, age, and diabetes duration, the prevalence of MAFLD significantly decreased across the serum OCN quartiles (55.3%, 52.0%, 48.6%, and 42.1% for the first, second, third, and fourth quartiles, respectively, P < 0.001 for trend). A fully adjusted multiple logistic regression analysis showed that serum OCN levels were independently and negatively associated with the presence of MAFLD in T2DM patients (odds ratio, 0.832; 95% confidence interval, 0.719–0.962; P = 0.013). Furthermore, there were significant decreases in HOMA-IR (P = 0.001 for trend) and C-reactive protein (P < 0.001 for trend) levels across the serum OCN quartiles after controlling for sex, age, and diabetes duration.

Conclusion

Serum OCN levels were independently and negatively associated with the presence of MAFLD in Chinese T2DM patients, partially due to the improvement of insulin resistance and inflammation mediated by OCN. Serum OCN may be used as a biomarker to assess the risk of MAFLD in T2DM patients.

Keywords:

• diabetes mellitus
• type 2
• metabolic dysfunction-associated fatty liver disease
• osteocalcin
• insulin resistance
• inflammation

Acknowledgments

We thank the support from Shanghai Municipal Key Clinical Specialty, and thank the other investigators, the staff and all the participants of the present study for their invaluable contributions.

This work was supported by grants from the National Key Research and Development Plan (2018YFC1314900, 2018YFC1314905), the National Natural Science Foundation of China (81770813 and 82070866), the Translational Medicine National Key Science and Technology Infrastructure Open Project (TMSK-2021-116), the Exploratory Clinical Research Project of Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine (ynts202105), and Shanghai Municipal Key Clinical Specialty.

Disclosure

The authors report no conflicts of interest in this work.