Risk Factors for Nonalcoholic Fatty Liver Disease in Postmenopausal Women with Type 2 Diabetes Mellitus and the Correlation with Bone Mineral Density at Different Locations

Figures & data

Table 1 Comparison of General Data and Biochemical Indexes Between the Two Groups

Index	Non NAFLD Group	NAFLD Group	P
Age (years)	63.29±8.93	63.17±9.37	0.895
Course of disease (years)	10 (5, 15)	8 (2, 12)	0.001
SBP (mmHg)	132.49±20.58	140.64±48.50	0.020
DBP (mmHg)	76.68±11.13	78.14±12.86	0.098
BMI (kg/m^2)	23.64±3.48	26.40±3.79	<0.001
FBS (mmol/L)	8.64±3.62	9.12±3.12	0.148
2hPG (mmol/L)	17.90±5.48	17.89±4.96	0.978
HbA1c (%)	8.45±2.13	9.05±1.90	0.003
ALT (U/L)	20 (17, 27)	27 (20, 38.75)	<0.001
AST (U/L)	23 (20, 27)	25 (21.75, 35.25)	<0.001
GGT (U/L)	22 (16, 32)	31 (21, 48)	<0.001
TG (mmol/L)	1.32 (1.01, 1.95)	1.81 (1.3, 2.6)	<0.001
TCH (mmol/L)	4.72 (4.01, 5.51)	4.87 (4.21, 5.61)	0.096
LDL-C (mmol/L)	3.00±0.89	3.11±0.86	0.213
HDL-C (mmol/L)	1.28±0.6	1.11±0.4	0.004
Cr (umol/L)	62 (50.25, 76)	61 (50, 76.75)	0.328
UA (umol/L)	268.92±94.76	310.02±102.51	<0.001
ALP (U/L)	89 (70, 109)	97 (78, 114)	0.221
Calcium (mmol/L)	2.25±0.17	2.31±0.39	0.064
Phosphorus (mmol/L)	1.23±0.21	1.24±0.18	0.459
uACR (mg/g)	18.2 (4.55, 29.77)	19.47 (5.45, 28.89)	0.597
eGFR [mL/ (min.1.73m^2)]	104.4±49.35	110.18±47.67	0.243
HOMA-IR (CP)	3.70±1.88	4.10±1.47	0.031

Abbreviations: SBP, systolic blood pressure; DBP, diastolic blood pressure; BMI, body mass index; FPG, fasting blood glucose; 2hPG, 2-hour postprandial blood glucose; HbA1c, glycosylated hemoglobin; ALT, alanine aminotransferase; AST, aspartate aminotransferase; GGT, gamma-glutamyl transpeptidase; TG, triacylglycerol; TCH, total cholesterol; LDL-C, low-density lipoprotein cholesterol; HDL-C, high-density lipoprotein cholesterol; Cr, creatinine; UA, uric acid; ALP, alkaline phosphatase; uACR, urine albumin-creatinine ratio; eGFR, estimated glomerular filtration rate; HOMA-IR, homeostatic model assessment for insulin resistance; CP, C-peptide.

Table 2 Univariate Logistic Regression Analysis of Related Factors for NAFLD in Postmenopausal Women with T2DM

Index	P	OR	95% CI
			Lower Limit	Upper Limit
Age (years)	0.927	1.001	0.979	1.023
Course of disease (years)	0.018	0.965	0.938	0.994
SBP (mmHg)	0.012	1.012	1.003	1.021
DBP (mmHg)	0.098	1.014	0.997	1.031
BMI (kg/m^2)	0.000	1.253	1.171	1.341
FBS (mmol/L)	0.150	1.042	0.985	1.103
2hPG (mmol/L)	0.992	1.000	0.961	1.041
HbA1c (%)	0.003	1.155	1.049	1.272
ALT (U/L)	0.000	1.020	1.010	1.031
AST (U/L)	0.067	1.010	0.999	1.020
GGT (U/L)	0.005	1.011	1.003	1.019
TG (mmol/L)	0.000	1.593	1.313	1.933
TCH (mmol/L)	0.871	1.009	0.906	1.123
LDL-C (mmol/L)	0.214	1.165	0.916	1.481
HDL-C (mmol/L)	0.006	0.383	0.193	0.757
Cr (umol/L)	0.137	0.995	0.989	1.002
UA (umol/L)	0.000	1.004	1.002	1.006
ALP (U/L)	0.216	1.003	0.998	1.007
Calcium (mmol/L)	0.583	0.985	0.932	1.040
Phosphorus (mmol/L)	0.456	1.476	0.530	4.110
uACR (mg/g)	0.138	0.998	0.995	1.001
eGFR [mL/(min.1.73m^2)]	0.252	1.002	0.998	1.007
HOMA-IR (CP)	0.024	1.171	1.021	1.344

Abbreviations: SBP, systolic blood pressure; DBP, diastolic blood pressure; BMI, body mass index; FPG, fasting blood glucose; 2hPG, 2-hour postprandial blood glucose; HbA1c, glycosylated hemoglobin; ALT, alanine aminotransferase; AST, aspartate aminotransferase; GGT, gamma-glutamyl transpeptidase; TG, triacylglycerol; TCH, total cholesterol; LDL-C, low-density lipoprotein cholesterol; HDL-C, high-density lipoprotein cholesterol; Cr, creatinine; UA, uric acid; ALP, alkaline phosphatase; uACR, urine albumin-creatinine ratio; eGFR, estimated glomerular filtration rate; HOMA-IR, homeostatic model assessment for insulin resistance; CP, C-peptide.

Table 3 Multivariate Logistic Regression Analysis of Related Factors for NAFLD in Postmenopausal Women with T2DM

Index	P	OR	95% CI
			Lower Limit	Upper Limit
Course of disease (years)	0.198	0.982	0.953	1.041
SBP (mmHg)	0.163	1.009	0.994	1.016
BMI (kg/m2)	<0.001	1.303	1.152	1.346
HbA1c (%)	0.001	1.263	1.095	1.392
ALT (U/L)	0.107	1.010	0.996	1.021
GGT (U/L)	0.161	1.007	0.997	1.013
TG (mmol/L)	0.012	1.263	1.031	1.601
HDL-C (mmol/L)	0.145	0.617	0.306	1.321
UA (umol/L)	0.008	1.005	1.001	1.007
HOMA-IR (CP)	0.678	0.978	0.812	1.175

Abbreviations: SBP, systolic blood pressure; BMI, body mass index; HbA1c, glycosylated hemoglobin; ALT, alanine aminotransferase; GGT, gamma-glutamyl transpeptidase; TG, triacylglycerol; HDL-C, high-density lipoprotein cholesterol; UA, uric acid; HOMA-IR, homeostatic model assessment for insulin resistance; CP, C-peptide.

Table 4 Comparison of Prevalence of Chronic Complications and Comorbidities of Diabetes Mellitus Between Two Groups [n(%)]

Item	Non NAFLD Group (n=236)	NAFLD Group (n=198)	P
Diabetic retinopathy	93 (39.4)	61 (30.8)	0.062
Diabetic nephropathy	38 (16.1)	31 (15.7)	0.899
Diabetic peripheral vascular disease	189 (80.1)	173 (87.4)	0.042
Diabetic neuropathy	164 (69.5)	132 (66.7)	0.529
Hypertension	100 (42.4)	113 (57.1)	0.002
Coronary heart disease	18 (7.6)	20 (10.1)	0.364
Stroke	26 (11.0)	28 (14.1)	0.326
Hyperuricemia	12 (5.1)	24 (12.1)	0.006

Table 5 Comparison of the Prevalence of Osteoporosis [n(%)] and Bone Mineral Density in Different Parts Between the Two Groups

	Non NAFLD Group (n=236)	NAFLD Group (n=198)	P
Osteoporosis	42 (17.8)	29 (14.6)	0.377
Osteopenia	98 (41.5)	81 (40.9)	0.897
Normal bone mass	96 (40.7)	88 (44.4)	0.429
BMD of Lumbar L1-4	0.99±0.18	1.01±0.19	0.285
BMD of Femoral neck	0.81±0.15	0.84±0.15	0.038
BMD of Total hip	0.85±0.16	0.93±0.28	0.001

Table 6 Correlation of BMD in Postmenopausal T2DM Women Complicated with NAFLD

Index	BMD of Lumbar Spine		BMD of Femoral Neck		BMD of Total Hip
	r	P	r	P	r	P
Age (years)	−0.253	0.001	−0.406	<0.001	−0.082	0.275
Course of disease (years)	−0.016	0.835	−0.234	0.001	−0.137	0.068
SBP (mmHg)	−0.021	0.779	−0.060	0.420	0.030	0.688
DBP (mmHg)	0.138	0.062	0.079	0.287	0.043	0.568
BMI (kg/m2)	0.201	0.010	0.120	0.124	−0.006	0.944
FBS (mmol/L)	−0.010	0.891	−0.067	0.373	−0.116	0.125
2hPG (mmol/L)	−0.026	0.753	−0.071	0.381	−0.149	0.067
HbA1c (%)	0.009	0.911	0.097	0.201	−0.094	0.221
ALT (U/L)	0.033	0.675	0.106	0.175	0.008	0.915
AST (U/L)	0.044	0.579	0.071	0.366	0.013	0.871
GGT (U/L)	−0.078	0.323	0.030	0.705	−0.050	0.531
TG (mmol/L)	0.053	0.296	0.074	0.150	0.036	0.487
TCH (mmol/L)	0.095	0.216	0.087	0.261	0.041	0.600
LDL-C (mmol/L)	0.090	0.275	0.085	0.299	−0.084	0.308
HDL-C (mmol/L)	0.008	0.923	−0.031	0.706	0.254	0.002
Cr (umol/L)	−0.047	0.553	−0.097	0.216	−0.127	0.109
UA (umol/L)	0.007	0.934	0.008	0.918	0.053	0.508
ALP (U/L)	−0.101	0.206	−0.086	0.278	−0.070	0.381
Calcium (mmol/L)	0.011	0.885	−0.022	0.776	−0.044	0.579
Phosphorus (mmol/L)	−0.047	0.552	0.023	0.766	−0.018	0.821
uACR (mg/g)	−0.043	0.579	−0.108	0.158	−0.064	0.411
eGFR [mL/ (min.1.73m2)]	−0.043	0.589	0.064	0.421	0.067	0.398
HOMA-IR (CP)	0.083	0.309	−0.059	0.472	−0.026	0.750

Abbreviations: SBP, systolic blood pressure; DBP, diastolic blood pressure; BMI, body mass index; FPG, fasting blood glucose; 2hPG, 2-hour postprandial blood glucose; HbA1c, glycosylated hemoglobin; ALT, alanine aminotransferase; AST, aspartate aminotransferase; GGT, gamma-glutamyl transpeptidase; TG, triacylglycerol; TCH, total cholesterol; LDL-C, low-density lipoprotein cholesterol; HDL-C, high-density lipoprotein cholesterol; Cr, creatinine; UA, uric acid; ALP, alkaline phosphatase; uACR, urine albumin-creatinine ratio; eGFR, estimated glomerular filtration rate; HOMA-IR, homeostatic model assessment for insulin resistance; CP, C-peptide.