Endocrine Abstracts

Background and aims: To investigate the level of lipoprotein associated phospholipase A2 (LpPLA2), nitrogen oxide (NO) in patients with type 2 diabetes (DM2) and nonalcoholic fatty liver disease (NAFLD) against a variety of hypoglycemic therapies (HT).

Materials and methods: A one-stage examination of 90 patients with DM 2 and NAFLD was carried out. Men ratio 37.8%, women ratio 62.2%, mean age 57.3±11.6 years. Mean HbAlc 7.4±1.82%. According to the HT conducted, the patients were divided into groups: 1) monotherapy with metformin (MF); 2) sulfonylurea preparations (SU)+MF; 3) insulin therapy IT+MF; 4) IT+(SU). The cytolysis parameters (ALT, AST), systemic inflammations (LpPLA2, NO) were evaluated. All the patients underwent liver elastography.

Results: The group average BMI 33.7±3.48 kg², waist circumference 118.6±38.4 cm. The highest ALT level (56.35±38.6 u/l), AST (38.6±14.4 u/l) was noted in the group of patients receiving MF. In the group of patients receiving SU, both in combination with MF and with insulin, the concentration of LpPLA2 was significantly higher than in the other groups (562.6±97.8 ng/ml and 672.7±173.08 ng/ml, respectively). The NO level was elevated in all groups, an average of 85.08±40.58 μmol/l. The highest level of NO was recorded in the group of patients receiving insulin. In patients with DM 2 and NAFLD, the most common change in the liver according to elastometry is steatosis (77%). In 33% of the patients fibrosis (F) was detected. The highest F rates were noted in the group of patients on IT (11.8±9.38 kr), with this group having a longer duration of the disease (9.7±4.59 years).

Conclusion: It was found that the patients with DM2 and NAFLD have an increased level of LpPLA2, with its highest rate in patients receiving SU, both in combination with MF and with continuous-acting insulin, that may indicate a higher cardiometabolic risk in this group of patients. Regardless of the variant of hypoglycemic therapy, all the patients had an increase in NO level. The most common change in the liver in combination with NAFLD and DM 2 is steatosis (77%), one in three patients showed signs of liver fibrosis.