miR-122、NOX2、β-arrestin 2与2型糖尿病合并代谢相关脂肪性肝病患者胰岛素抵抗及肝纤维化的相关性分析OA

Objective To explore relationships between serum miR-122,nicotinamide adenine dinucleotide phosphate ox-idase 2(NOX2),β-arrestin 2 levels and insulin resistance(IR)and liver fibrosis in patients with type 2 diabetes mellitus(T2DM)complicated with metabolic dysfunction-associated fatty liver disease(MAFLD).Methods From February 2022 to April 2025,total 146 T2DM patients were included,including 91 patients with MAFLD(MAFLD group)and 55 patients without MAFLD(non-MAFLD group).The RT-qPCR method was used to detect serum miR-122.ELISA method was performed to detect serum NOX2 and β-arrestin 2.Pearson method was performed to explore the correlation between serum miR-122,NOX2,β-arrestin 2,and IR in patients with T2DM complicated with MAFLD.Logistic regression was used to explore the influencing factors of liver fibrosis in patients with T2DM complicated with MAFLD.In addition,ROC curve was used to evaluate the diagnostic efficacy of serum miR-122,NOX2,and β-arrestin 2 for liver fibrosis in patients with T2DM complicated with MAFLD.Results Patients in the MAFLD group exhibited significantly higher body mass index(BMI),triglycerides(TG),aspartate aminotransferase(AST),gam-ma-glutamyl transferase(GGT),alanine aminotransferase(ALT),glycated hemoglobin(HbA1c),fasting blood glucose(FBG),fasting insulin(FINS),homeostasis model assessment-insulin resistance(HOMA-IR),liver stiffness measurement(LSM),control attenuation parameter(CAP),serum miR-122,NOX2 and β-arrestin 2 levels than those in the non-MAFLD group,while high-den-sity lipoprotein cholesterol(HDL-C)and 25-hydroxyvitamin D(25-(OH)D)levels were lower(P＜0.05).The mild group and moderate to severe fibrosis group had prominently higher HOMA-IR,LSM,CAP,serum miR-122,NOX2,and β-arrestin 2 than the non-fibrosis group,and the differences between the mild group and moderate to severe fibrosis group were prominent(P＜0.05).Serum miR-122,NOX2,and β-arrestin 2 in patients with T2DM complicated with MAFLD were positively correlated with FINS and HOMA-IR(P＜0.05).Elevated HOMA-IR,LSM,CAP,serum miR-122,NOX2,and β-arrestin 2 were risk factors for the occur-rence of liver fibrosis(P＜0.05).The combination of serum miR-122,NOX2,and β-arrestin 2 had a clearly higher AUC in diag-nosing liver fibrosis in patients with T2DM complicated with MAFLD than their individual detection(Zcombination-miR-122=2.075,Zcombination-NOX2=2.383,Zcombination-β-arrestin2=2.566,P＜0.05).Conclusion Serum miR-122,NOX2,and β-arrestin 2 are elevated in patients with T2DM complicated with MAFLD,and all three are clearly correlated with IR and liver fibrosis.In addition,their combined detection has high diagnostic value for liver fibrosis.