Changes and significance of serum level of hepcidin in patients newly diagnosed with type 2 diabetes mellitus complicated with nonalcoholic fatty liver disease

Objective To investigate the changes and significance of serum level of hepcidin in patients newly diagnosed with type 2 diabetes mellitus （T2DM） complicated with nonalcoholic fatty liver disease （NAFLD）. Methods A total of 216 patients newly diagnosed with T2DM were divided into four groups according to results of color Doppler ultrasound screening of the liver including T2DM without NAFLD group （group 1, n = 54）, T2DM complicated with mild NAFLD group （group 2, n = 48）, T2DM complicated with moderate NAFLD group （group 3, n = 59） and T2DM complicated with severe NAFLD group （group 4, n = 55） , and 52 healthy individuals were assigned into the control group （NC group）. The body mass index （BMI）, waist-to-hip ratio, waist circumference were recorded in 4 groups. The levels of blood lipid, blood glucose, blood uric acid, serum hepcidin, ferritin and hypersensitive C-reactive protein （hsCRP） were detected and statistically compared among four groups. The correlation between hepcidin and blood lipid, blood glucose, blood uric acid and hsCRP was analyzed. Results The BMI, waist-to-hip ratio, waist circumference, serum total cholesterol, triglyceride, LDL-C, fasting blood glucose, 2h postprandial blood glucose, GHbA_1c, uric acid, ferritin and transferrin in the four subgroups of DM group were all significantly higher than those in the control group （all P < 0.05）. These parameters did not significantly differ among four subgroups （all P > 0.05）. The hepcidin level and hsCRP in four subgroups of DM group were considerably higher compared with those in the control group （all P < 0.05）, and remarkably elevated with the severity of fatty liver （both P < 0.05）. Spearman rank correlation analysis demonstrated that serum hepcidin level was positively correlated with ferritin, uric acid and hsCRP （all P < 0.05）. Conclusions T2DM patients present with abnormal iron metabolism. The serum hepcidin level in T2DM patients complicated with NAFLD is increased with the severity of liver injury. The serum hepcidin level can reflect the severity of NAFLD in T2DM patients to certain extent.