Relation between Serum Calcium Level and Non Alcoholic Fatty Liver Disease in Patients with Type 2 Diabetes Mellitus

摘要

Background : Calcium homeostasis has been shown to affect insulin resistance and secretion. Moreover, several studies have reported that elevated serum calcium is associated with an increased risk of developing metabolic abnormalities, including type 2 diabetes mellitus (DM). However, it remains unclear whether serum calcium level can affect the presence of nonalcoholic fatty liver disease (NAFLD), which has been considered as the hepatic expression of metabolic syndrome. Aim of the present study was to investigate the relationship between serum calcium level and NAFLD in patients with type 2 DM. Subjects and Methods : This study was conducted on 100 subjects subdivided into 3 groups : 20 apparently healthy persons with no history of diabetes mellitus or non-alcoholic fatty liver disease (NAFLD) used as a control group (Group I) , 40 Diabetic patients (T2DM) with non-alcoholic fatty liver disease (NAFLD) as (Group II) and 40 Diabetic Patients (T2DM) without non-alcoholic fatty liver disease (NAFLD) as (Group III). They were subjected to full history taking & thorough clinical examination, and they investigated for Total Serum Calcium, Fasting and 2 hours post prandial blood glucose level, Glycated haemoglobin (HA1c), Lipid profile (Total Serum Cholesterol, Serum Triglycerides, HDL-Cholesterol and LDL-Cholesterol), Liver enzymes (AST, ALT and GGT), Serum Creatinine & urea, Ultrasonography for NAFLD evaluation and calculation of fatty liver index . Results: The major findings made in the current study are the discovery of significant correlation between total serum calcium concentrations with fasting serum glucose. Diabetes mellitus is a condition in which cell calcium homeostasis is impaired. Association of NAFLD with diabetes causes more increase of serum calcium suggesting the possibility that increased serum calcium may in part be involved in developing NAFLD in subjects with type 2 DM. FLI, was suggested as a proxy for fatty liver. Also only GGT was an independent predictor of FL while AST and ALT level has a little diagnostic or prognostic value when assessing patients for NAFLD. In addition, total cholesterol, LDL cholesterol and plasma triglyceride levels were significantly higher in subjects with NAFLD. Conclusion : These findings suggest the possibility that increased Total serum calcium may in part be involved in developing NAFLD in subjects with type 2 DM.