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Objective:To observe the effect of nutrition intervention and exercise rehabilitation treatment on the sarcopenia in elderly patients with type 2 diabetes.Methods:It was a cross-sectional study. From March 2019 to September 2020, 101 elderly patients with type 2 diabetes complicated with sarcopenia treated in the Department of Endocrinology of Tianjin Third Central Hospital were enrolled in this study. The patients were divided into four groups with propensity score matching method: sarcopenia education group without nutrition and resistance training group (group A, n=22), simple nutrition intervention group (group B, n=28), nutritional intervention combined with resistance training group (group C, n=27) and nutritional intervention combined with aerobic and resistance training group (group D, n=24). All the patients were intervened for 24 weeks, two patients in groups C and D dropped due to their own reasons. The 25-dihydroxy vitamin D3 (25(OH)D 3), grip strength, muscle mass of the limbs and short physical performance battery (SPPB) scores were measured before and 24 weeks after the intervention in all the participants. Results:After the intervention, the 25(OH)D 3 levels in the B, C, D groups was (33.45±4.05), (33.68±4.69), (34.28±5.58) μg/L, respectively, all were higher than those before the treatment (all P<0.01), and there was no significant differences among the three groups ( P>0.05). The muscle mass in the B, C, D groups after intervention was 5.650 (5.102, 6.658), 6.601 (6.007, 7.156) and 6.520 (6.017, 7.302) kg/m 2, respectively, all were significantly higher than those before the treatment (all P<0.01); the muscle mass in group C and D increased more significantly than that in group B ( P<0.01), but there was no significant differences between group C and D ( P>0.05). After the intervention, the muscle strength in the C and D groups was 20.60 (19.20, 24.55) kg and 21.15 (19.43, 26.63) kg, and the SPPB scores was 8.00 (7.00, 9.00) points and 8.00 (8.00, 9.00) points, respectively, all were higher than those before the intervention (all P<0.01), but there was no significant differences between the two groups(both P>0.05). The SPPB function score in group D was better than that in group C, the difference was statistically significant ( P<0.05). Conclusions:Nutritional intervention can improve the muscle mass in elderly type 2 diabetes patients with sarcopenia. Combined with rehabilitation training, the muscle strength and muscle function of these patients could also be improved, and the improvement of muscle mass is better than that in patients receiving nutritional intervention only. In terms of increasing muscle strength, the two kinds of rehabilitation training are equivalent. If combined with aerobic exercise, it can also improve the muscle function of these patients.
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Objective To evaluate the accuracy of different noninvasive methods for the diagnosis of nonalcoholic steatohepatitis(NASH) and hepatic fibrosis in patients with non-alcoholic fatty liver disease (NAFLD) combined with type 2 diabetes mellitus(T2DM). Method A prospective comparative study was performed for 91 patients with T2DM and NAFLD, which were diagnosed by glucose tolerance test and liver biopsy. The height and body mass of the patient were measured, and the body mass index(BMI) was calculated. The fasting venous blood of the patient was collected, and then the blood routine, liver function and ferritin were measured. NPS, neutrophil lymphocyte ratio(NLR), BARD score, FIB-4 index, APRI, and NAFLD fibrosis score(NFS) were calculated. All patients underwent transient elastography (Fibrotouch) to evaluate the degree of liver stiffness measurement (LSM) and controlled attenuation parameter. All the liver biopsy specimens were categorized by SAF as the gold standard for evaluating NASH and liver fibrosis NASH. Correlation analysis was applied to compare the correlation between the noninvasive methods and SAF. The receiver operating characteristic (ROC) curve and the area under the curve (AUC) were used to assess the diagnostic value of the noninvasive methods for NASH and liver fibrosis NASH. Results In T2DM combine with NAFLD patients, NPS, LSM, NFS, APRI, FIB4 and BMI scores were positively correlated with SAF (r value was 0.509, 0.508, 0.252, 0.396, 0.313 and 0.213, respectively; P value was <0.001, <0.001, 0.016,<0.001, 0.003 and 0.043, respectively). LSM, NPS, NFS and FIB4 scores were positively correlated with liver fibrosis (r value was 0.535, 0.337, 0.315 and 0.315, respectively; P value was <0.001, 0.001, 0.002, 0.002, respectively). The ROC curve shows that the area under the curve of NPS, LSM, APRI, FIB4 and BMI for diagnosing NASH was 0.838, 0.760, 0.734, 0.623 and 0.682, respectively, and P value was 0.000, 0.000, 0.000, 0.044 and 0.003, respectively. For the diagnosis of fibrotic NASH, that value of LSM, NFS, FIB4 and NPS was 0.795, 0.765, 0.686 and 0.623, respectively, and P value was 0.000, 0.001, 0.020 and 0.123, respectively. Conclusions NPS, LSM and APRI have good clinical diagnostic value for NASH. LSM and NFS have good diagnostic value for fibrotic NASH.
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Objective@#To investigate the effect of dietary control combined with different exercise modes on plasma vaspin, irisin, and metabolic parameters in patients with non-alcoholic fatty liver disease (NAFLD) through a randomized open parallel-controlled study.@*Methods@#The patients aged 30-65 years who visited Tianjin Third Central Hospital from January 2013 to December 2014 and were diagnosed with NAFLD by liver ultrasound and fat content determination were screening, and 474 patients were enrolled in this randomized controlled trial and divided into aerobic exercise group, resistance exercise group, and control group. All patients received dietary intervention. The three groups were compared in terms of biochemical parameters, fat content, NFS score, energy metabolic parameters, body composition index, and levels of vaspin and irisin at baseline and after 6 months of intervention. SPSS 19.0 was used for statistical analysis. The t-test, the Mann-Whitney U test, the chi-square test, and an analysis of variance were used for comparison between groups. The multiple imputation method was used for missing data, and the results were included in the intention-to-treat analysis.@*Results@#There were no significant differences in age, sex, anthropometrical parameters, and biochemical parameters between the three groups at baseline. Compared with dietary control alone, aerobic exercise and resistance exercise helped to achieve significant reductions in waist circumference, diastolic pressure, percentage of body fat, volatile fatty acid, fasting blood glucose, homeostasis model assessment of insulin resistance, triglyceride, low-density lipoprotein cholesterol, free fatty acid, uric acid, alanine aminotransferase, and liver fat content after 6 months of intervention (P < 0.05). The aerobic exercise group had a significant increase in non-protein respiratory quotient and significant reductions in body mass index and aspartate aminotransferase after intervention, as well as a significant increase in resting energy expenditure and significant reductions in abdominal fat ratio and total cholesterol after 6 months of resistance exercise (P < 0.05). The aerobic exercise group and the resistance exercise group had a significant reduction in vaspin and a significant increase in irisin after intervention (P < 0.05), and the resistance exercise group had significantly greater changes in these two adipokines than the aerobic exercise group (P < 0.05).@*Conclusion@#Exercise therapy is an effective method for the treatment of metabolism-associated diseases, and a combination of resistance and aerobic exercises is more reasonable and effective in clinical practice. As a relatively safe exercise mode, resistance exercise can also effectively improve the metabolic state of NAFLD patients.
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Objective@#To investigate the influence of high-fat diet (HFD) in paternal C57BL/6 mice on HFD-induced liver fat deposition in male offspring, as well as transgenerational inheritance caused by paternal HFD and related mechanisms.@*Methods@#A total of 20 male C57BL/6 mice aged 3 weeks (F0) were randomly divided into normal control group (C, 10 mice) and HFD group (HF, 10 mice). After 12 weeks of HFD intervention, the male mice in the HFD group mated with female ones treated with normal diet and pups were obtained. Male pups (F1) were selected as study subjects. According to the intervention for F0 mice, male F1 mice were divided into control male offspring group (CM, 8 mice) and HFD male offspring group (HFM, 9 mice). All these mice were given normal diet after weaning until 4 weeks old, followed by HFD for 4 weeks. The body length and body weight were measured and recorded every week. Oil red O staining was used to observe fat deposition in the liver. Western blot and real-time PCR were used to measure the expression of related proteins and genes involved in the de novo synthesis and aerobic oxidation of fatty acid, mitochondriogenesis, and autophagy.@*Results@#After 4 weeks of HFD intervention, the HFM group had a significantly higher body weight than the CM group (P < 0.05); the oil red O staining showed that compared with the CM group, the HFM had a significant increase in liver fat deposition and a significantly higher integral absorbance value in the oil red O staining-positive area (384 360±57 600 vs 236 754±12 607, P < 0.01). For related factors involved in the de novo synthesis of fatty acid in the liver, compared with the CM group, the HFM group had significant increases in the expression of sterol regulatory element-binding protein-1 and fatty acid synthase (P < 0.05); for related factors involved in the mitochondrial biosynthesis in the liver, the HFM group had significant reductions in the relative expression of peroxisome proliferator-activated receptor-γ coactivator-1α, nuclear respiratory factor 1, and mitochondrial transcription factor A compared with the CM group (P < 0.05). For autophagy-related factors in the liver in the F1 mice, compared with the CM group, the HFM group had a significant reduction in microtubule-associated protein I light chain 3 (LC3-II/I) (P < 0.05) and a significant increase in P62 (P < 0.05), suggesting a reduced autophagy function in the liver.@*Conclusion@#HFD intervention for paternal C57BL/6 mice can increase HFD-induced liver fat deposition in male offspring, which may be related to the increased de novo synthesis of fatty acid and reduced mitochondriogenesis and autophagy function in the liver.
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Objective To study the relationship between microalbuminuria and cardiac diastolic function in patients with type 2 diabetes mellitus (T2DM) and nonalcoholic fatty liver disease (NAFLD). Methods A total of 262 patients with T2DM and NAFLD were included in this study. Patients were divided into normal group (n=106) and abnormal group (n=156) according to their cardiac diastolic function. Data of waist circumference (WC), low density lipoprotein cholesterol (LDL-C), triglyceride(TG), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FBG), fasting insulin level (FINS), insulin resistance index (HOMA-IR), glycosylated hemoglobin (HbA1c), glomerular filtration rate (GFR), C reactive protein (CRP), urinary microalbuminuria excretion rate (UAER), left ventricular myocardial quality index (LVWI) and liver fat content (LFC) were compared between two groups. All patients were divided into four groups according to data of UAER and GFR:group A[UAER<20μg/min and GFR≥90 mL/(min · 1.73 m2)], group B [UAER<20μg/min and GFR<90 mL/(min·1.73 m2)], group C [UAER≥20μg/min and GFR≥90 mL/(min·1.73 m2)], and group D [UAER≥20μg/min and GFR<90 mL/(min · 1.73 m2)]. The differences between the relevant indicators were analyzed between groups. Logistic regression analysis was used to compare UAER between normal group and abnormal group. Also the relationship between the related factors and cardiac diastolic function was compared between these two groups. Results For abnormal group, TG, SBP, HOMA-IR, CRP, UAER, LVWI and LFC were significantly higher, and GFR was significantly lower, than those of normal group (P<0.05). There were no significant differences in other indicators between two groups. Values of peak early/late diastolic filling velocity (E/A) showed a reduction trend in order in A, B,C and D groups (P<0.05). Values of LVWI showed a increasing trend in order in four groups (P<0.05). Values of LFC were significantly higher in C and D groups compared with those of A and B groups (P<0.05). There was no significant difference in LFC between A group and B group. The GFR<90 mL/(min·1.73 m2)was an independent risk factor for cardiac diastolic function in normal group of UAER, and higher UAER was an independent risk factor for cardiac diastolic function in the abnormal group of UAER. Conclusion There is obviously reduced cardiac diastolic function in patients with T2DM and NAFLD and microalbuminuria. When UAER≥20 μg/min, the higher UAER is an independent risk factor for reducing diastolic cardiac dysfunction.
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Objective To study the relationship between advanced liver fibrosis and peripheral neuropathy in patients with type 2 diabetes mellitus (DPN). Methods A total of 173 patients (89 men and 84 women) with type 2 diabetes who hos?pitalized in Tianjin Third Central Hospital within nearly three years (2013.02-2015.02) were divided into three groups ac?cording to non-alcoholic fatty liver disease (NAFLD) fibrosis score:group A (NFS≤-1.455), group B (-1.455
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Objective To evaluate the role of adrenal venons sampling (AVS) in differential diagnosis of subtypes in primary aldosteronism.Methods Twenty-two patients diagnosed as primary aldosteronism in the Third Central Hospital of Tianjin from November 201 1 to July 2014, were undergone AVS for measurement of plasma aldosterone and cortisol levels in each adrenal vein and infrarenal inferior vena cava.The data were compared with the results of the thin slice incremental scanning in adrenal and postoperative pathologic diagnosis.Other 8 patients, whose screening test and confirmed diagnosis did not support the primary aldosteronism, with nodule larger than 4 cm pathologically confirmed as non-functioning adrenal adenoma, were also recruited.Results Among all the 22 patients with primary aldosteronism, the incidence rate of hypertention was 95.4%, and the incidence of hypokalemia was 81.8%.Compared with idiopathic hyperaldosteronism patients, the patients with aldosterone producing adenoma had higher blood pressure and aldosterone level in plasma, but lower plasma potassium, while the clinical and biochemical index of the non-functioning adrenal adenoma group were within the normal range.The overall accuracy rate of adrenal CT in the diagnosis of subtypes of primary aldosteronism was 77.27% (17/22), and the accuracy rates were 78.95% (15/19) in aldosterone producing adenoma and 66.7% (2/3) in idiopathic hyperaldosteronism, respectively.The accuracy rate of AVS was 100% with the ratio of aldosterone to cortisol as the criterion.Conclusions Misdiagnose may occur when using CT scan only to differentially diagnose primary aldosteronism.Compared with CT imaging of the adrenal glands, AVS has higher coincidence rate and is an elective approach to establish the subtype diagnosis of questionable primary aldosteronism.
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<p><b>OBJECTIVE</b>To explore the relationship between socioeconomic status (SES) and non-alcoholic fatty liver disease (NAFLD) in patients with type 2 diabetes mellitus (T2DM).</p><p><b>METHODS</b>The medical records of Tianjin Third Central Hospital were retrospectively reviewed to identify patients who had been hospitalized for treatment of T2DM but without diagnosis of NAFLD between 2007 and 2012 and who had required a second hospitalization during this same period. Each patient was contacted by telephone for self-reporting of SES. Analysis was carried out with patients grouped according to SES (high vs. low) to determine association of SES with incidence of NAFLD at the second hospitalization; the relative risk (RR), attributable risk (AR) and attributable risk percent (ARP) were calculated. Furthermore, the correlation of SES with other clinical and socio-psychological variables was assessed.</p><p><b>RESULTS</b>The patients in the high and low SES groups showed no significant differences at baseline. For development of NAFLD by the time of the second hospitalization, the low SES group had an RR of 2.19, an AR of 20.74%, and an ARP of 54.39%. Correlation analysis showed that SES was positively correlated with body mass index (r=-0.582) and levels of glycated hemoglobin (r=-0.421), fasting serum insulin (r=-0.570), insulin resistance (as assessed by the HOMA method) (r=-0.487), low-density lipopmtein (r=-0.396) and C-reactive protein (r=-0.353) (all P<0.05), and negatively correlated with high-density lipopmtein (r =0.539) and with the scores for physical functioning (r =0.241), general health (r=0.234), social functioning (r =0.286), emotional health (r=0.251), and mental health (r=0.215) (all P<0.05).</p><p><b>CONCLUSION</b>SES is an influencing factor of NAFLD in patients with T2DM and is closely related to obesity, insulin resistance, lipid metabolic disorder, chronic inflammation and life quality in patients with NAFLD and T2DM.</p>
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Humans , Body Mass Index , C-Reactive Protein , Diabetes Mellitus, Type 2 , Insulin Resistance , Non-alcoholic Fatty Liver Disease , Obesity , Risk Factors , Social ClassABSTRACT
Objective To evaluate the correlation of sub-foveal chomidal thickness (SFCT) variation in type 2 diabetic patients with clinically significant diabetic macular edema (CSME) and the related factors using enhanced depth imaging optical coherence tomography technique (EDI-OCT).Methods A total of 40 normal volunteers (group A), 49 type 2 diabetic patients without CSME(group B) and 37 type 2 diabetic patients with CSME (group C) were recruited, including 67 male and 59 female.All study subjects received EDI-OCT examination.The SFCT in A, B and C groups were compared using one-way ANOVA analysis.The correlations between SFCT and duration of diabetes, fasting blood glucose (FBG), glycoseylated hemoglobin HbAlc, low density lipopmtein (LDL), triglyceride (TG), total cholesterol (TC), high density lipopmtein (HDL), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were analyzed using logistic regression analysis.Results Average SFCT in group A was (271.49±36.18) μm.Average SFCT in group B was (260.48±35.27) μm, and compared with group A, the difference was not statistically significant (P> 0.05).Average SFCT in group C was (227.90±34.73) μm, and compared with group A, the difference was statistically significant (P<0.01).There was a significant difference of SFCT between groups B and C (P<0.01).There was no statistically correlation between average SFCT and duration of diabetes, FBG, HbA1c, TG, TC, HDL, creatinine, SBP and DBP (P>0.05), while a statistically correlation between SFCT and LDL or urinary albumin excretion rate (UAER) was observed in the study (r=-0.609,-0.681, P<0.01).Conclusions Compared with groups A and B, SFCT in type 2 diabetic patients with CSME was significantly thinner.UAER and LDL levels in type 2 diabetic patients with CSME were negatively correlated with SFCT, that is to say, with the increasing of UAER and LDL levels, SFCT in type 2 diabetic patients with CSME decreased.
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Objective To investigate the relationship between plasma levels of chromogranin A (CHGA) and adi-pose triglyceride lipase (ATGL) in patients with type 2 diabetes (T2DM) combined non-alcoholic fatty liver disease (NAFLD). Methods The plasma levels of CHGA and ATGL were assayed by enzyme-linked immunosorbent assay (ELISA) in T2DM patients with NAFLD (group A, n=74), T2DM without NAFLD (group B, n=76), and normal group (group NC, n=75). The correlation between CHGA, ATGL and other metabolic index was analyzed. Results The plasma level of CHGA was significantly higher in group A (83.15±9.46) and group B (70.90±2.75) than that of group NC (46.74±8.15, P<0.01), and the level of CHGA was significantly higher in group A than that of group B (P<0.01). The plasma level of ATGL was sig-nificantly lower in group A (21.36±13.42) and group B (40.29±22.83) than that of group NC (72.30±26.41, P<0.01), and the level was lower in group A than that of group B (P<0.01). There was a negative correlation between the plasma CHGA, AT-GL and carbohydrate oxidation rate in group A. There was a positive correlation between fasting insulin (FINS), insulin resis-tance index (HOMA-IR), free fatty acid (FFA) and fat oxidation rate in group A. There was a negative correlation between plasma level ATGL and body mass index (BMI), FINS, cholesterol (TC), triglyceride (TG) and HOMA-IR, meanwhile, it was positively correlated with FFA. The multiple stepwise regression analysis showed that FINS, ATGL and FFA were indepen-dent variables for CHGA. The Logistic regression analysis showed that plasma levels of CHGA, ATGL and FFA were the in-dependent predictors of T2DM with NAFLD. Conclusion The plasma levels of CHGA and ATGL are closely correlated with substance and energy metabolism, and the interaction between them may play an important role in the pathogenesis of T2DM with NAFLD .
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Objective To investigate the relationship between plasma soluble CD36 (sCD36) and nonalcoholic fatty liver disease (NAFLD) in patients combined with type 2 diabetes mellitus (T2DM). Methods Plasma levels of sCD36 were determined in normal control group (group A, n=39), patients of T2DM without NAFLD group (group B, n=39) and T2DM with NAFLD group (group C, n=59). Liver fat content (LFC) and nonalcoholic fatty liver fibrosis score (NFS) were calculated in group C. Glucose and lipid metabolic parameters, liver function parameters and inflammatory parameters were also detect?ed in all three groups. Variance analysis was applied to analyze the differences of the above parameters among three groups;Correlation analysis was used to analyze the relationship between sCD36 level and all the above parameters;Multiple step? wise regression analysis was applied to determine the influencing factors of sCD36 level in patients of group C. Results Plasma sCD36 (μg/L) levels in group B (3.87 ± 1.16) and group C (5.72 ± 1.79) are higher than that of group A (2.57 ± 0.93) (both P<0.01), and it is higher in group C than in group B (each P<0.05);Correlation analysis showed that sCD36 level was positively correlated with body mass index (BMI), waist, visceral adipose tissue,fast insulin (FINS), insulin resistance in?dex (HOMA-IR), free fatty acid (FFA), alanine transaminase (ALT), tumor necrosis factor-α(TNF-α), interleukin-6 (IL-6), LFC and NFS (P<0.01 or P<0.05);Multiple stepwise regression analysis showed that FFA, LFC, TNF-αand IL-6 were in?fluencing factors of sCD36 level in patients of group C. Conclusion Plasma sCD36 level was related to fatty liver severity, liver injury and fatty liver fibrosis, it might be used as a plasma marker of T2DM combined with NAFLD. CD36 might con?tribute to the development of T2DM combined with NAFLD through inflammatory mechanisms.
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Objective To investigate the relationship of omentin-1 with adiponectin and inflammatory cytokines in type 2 diabetes (T2DM) patients with nonalcoholic fatty liver disease (NAFLD). Methods The serum levels of omentin-1 and adiponectin were assayed by enzyme-linked immunosorbent assay (ELISA) in patients of T2DM with NAFLD (group A, n=63), T2DM without NAFLD (group B, n=63)and normal control group (group C, n=70). At the same time the biochemical markers and inflammatory marker, such as tumor necrosis factor (TNF)-α, high-sensitivity C-reactive protein (hs-CRP) and interleukin 6(IL-6) were detected in three groups. The correlation analysis and multiple regression analysis were used to de-tect the association of omentin-1 with adiponectin and inflammatory markers. The logistic regression was used to analyze fac-tors influencing NAFLD in patients with T2DM. Results The serum levels of omentin-1 and adiponectin were significant-ly lower in group A [ (27.02±2.82)μg/L and (11.98±3.63) mg/L] than those of group B [(31.52±2.81)μg/L and (15.85±3.28) mg/L] and group C [(35.92±2.80)μg/L and (19.88±3.44) mg/L], and there were significantly lower levels of them in group B than those of group C (P<0.01). The plasma omentin-1 level was positively correlated with adiponectin and high density li-poprotein (HDL-C) in group A. Also the plasma omentin-1 level was negatively correlated with TNF-α, IL-6, fasting blood glucose (FBG), homeostasis model assessment of insulin resistance (HOMA-IR), visceral adipose tissue, waist, waist-to-hip ratio (WHR) and free fatty acid in group A (P<0.05 or P<0.01). Multiple stepwise regression analysis showed that adipo-nectin, TNF-αand IL-6 were independent factors influencing the level of plasma omentin-1. Logistic regression analysis showed that omentin-1 was one of independent factors influencing T2DM combined with NAFLD (P<0.01). Conclusion The incident of NAFLD in T2DM patients is related to the lower level of omentin-1, which may be influenced by adiponectin and inflammatory factors.
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Objective To assay the plasma omentin level in patients of type 2 diabetes mellitus (T2DM) combined with non-alcoholic fatty liver disease (NAFLD) and investigate the relationship between plasma omentin level,glucose and lipid metabolism,insulin resistance and NAFLD.Methods The plasma omentin level was assayed by enzyme-linked immunosorbent assay(ELISA) in all subjects,including patients of T2DM controls with NAFLD (group A,50 cases),T2DM without NAFLD (group B,50 cases),simple with NAFLD(group C,51 cases) and normal controls (group D,49 cases).Meanwhile,blood glucose,glycosylated hemoglobin(HbA1c),lipids and insulin levels were also measured.Body mass index (BMI) and waist-to-hip ratio were evaluated.Insulin sensitivity was assessed by HOMA-IR.Results The plasma omentin level was (17.85 ±3.68),(13.89 ±10.68),(26.05 ±7.26) and (22.92 ±2.71)μg/L in group A,B,C and D respectively.The plasma omentin level of group A and group B was significantly lower than that of group C and group D(P < 0.05).The plasma omentin level of group A was higher than that of group B (P < 0.05).The plasma omentin level of group C was higher than that of group D (P< 0.05).Correlation analysis showed that the plasma omentin level was negatively correlated to weight,BMI,waist,triglyceride,fasting blood glucose,fasting insulin (FINS) and HOMA-IR (P <0.05 or <0.01),and positively correlated to high-density lipoprotein cholesterol (HDL-C)(P <0.01).Multiple stepwise regression analysis showed that BMI,HOMA-IR and FINS was independent variable of omentin.The concentration of omentin was 24.82 μ g/L which could predict the risk of NAFLD in people with normal glucose regulation.Conclusions The plasma omentin level is closely correlated with glucose,lipid metabolism and insulin resistance.Plasma omentin may play an important role in the pathogenesis of T2DM and NAFLD.