The Correlations Between Level of Zonulin, Leptin and Anthropometric Indicators in Patients with Metabolic-associated Fatty Liver Disease in Combination with Type 2 Diabetes mellitus

Abstract

The objective: to analyze the correlations between the level of zonulin, leptin and anthropometric parameters in patients with metabolically associated fatty liver disease (MAFLD) in combination with type 2 diabetes mellitus (DM). Materials and methods. 42 patients with MAFLD and type 2 diabetes took part in the study, and were examined and divided into groups. The first group included 22 patients with MAFLD and type 2 DM without bacterial overgrowth syndrome (BOS), the second group included 20 patients with MAFLD in combination with 2D DM and BOS. 15 practically healthy persons were included in the control group. During the physical examination of the patient, anthropometric indicators were measured, including height, body weight, body mass index (BMI) according to the Quetelet formula, waist circumference (WC) and hip circumference (HC) and the WC/HC ratio. The content of serum zonulin was determined by ELISA using test systems IDK Zonulin ELISA, KR5601 (Immunodiagnostic AG, Germany). An ELISA method was used to quantify serum leptin. Results. It was found that zonulin concentration in blood serum was significantly increased in patients of the first and second groups – 67.79±2.12 ng/ml and 80.36±3.44 ng/ml, respectively. In patients of the control group the zonulin amount was 12.34±1.41 ng/ml (p<0.001). Quantitative research of the leptin level in blood serum revealed a significant increase in patients of the first and second groups – 25.09±0.35 ng/ml and 28.21±1.03 ng/ml, respectively. In patients of the control group the level of leptin was 4.69±0.37 ng/ml (p<0.001). There was no significant difference in anthropometric parameters between the patients of the first and second groups (p>0.05). When comparing statistical indicators of anthropometry of patients of the first and second groups with the control group, significant differences were found in body weight, BMI, WC, HC, CTC (p<0.001), which indicates excess body weight and obesity in patients of the first and second groups. Conclusions. The results of the study present that in patients with MAFLD in combination with type 2 DM without BOS and BOS, increased intestinal permeability and hyperleptinemia were found, and a direct correlation of medium strength was established between the level of zonulin and body weight, BMI, a weak correlation between the level of zonulin and WC, HC, CTC was determined and mean strength correlation between zonulin and leptin levels was found.