Impaired ketogenesis is associated with metabolic-associated fatty liver disease in subjects with type 2 diabetes

Frontiers in Endocrinology

Endocrinology

Doo Ri Jo¹  Sejeong Lee²  Jaehyun Bae³  Bong-Soo Cha⁴  Eun Seok Kang⁴  Yong-ho Lee⁴  Minyoung Lee⁴  Byung-Wan Lee⁴ 

[1] Department of diabetes mellitus, Biomedical Research Center, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea;Division of Endocrinology and Metabolism, Department of Internal Medicine, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Republic of Korea;Division of Endocrinology and Metabolism, Department of Internal Medicine, Catholic Kwandong University College of Medicine, International St. Mary’s Hospital, Incheon, Republic of Korea;Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea;

关键词: ketogenesis;    β-hydroxybutyrate;    steatosis;    MAFLD;    diabetes;   

DOI  :  10.3389/fendo.2023.1124576

 received in 2022-12-15, accepted in 2023-02-09,  发布年份 2023

来源: Frontiers

【 摘 要 】

AimsThe ketogenic pathway is an effective mechanism by which the liver disposes of fatty acids (FAs) to the peripheral tissues. Impaired ketogenesis is presumed to be related to the pathogenesis of metabolic-associated fatty liver disease (MAFLD), but the results of previous studies have been controversial. Therefore, we investigated the association between ketogenic capacity and MAFLD in subjects with type 2 diabetes (T2D).MethodsA total of 435 subjects with newly diagnosed T2D was recruited for the study. They were classified into two groups based on median serum β-hydroxybutyrate (β-HB) level: intact vs. impaired ketogenesis groups. The associations of baseline serum β-HB and MAFLD indices of hepatic steatosis index, NAFLD liver fat score (NLFS), Framingham Steatosis index (FSI), Zhejian University index, and Chinese NAFLD score were investigated.ResultsCompared to the impaired ketogenesis group, the intact ketogenesis group showed better insulin sensitivity, lower serum triglyceride level, and higher low-density lipoprotein-cholesterol and glycated hemoglobin levels. Serum levels of liver enzymes were not different between the two groups. Of the hepatic steatosis indices, NLFS (0.8 vs. 0.9, p=0.045) and FSI (39.4 vs. 47.0: p=0.041) were significantly lower in the intact ketogenesis group. Moreover, intact ketogenesis was significantly associated with lower risk of MAFLD as calculated by FSI after adjusting for potential confounders (adjusted odds ratio 0.48, 95% confidence interval 0.25-0.91, p=0.025).ConclusionsOur study suggests that intact ketogenesis might be associated with decreased risk of MAFLD in T2D.

【 授权许可】

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Copyright © 2023 Lee, Bae, Jo, Lee, Lee, Kang, Cha and Lee