Correlation analysis between ferroptosis-related indicators and metabolic-associated fatty liver disease in type 2 diabe-tes mellitus
Shi Limin
Zhang Ziqi
Zhao Ting
Li Min
Sun Jian
Abstract：Objective To investigate the correlation between ferroptosis-related indicators and metabolic-associated fatty liver disease(MAFLD)in type 2 diabetes mellitus(T2DM).Methods A total of 167 T2DM patients admitted to the Department of Endocrinology of the Second Affiliated Hospital of Baotou Medical College from January 2023 to April 2024 were selected.Based on abdominal ultrasound results,they were divided into a T2DM group(44 cases)and a T2DM-MAFLD group(123 cases).According to the fatty liver index(FLI),T2DM-MAFLD patients were further divided into a low-risk sub-group(37 cases,FLI＜30),a medium-risk subgroup(46 cases,30 ≤ FLI＜60),and a high-risk subgroup(40 cases,FLI ≥60).Enzyme-linked immunosorbent assay was used to detect the levels of ferroptosis-related indicators including ferritin(FE),glutathione peroxidase 4(GPX4),reactive oxygen species(ROS),acyl-CoA synthase long-chain family member 4(ACSL4),glutathione(GSH),and superoxide dismutase(SOD).Pearson and Spearman correlation analyses were used to investigate the correlation between ferroptosis-related indicators and clinical parameters in T2DM-MAFLD patients.Multivariate logistic re-gression analysis was performed to identify influencing factors for MAFLD in T2DM patients.Results Serum levels of FE,ROS,and ACSL4 showed an increasing trend:T2DM group＜low-risk subgroup＜medium-risk subgroup＜high-risk sub-group(F/P=112.240/＜0.001,42.118/＜0.001,22.607/＜0.001).Serum levels of GPX4,GSH,and SOD showed a decreasing trend:T2DM group＞low-risk subgroup＞medium-risk subgroup＞high-risk subgroup(F/P=40.784/＜0.001,11.040/＜0.001,17.371/＜0.001).BMI,FPG,HbA1c,TG,TC,GGT,and HOMA-IR levels showed an increasing trend:T2DM group＜low-risk subgroup＜medium-risk subgroup＜high-risk subgroup(F/H/P=5.904/0.001,25.409/＜0.001,26.011/＜0.001,16.694/＜0.001,6.633/＜0.001,91.146/＜0.001,44.600/＜0.001).LDL-C levels showed:T2DM group＜low-risk subgroup＜medium-risk sub-group(F/P=7.215/＜0.001).HDL-C levels showed:T2DM group＞low-risk subgroup＞medium-risk subgroup＞high-risk subgroup(F/P=6.894/＜0.001).Ferroptosis-related indicators FE,ROS,and ACSL4 were positively correlated with clinical in-dicators BMI,FPG,HbA1c,TG,TC,CPS,HOMA-IR,and GGT in T2DM-MAFLD patients(all P＜0.05).FE and ROS were negatively correlated with HDL-C(r/P=-0.255/0.001,-0.160/0.039).GPX4,GSH,and SOD were negatively correlated with BMI,FPG,HbA1c,TG,TC,CPS,HOMA-IR,and GGT(all P＜0.05).Multivariate logistic regression analysis showed that high BMI,high FE,high ROS,high ACSL4,high FPG,high HbA1c,high TG,high GGT,and high HOMA-IR were independent risk factors for MAFLD in T2DM patients[OR(95％CI)=1.182(1.003-1.392),1.044(1.009-1.080),1.552(1.512-1.592),1.008(1.002-1.014),1.879(1.051-3.360),1.760(1.114-2.782),1.209(1.007-1.453),1.072(1.025-1.121),1.482(1.152-1.906)],while high GPX4 was an independent protective factor[OR(95％CI)=0.951(0.912-0.993)].Conclusion Fer-roptosis is associated with the progression of metabolic-associated fatty liver disease in type 2 diabetes mellitus.
Keywords：Metabolic-associated fatty liver diseaseType 2 diabetesFerroptosisFatty liver indexCorrelation
Publication Date：2026-02-18
Online Publishing Date：2026-03-18(First online date of this platform, not the publication date of the document)
Pages：6( 129-133,145 )