Blood lactate levels are associated with an increased risk of metabolic dysfunction-associated fatty liver disease in type 2 diabetes: a real-world study

Yi-Lin Ma; Jiang-Feng Ke; Jun-Wei Wang; Yu-Jie Wang; Man-Rong Xu; Lian-Xi Li

doi:10.3389/fendo.2023.1133991

Blood lactate levels are associated with an increased risk of metabolic dysfunction-associated fatty liver disease in type 2 diabetes: a real-world study

Front Endocrinol (Lausanne). 2023 May 8:14:1133991. doi: 10.3389/fendo.2023.1133991. eCollection 2023.

Authors

Yi-Lin Ma¹, Jiang-Feng Ke², Jun-Wei Wang¹, Yu-Jie Wang¹, Man-Rong Xu¹, Lian-Xi Li¹

Affiliations

¹ Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China.
² Department of Radiation Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, China.

Abstract

Aim: To investigate the association between blood lactate levels and metabolic dysfunction-associated fatty liver disease (MAFLD) in type 2 diabetes mellitus (T2DM).

Methods: 4628 Chinese T2DM patients were divided into quartiles according to blood lactate levels in this real-world study. Abdominal ultrasonography was used to diagnosis MAFLD. The associations of blood lactate levels and quartiles with MAFLD were analyzed by logistic regression.

Results: There were a significantly increased trend in both MAFLD prevalence (28.9%, 36.5%, 43.5%, and 54.7%) and HOMA2-IR value (1.31(0.80-2.03), 1.44(0.87-2.20), 1.59(0.99-2.36), 1.82(1.15-2.59)) across the blood lactate quartiles in T2DM patients after adjustment for age, sex, diabetic duration, and metformin use (all p<0.001 for trend). After correcting for other confounding factors, not only increased blood lactate levels were obviously associated with MAFLD presence in the patients with (OR=1.378, 95%CI: 1.210-1.569, p<0.001) and without taking metformin (OR=1.181, 95%CI: 1.010-1.381, p=0.037), but also blood lactate quartiles were independently correlated to the increased risk of MAFLD in T2DM patients (p<0.001 for trend). Compared with the subjects in the lowest blood lactate quartiles, the risk of MAFLD increased to 1.436-, 1.473-, and 2.055-fold, respectively, in those from the second to the highest lactate quartiles.

Conclusions: The blood lactate levels in T2DM subjects were independently associated with an increased risk of MAFLD, which was not affected by metformin-taking and might closely related to insulin resistance. Blood lactate levels might be used as a practical indicator for assessing the risk of MAFLD in T2DM patients.

Keywords: HOMA2-IR; insulin resistance; lactate; metabolic dysfunction-associated fatty liver disease; type 2 diabetes mellitus.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Asian People
Diabetes Mellitus, Type 2* / complications
Humans
Lactic Acid
Metformin* / therapeutic use
Non-alcoholic Fatty Liver Disease*

Substances

Metformin
Lactic Acid

Grants and funding

This work was supported by the National Natural Science Foundation of China (grant numbers 81170759, 81770813, and 82070866), the National Key Research and Development Plan (grant numbers 2018YFC1314900 and 2018YFC1314905), the Translational Medicine National Key Science and Technology Infrastructure Open Project (grant number TMSK-2021-116), the Shanghai Research Center for Endocrine and Metabolic Diseases (2022ZZ01002), the Exploratory Clinical Research Project of Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine (grant number ynts202105), and Shanghai Municipal Key Clinical Specialty. The funders were not involved in the study design, collection, analysis, interpretation of data, the writing of this article, or the decision to submit it for publication.