Association between rs2943650 mutation and insulin resistance in patients with chronic liver disease and type 2 diabetes mellitus

Objective To investigate the features of insulin resistance in patients with liver disease and diabetes and possible pathways leading to insulin resistance. Methods A total of 67 patients with liver disease and type 2 diabetes who were admitted to Beijing You'an Hospital from September 2017 to March 2018 were enrolled. The insulin secretory function of pancreas islet B cells and insulin resistance in the stages of chronic hepatitis and liver cirrhosis were analyzed. The presence or absence rs2943650 mutation was detected, and the association between rs2943650 mutation and insulin resistance in different degrees of liver injury was analyzed. The t-test or the rank sum test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data between groups. Results There was no significant difference in the secretory function of pancreas islet B cells between the patients with chronic hepatitis and type 2 diabetes and those with liver cirrhosis and type 2 diabetes ( 52. 72 ± 34. 56 vs 52. 35 ± 36. 59, t = 0. 24, P = 0. 99) , while there was a significant difference in insulin resistance index ( 1. 33 ± 0. 62 vs 2. 08 ± 1. 79, t = 2. 27, P = 0. 02) . There was a significant difference in insulin resistance between the patients with rs2943650 mutation and those without such mutation ( t = 2. 11, P = 0. 04) . There was a significant difference in the presence or absence of rs2943650 mutation between different stages of liver disease ( χ2= 6. 73, P = 0. 01) , and rs2943650 mutation was more common in patients with liver cirrhosis. Conclusion In patients with chronic liver disease and diabetes, there is no significant reduction in the function of pancreas islet B cells with the increase in the degree of liver injury, while there is a significant increase in insulin resistance. The rs2943650 mutation is significantly associated with insulin resistance and increases significantly with the aggravation of liver injury, and therefore, it may be an important pathway for insulin resistance induced by liver disease and diabetes.