Measurement significance of Mac-2 binding protein glycosylation isomer (M2BPGi) in patients with type 2 diabetes mellitus

Abstract

With the recent increase in cases of lifestyle-related diseases, the numbers of patients with nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) are increasing, which are becoming the main causes of hepatocellular carcinoma and liver cirrhosis. Since NAFLD and NASH have common risk factors with type 2 diabetes, such as obesity and insulin resistance, they appear with high frequency as complications of type 2 diabetes. In this study, we investigated the status of hepatic fibrosis and factors affecting them from the measured M2BPGi levels of type 2 diabetes patients. We also compared them with the FIB-4 index, a currently used hepatic fibrosis scoring system. The M2BPGi levels of all the patients with type 2 diabetes ranged from 0.22 to 4.11 C.O.I. with a median of 0.815 C.O.I. The M2BPGi positivity rate was 38.2% when the cut-off was set at 1.0 C.O.I To verify the factors that affect the M2BPGi level, multiple regression analysis was carried out using the M2BPGi level as the dependent variable and biochemical test results (e.g., blood count and HbA1c level), age, and BMI as explanatory variables. The results showed that high AST level, old age, low albumin level, and high triglyceride levels were the factors significantly associated with high M2BPGi level. The correlation coefficient (r) for the correlation with the FIB-4 index in 169 cases after excluding extreme values was 0.449. The agreement between assessment using M2BPGi level and that using the FIB-4 index was 53.5% (53 M2BPGi-positive cases, 38 M2BPGi-negative cases). There were mismatched cases: 66 cases negative for M2BPGi and positive for the FIB-4 index, and 12 cases positive for M2BPGi and negative for the FIB-4 index. In type 2 diabetes patients, measurement of M2BPGi levels even in FIB-4 index-negative cases is expected to prevent oversight of cases of liver fibrosis.