Objective To explore the correlation between inflammatory markers and fibrosis of metabolic dysfunction-associated fatty liver disease(MAFLD)in patients with type 2 diabetes mellitus(T2DM).Methods A total of 769 hospitalized patients with T2DM were enrolled in this study from the Department of Endocrinology,The Second Affiliated Hospital of Xuzhou Medical University from January 2020 to December 2023.They were divided into T2DM group(n=389)and MAFLD group(n=380)according to whether they were combined with MAFLD.According to the FIB-4 score,the MAFLD group was further divided into non-hepatic fibrosis subgroup(FIB-4＜1.3,n=267),suspected hepatic fibrosis subgroup(1.3≤FIB-4≤2.67,n=99)and advanced hepatic fibrosis subgroup(FIB-4＞2.67,n=14).The general data and biochemical indicators of each group were compared,Logistic regression analysis of influencing factors for liver fibrosis in T2DM patients with MAFLD.The diagnostic value of NLR,SIRI,PLR and PHR in predicting T2DM complicated with MAFLD liver fibrosis was evaluated by ROC curve analysis.Results BMI,lymphocytes(LY),red blood cells(RBC),hemoglobin(Hb),FPG,TG,TC,LDL-C,alanine aminotransferase(ALT),aspartate aminotransferase(AST),albumin(ALB),γ-glutamyl transpeptidase(GGT),and serum uric acid(SUA)were higher,while age,duration of DM,mean platelet volume and high-density lipoprotein cholesterol(HDL-C)were lower in MAFLD group than in T2DM group(P＜0.05).Compared with the non-hepatic fibrosis subgroup,the age,duration of DM,mean platelet volume AST and NLR were increased,while LY,PLR and PHR were decreased in the suspected hepatic fibrosis subgroup(P＜0.05).The age,AST and NLR were higher,while LY,RBC,LDL-C,PLR and PHR were lowerin the advanced hepatic fibrosis subgroup than in non-hepatic fibrosis subgroup(P＜0.05).Compared with the suspected hepatic fibrosis subgroup,FPG,HbA1c and SIRI were increased(P＜0.05),however,Hb,PLT and ALB were decreased in the advanced hepatic fibrosis subgroup(P＜0.05).Logistic regression analysis showed that NLR,SIRI,PLR and PHR were the influencing factors for liver fibrosis in T2DM combined with MAFLD.Area under ROC curve for NLR,SIRI,PLR and PHR in predicting liver fibrosis in T2DM combined with MAFLD were 0.712,0.757,0.703,0.806,respectively.The sensitivities were 0.929,0.500,0.857,0.929,and the specificities were 0.388,0.902,0.497,0.593 respectively.The optimal cut-off values were 1.573、1.465、110.819、185.379.Conclusions NLR,SIRI,PLR and PHR are the influencing factors for liver fibrosis in patients with T2DM complicated with MAFLD,which are helpful for their diagnosis.

Objective To investigate the effect of systemic administration of gabapentin on the expression of Nrf2 in dorsal root ganglion neurons in a rat model of diabetic neuropathic pain (DNP). Methods 60 male SD rats weighing 200-220 g were randomly divided into 4 groups (n= 15 each): control group (group C), DNP group, saline group (SC + DNP group) and gabapentin group ( GBP + DNP group). Diabetes was induced with streptozocin (70 mg/ kg) subcutaneously. Paw withdrawal mechanical threshold ( PWMT) and paw withdrawal thermal latency (PWTL) were measured at 1d before and 3,7,10,14,21, and 28 d after streptozocin injection, and 21 and 28 d after administration of gabapentin (50 mg·kg-1 ·d-1 ,once) intraperitoneally. Saline and gabapentin (50 mg·kg-1 · d-1 ) were given intraperitoneally once a day for 7 d starting from 15 d after streptozocin injection in saline and gabapentin groups respectively. The expression of Nrf2 was determined at 21 d after streptozocin injection by immune-histochemistry and Western blot. Results Compared with group C, PWMT ( 3. 95 ± 0. 57) was significantly decreased, PWTL(6.3 ± 0.81) was significantly shorten, Nrf2 in expression was significantly decreased in DNP, SC+DNP and group (P<0.05). Compared with SC+DNP group, PWMT(8.2 ± 0.79) was significantly increased, PWTL(9.7 ± 1.13) was significantly prolonged, Nrf2 expression was significantly increased in GBP+DNP group (P<0.05). There was no significant difference in the parameters mentioned above between DNP and SC+DNP group (P>0.05). Conclusion Systemic administration of gabapentin attenuates diabetic neuropathic pain by enhancing the expression of Nrf2 in DRG neurons.