Elevated serum preptin levels as a marker for non-alcoholic fatty liver disease severity in type 2 diabetes mellitus patients

Preptin is a hormone co-secreted with insulin and amylin by pancreatic beta cells. It plays a crucial role in metabolic regulation. Despite being connected to T2DM and NAFLD, the relationship between preptin levels and NAFLD severity in T2DM patients is not well understood.

To determine the preptin levels in T2DM patients with NAFLD and assess the levels of liver enzymes to correlate preptin levels with liver enzymes and severity of non-alcoholic fatty liver disease.

This is an analytical cross-sectional study comprising 64 T2DM patients in two groups based on their glycemic control and ALT levels: Group A, known cases of diabetes mellitus patients with HbA1c < 8.5 and ALT < 40 IU/L, and Group B, known cases of diabetes mellitus patients with HbA1c ≥ 8.5 and ALT ≥ 40 IU/L, conducted at a Diabetology OP in a tertiary care center in South India. The patients were aged 35–70. The data was analyzed using a statistical package of social service (SPSS 26.0).

Serum preptin levels were significantly higher (p < 0.001) in Group B, with levels 50% greater than those in Group A. Preptin levels showed a strong positive correlation with liver enzymes (r values, ALT = 0.369; ALP = 0.331; both p < 0.001) and the NAFLD score (r = 0.24, p < 0.042), indicating higher disease severity. Elevated preptin levels correlated with an increased risk of fibrosis and worse metabolic outcomes, evidenced by a moderate to strong inverse relationship (effect size =  − 0.583).

Increased levels of preptin are strongly linked to increased severity of NAFLD and poor glycemic control in patients with T2DM, indicating that preptin may be a useful indicator for fibrosis progression in NAFLD. These results highlight the necessity for more investigations into the function of preptin in the pathophysiology of metabolic disorders.