Abstract: Objective To investigate the effect of homocysteine (Hcy) on cardiac diastolic function in patients of type 2 diabetes mellitus (T2DM) combined with nonalcoholic fatty liver disease (NAFLD). Methods A total of 182 T2DM patients admitted to our hospital were divided into non-NAFLD and non-HHcy group (group A, n=46), NAFLD and non-HHcy group (group B, n=48), non-NAFLD and HHcy group (group C, n=42) and NAFLD and HHcy group (group D, n=46). The influence of NAFLD and HHcy on clinical indicators was analyzed. Ninety-four T2DM patients with NAFLD were divided into the normal diastolic function group (E/A>0.8) and the abnormal diastolic function group (E/A≤0.8) according to the diastolic peak velocity in the early phase (E)/the diastolic peak velocity in the late phase (A). The clinical data between the two groups were compared and analyzed. Logistic regression analysis was used to analyze the influencing factors of diastolic function in T2DM patients with NAFLD. Results The results of factorial analysis showed that NAFLD had significant effects on body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting insulin (FINS), insulin resistance index (HOMA-IR), C-reactive protein (CRP), E/A, triglyceride (TG), total cholesterol (TC) and glycosylated hemoglobin (HbA1c). HHcy showed significant effects on BMI, SBP, DBP, fasting blood glucose (FBG), FINS, HOMA-IR, CRP, LVMI and E/A. There was a interaction between them on SBP, FINS, HOMA-IR, CRP and E/A (P＜0.05). In 94 T2DM patients combined with NAFLD, the BMI, SBP, FINS, HOMA-IR, LVMI and incidence rate of HHcy were significantly higher in the E/A abnormal group than those in the normal group (P＜0.05). Regression analysis showed that HHcy was an independent risk factor for diastolic function in T2DM patients with NAFLD. Conclusion The diastolic function is significantly decreased in T2DM patients combined with NAFLD and HHcy. HHcy is an independent risk factor for decreasing diastolic function in T2DM patients combined with NAFLD.

Key words: diabetes mellitus, type 2, non-alcoholic fatty liver disease, hyperhomocysteinemia, diastolic function