Abstract: Abstract Objective: To investigate the relationship between the serum vaspin and the metabolism of substance and energy in patients of type2 diabetes mellitus(T2DM) with nonalcoholic fatty liver disease (NAFLD). Methods: The level of the serum vaspin was assayed by enzyme-linked immunosorbent assay (ELISA) in all subjects, patients of T2DM with NAFLD （group A), T2DM without NAFLD（group B）and nomal group（group NC).The indexs of energy metabolism were detected by indirect calorimetry，meanwhile，detect the relating clinical datas . Results: (1)The levels of serum vaspin were significantly increased in group B compared with that of group A and NC(P <0.01), in group A and B, the respiratory quotient (RQ) and oxidation of carbohydrate were significantly lower than in group NC,while the 24 hr urine nitrogen、real resting energy expenditure (REE)、REE/ body wheigt and the oxidation of fat significant higher than the group NC（P < 0.05或P<0.01），but there is no different between group A and B. The level of serum vaspin was positively correlated with body weigt ,body mass index(BMI),REE and sex,meanwhile, it was negatively correlated with respiratory quotient (RQ) in group A; The level of serum vaspin was positively correlated with BMI、waist-to-hip ratio(WHR)、fasting blood glucose (FBG)、fasting insulin（FINS）、homeostasis model assessment of insulin resistance（HOMA-IR）、real REE、real REE/body wheigt and TG, while it was negatively correlated with RQ in group B.The concentration of vaspin is 92.4μg/L could predict the risk of type 2 diabetes mellitus with fatty liver. Conclusion: The level of serum vaspin closely related with the metablism of substance and energy, and vaspin could be use to predict the risk of type 2 diabetes mellitus with fatty liver.

Key words: Vaspin, diabetes mellitus, type 2, nonalcoholic fatty liver disease , real resting energy expenditure, respiratory quotient