Abstract
AIMS/INTRODUCTION: High plasma 3-carboxy-4-methyl-5-propyl-2-furanpropanoic acid (CMPF) levels are significantly associated with type 2 diabetes mellitus, which is usually accompanied by metabolic syndrome and non-alcoholic fatty liver disease (NAFLD) with increased triglyceride levels. Thus, we hypothesized that elevated CMPF levels might be related to lipid metabolism and NAFLD risk. MATERIALS AND METHODS: Serum CMPF levels were determined using an enzyme-linked immunosorbent assay in a total of 466 individuals, including 116 controls with no NAFLD or type 2 diabetes mellitus, 53 individuals with NAFLD but no type 2 diabetes mellitus, 151 individuals with type 2 diabetes mellitus but no NAFLD, and 146 individuals with both NAFLD and type 2 diabetes mellitus. The associations with age, blood pressure, lipid profiles, body mass index and liver injury marker levels were examined, and a meta-analysis of non-diabetic and diabetic groups was carried out to detect the combined effects. RESULTS: The CMPF concentration in NAFLD patients was significantly lower than individuals without NAFLD in both the non-diabetic group (P < 0.05) and diabetic group (P < 0.01), and correlated negatively with several parameters of liver function and the adiposity index. Meta-analysis showed that serum CMPF levels was associated with decreased risk of NAFLD after combining the results (odds ratio 0.677, 95% confidence interval 0.552-0.831, P < 0.001). Additionally, the CMPF concentration was independently negatively associated with triglycerides and high-density lipoprotein cholesterol in the meta-analysis. Multiple stepwise regression analysis showed that body mass index, high-density lipoprotein cholesterol, triglyceride level, age, sex and fasting plasma glucose were independently associated with CMPF (all P < 0.05). CONCLUSIONS: The results suggest that serum CMPF levels are negatively related to lipid metabolism and could be used to predict NAFLD development.