Relation of Serum Vaspin Level to Atherogenic Risk Factors in Type 2 Diabetic Subjects

Abstract

T2DM is the major cause of diabetes worldwide. People with type 2 DM are more vulnerable to various forms of both short and long-term complications, which often lead to their premature death. Increase weight is an established risk factor for type 2 DM, recent studies have identified links between obesity and type 2 DM involving pro inflammatory cytokines, insulin resistance, deranged fatty acid metabolism and mitochondrial dysfunction, this risk determined not only by degree of obesity but also by where fat accumulate. Increased visceral adiposity is usually associated with a clustering of atherogenic risk factors, such as insulin resistance, hypertension, dyslipidemia, alterations in coagulation and inflammatory cytokine profiles. Visceral adipose tissue derived serpin (Vaspin) is a noval adipokine with insulin sensitizing effect, plasma Vaspin concentration is markedly elevated in humans with high body mass index (BMI), the increase in vaspin may be a compensatory response to antagonize the action of other unknown proteases that are up-regulated in obesity and in states of insulin resistance; hence this regulation may be defensive mechanism against insulin resistance. The aim of this study is to evaluate serum Vaspin level in relation to atherogenic risk factors such as insulin resistance, dyslipidemia, hypertension, inflammation in type 2 obese diabetic subjects and obese non diabetic subjects. The study was conducted on 80 subjects with age ranging from 30-60 years, BMI ranging from 27-39 selected from outpatient clinic of Internal medicine and Endocrinology of Ain shams University Hospital, and informed consent was obtained from each subject. They were divided into 2 groups 40 obese type 2 diabetic subjects divided into 20 male and 20 female and 40 obese non diabetic subjects divided into 20 male and 20 female. All subjects were submitted for full medical history, thorough clinical examination, fasting blood sugar (FBS), 2-h post prandial blood glucose level (2hpp), glycated hemoglobin (HBA1C), lipid profile (cholesterol, triglycerides, HDL and LDL), HOMA/IR, Serum Vaspin level (by ELISA) and Highly sensitive CRP

The results were statistically analyzed and the following was observed: On comparing the two studied groups as whole and after correction of gender: There was statistical significant difference between the studied groups being higher in group I than group II as regarding age (m=52.30±5.788 years vs m=45.45±7.815 years), SBP (m=138.88±18.134 md/dl vs m=130.50±15.925 md/dl); and after correction of gender there was also a significant difference between male case and control only with age (m=53±6 years vs m=42±8 years) and SBP (m=143±16 md/dl vs m=128±16 md/dl) , but there were no significant difference as regarding female gender. Regarding BMI, Waist/hip ratio and diastolic blood pressure there was no statistical significant difference between both groups with BMI (m=32.98±3.086 vs 32.77±2.95), WHR (m=0.937±0.086 vs 0.937±0.088), DBP (m=82.88±13.29 vs 80.63±11.27) or even after correction of the gender, being in females BMI (m=33.7±3.5 vs 33.4±2.4), WHR (m=0.91±0.08 vs 0.91±0.07), DBP (m=81±13 vs 82±11), and in males BMI (m=32.3±2.6 vs 32.2±3.4), WHR (m=0.97±0.09 vs 0.97±0.09), DBP (m=84±14 vs 79±11).