A Study of Serum Fetuin-A in Male patients with Type 1 Diabetes Mellitus: Association with Insulin Resistance and possible role of Metformin Therapy
Hany Khairy Mansour;
Abstract
Type 1 diabetes mellitus (DM) is a multisystem disease with both biochemical and anatomic/structural consequences. It is a chronic disease of carbohydrate, fat, and protein metabolism caused by the lack of insulin, which results from the marked and progressive inability of the pancreas to secrete insulin because of autoimmune destruction of the beta cells.
Insulin resistance plays a major pathogenic role in the development of the metabolic syndrome, which may include any or all of the following hyperinsulinemia,type 2 diabetes or glucose intolerance, Central obesity, HypertensionDyslipidemia that includes high triglyceride levelsLow HDL-C level and small, dense low-density lipoprotein (LDL) particles Hypercoagulability characterized by an increased plasminogen activator inhibitor–1 (PAI-1) level.
Serum fetuin-A (also called alpha-2 heremans schmid glycoprotein, AHSG) is a multifunctional glycoprotein which is exclusively secreted from hepatocytes in human. It was reported that fetuin-A could inhibit insulin receptor tyrosine kinase activity through blocking the autophosphorylation of tyrosine kinase and insulin receptor substrate-1(IRS-1), and induced a lower-grade inflammation, which resulted in insulin resistance.
Metformin is an oral anti-hyperglycemic agent commonly used in treating T2DM. Metformin increases insulin sensitivity in T2DM by mechanisms including lowering hepatic glucose output and increasing peripheral uptake of glucose, especially in the muscle. In adults with T1DM, adding metformin improved insulin sensitivity while lowering insulin requirements.
Our data showed that there was a highly significant positive correlation between Fetuin-A and age (r=0.505). BMI (r=0.489), FBS (r=0.659) and 2hr PP (r=0.627), HbA1c (r=0.691), cholesterol (r=0.374), TAG (r=0.426), LDL (r=0.266), HDL (r=0.386), C-peptide (r=0.504), eGDR (R=0.704), hs-CRP (r=0.698), waist circumference (r=0.481), hip circumference (r=0.446), waist/hip ratio (r=0.467) and insulin units per kg (r=0.565) in the three studied groups (p-value <0.01).
On comparing between patients with DM with IR before and after metformin therapy, there was a high statistical significant difference between the studied groups regarding fetuin-A level being higher in the group before metformin therapy (6450±3823.23ng/ml) than the group after metformin therapy (3082±2095.19) with (p-value < 0.001).
In conclusion, our results showed that patients with T1DM may have IR in association with insulin deficiency and those patients have higher level of serum fetuin-A level than those have T1DM without IR, also, use of metformin therapy in T1DM patients may play a role in improvement of insulin sensitivity and decrease insulin requirement doses
Insulin resistance plays a major pathogenic role in the development of the metabolic syndrome, which may include any or all of the following hyperinsulinemia,type 2 diabetes or glucose intolerance, Central obesity, HypertensionDyslipidemia that includes high triglyceride levelsLow HDL-C level and small, dense low-density lipoprotein (LDL) particles Hypercoagulability characterized by an increased plasminogen activator inhibitor–1 (PAI-1) level.
Serum fetuin-A (also called alpha-2 heremans schmid glycoprotein, AHSG) is a multifunctional glycoprotein which is exclusively secreted from hepatocytes in human. It was reported that fetuin-A could inhibit insulin receptor tyrosine kinase activity through blocking the autophosphorylation of tyrosine kinase and insulin receptor substrate-1(IRS-1), and induced a lower-grade inflammation, which resulted in insulin resistance.
Metformin is an oral anti-hyperglycemic agent commonly used in treating T2DM. Metformin increases insulin sensitivity in T2DM by mechanisms including lowering hepatic glucose output and increasing peripheral uptake of glucose, especially in the muscle. In adults with T1DM, adding metformin improved insulin sensitivity while lowering insulin requirements.
Our data showed that there was a highly significant positive correlation between Fetuin-A and age (r=0.505). BMI (r=0.489), FBS (r=0.659) and 2hr PP (r=0.627), HbA1c (r=0.691), cholesterol (r=0.374), TAG (r=0.426), LDL (r=0.266), HDL (r=0.386), C-peptide (r=0.504), eGDR (R=0.704), hs-CRP (r=0.698), waist circumference (r=0.481), hip circumference (r=0.446), waist/hip ratio (r=0.467) and insulin units per kg (r=0.565) in the three studied groups (p-value <0.01).
On comparing between patients with DM with IR before and after metformin therapy, there was a high statistical significant difference between the studied groups regarding fetuin-A level being higher in the group before metformin therapy (6450±3823.23ng/ml) than the group after metformin therapy (3082±2095.19) with (p-value < 0.001).
In conclusion, our results showed that patients with T1DM may have IR in association with insulin deficiency and those patients have higher level of serum fetuin-A level than those have T1DM without IR, also, use of metformin therapy in T1DM patients may play a role in improvement of insulin sensitivity and decrease insulin requirement doses
Other data
| Title | A Study of Serum Fetuin-A in Male patients with Type 1 Diabetes Mellitus: Association with Insulin Resistance and possible role of Metformin Therapy | Other Titles | دراسة مستوى فيتوين-أ فى الدم فى الرجال المصابين بداء السكرى من النوع الأول:العلاقة بمقاومة الأنسولين ودور العلاج بالميتفورمين | Authors | Hany Khairy Mansour | Issue Date | 2015 |
Recommend this item
Similar Items from Core Recommender Database
Items in Ain Shams Scholar are protected by copyright, with all rights reserved, unless otherwise indicated.