Research Article
Year 2020,
Volume: 4 Issue: 1, 29 - 33, 30.04.2020
Abstract
Amaç: Fetuin-A insülin reseptörünün otofosforilasyonunun ve tirozin kinaz aktivitesinin doğal bir inhibitörüdür. Fetuin-A’nın
postprandiyal glikoz seviyesinin ayarlanmasında, insülin duyarlılığında, kilo alımında ve yağ birikiminde önemli bir rol oynadığı
düşünülmektedir. Biz çalışmamızda, tip-2 diyabetes mellitus hastalarında insülin kullanımının fetuin-A seviyesi üzerine etkisini
araştırdık. Aynı zamanda, sağlıklı gönüllülerle tip-2 diyabetes mellitus hastalarında fetuin-A düzeylerini de karşılaştırdık.
Gereç ve Yöntemler: Çalışma 2013 Mayıs ayı ile 2013 Temmuz ayı arasında yapıldı. Toplamda 69 tip-2 diyabetes mellitus’lu hasta
(%37,7’sı oral antidiyabetik ajan kullanan, %62,3’ü insülin kullanan) ve 20 sağlıklı gönüllü dahil edildi. Diyabetik grup kendi arasında
insulin kullanan grup ve oral antidiyabetik ajan kullanan grup olarak iki alt gruba ayrıldı. Bu çalışma grubunda fetuin-A düzeyleri
bakıldı. Ek olarak; diyabetik grup ve kontrol grubunda ALT, AST, total kolesterol, LDL,HDL, VLDL, trigliserit, üre ve kreatinin gibi
diğer biyokimyasal parametreler ve diyabetik grubun subgruplarında bunlara ek olarak diyabet yaşı karşılaştırıldı.
Bulgular: Diyabetik grupta yaş ortalaması, kontrol grubuna göre anlamlı olarak yüksekti (sırasıyla 54,97 ± 6,13 ve 49,95 ± 8,82,
p=0,025). Diyabetik grupta kontrol grubuna göre ALT düzeyi anlamlı olarak yüksekti (p=0,018) ancak diğer biyokimyasal parametreler
açısından her iki grup arasında anlamlı fark saptanmadı (p>0,05). İnsulin tedavisi alanlarda OAD kullananlara göre açık kan
şekeri ve HbA1c düzeyi anlamlı olarak yüksekti (sırasıyla, p=0,004 ve p<0,001). Bununla beraber insulin grubunun diyabet yaşı OAD
grubuna göre anlamlı olarak daha yüksekti (p<0,001). Ortalama fetuin-A düzeyi oral antidiyabetik ajan grubunda 88,6 ± 23,3 ng/mL
ve insülin grubunda 84,8 ± 27,8 ng/mL idi, ancak gruplar arasında istatistiksel olarak anlamlı fark saptanmadı (p=0,570). Kontrol
grubunda ortalama fetuin-A düzeyleri 65,5 ± 27,8 ng/mL olup diyabetik grupta 86,3 ± 26,1 ng/mL idi ve fetuin-A düzeyi kontrol grubunda
anlamlı olarak düşüktü (p=0,003).
Sonuç: Fetuin-A düzeyi diyabetik grupta anlamlı olarak yüksekti ancak diyabetik grup içinde oral antidiyabetik kullananlarla insülin
kullananlar arasında anlamlı fark saptanmadı. Karşılaştırılan diğer biyokimyasal parametrelerden ALT düzeyi diyabetik grupta
fetuin-A ile benzer şekilde daha yüksekti ancak bu fark insulin kullanımı veya oral antidiyabetik kullanımı ile ilişkili değildi. Bu
çalışma, tip-2 diyabetes mellituslu hastalarda tedavi rejiminin fetuin-A düzeyi üzerine olan etkisini araştıran ilk çalışmadır.
Keywords
Supporting Institution
S.B Haseki Eğitim ve Araştırma Hastanesi Klinik Araştırma Kurulu
Thanks
Çalışmada kit alımı sırasında sağladığı desteklerden dolayı teşekkür ederiz. Herhangi bir çıkar çatışması yoktur.
References
- Referans1: Satman I, et al. Twelve-year trends in the prevalence and risk factors of diabetes and prediabetes in Turkish adults. TURDEP-II Study Group. Eur J Epidemiol. 2013 Feb;28(2):169-80.
- Referans2: Auberger P, et al.; Characterization of a natural inhibitor of the insulin receptor tyrosine kinase: cDNA cloning, purification, and anti-mitogenic activity. Cell. 1989;58:631–640.
- Referans3: Mathews ST, et al Improved insulin sensitivity and resistance to weight gain in mice null for the Ahsg gene. Diabetes. 2002;51:2450–2458.
- Referans4: Ix JH, et al. Association between human fetuin-A and the metabolic syndrome: data from the Heart and Soul Study. Circulation. 2006;113:1760-67.
- Referans5: Song A, et al. Serum fetuin-A associates with type 2 diabetes and insulin resistance in Chinese adults. PLoS One. 2011;6(4): e19228.
- Referans6: Stefan N, et al. Plasma fetuin-A levels and the risk of type 2 diabetes. Diabetes 2008;57(10);2762-7.
- Referans7: Yilmaz Y, et al. Serum fetuin-A/a2HS-glycoprotein levels in patients with non-alcoholic fatty liver disease: relation with liver fibrosis. Ann Clin Biochem. 2010;47:549–553.
- Referans8: Huang Y, et al.Serum Fetuin-A Associated With Fatty Liver Index, Early Indicator of Nonalcoholic Fatty Liver Disease: A Strobe-Compliant Article. Medicine (Baltimore). 2015 Sep;94(39):e1517.
- Referans9: Ou HY, et al. Serum fetuin-A concentrations are elevated in subjects with impaired glucose tolerance and newly-diagnosed type 2 diabetes. Clin Endocrinol(oxf) 2011 Oct;75(4):450-5.
Year 2020,
Volume: 4 Issue: 1, 29 - 33, 30.04.2020
Abstract
Aim: Fetuin-A is a natural inhibitor of tyrosine kinase activity and autophosphorylation of the
insulin receptor. It is thought that fetuin-A plays an essential role in adjusting postprandial glucose
level plays, insulin sensitivity, weight gain, and fat accumulation. In this study, we investigated
the effect of insulin use on fetuin-A level in patients with type-2 diabetes mellitus. Also compared
fetuin-a levels between healthy individuals and type 2 diabetes patients.
Material and Methods: The cross-sectional study was performed between May 2013 and July
2013. Sixty-nine patients with type 2 diabetes mellitus (37.7% oral antidiabetic agents and 62.3%
insulin users) and 20 healthy individuals were included in the study. Diabetic group was divided
into two subgroups as insulin group and oral antidiabetic agent group. We studied fetuin-A levels
in these individuals. Additionally, we compared other biochemical parameters as ALT, AST, total
cholesterol, LDL, HDL, VLDL, triglycerides, urea and creatinine in the diabetic group and control
group as well diabetic year in subgroups of the diabetic group.
Results: The mean age in the diabetic group was significantly higher than the control group (54.97
± 6.13 and 49.95 ± 8.82, respectively, p=0.025). ALT levels in the diabetic group were higher than
the control group (p=0.018), but there was no statically significant difference between the two
groups in terms of other biochemical parameters (p>0.05). Fasting blood glucose and HbA1c
levels in the insulin group were significantly higher than the oral antidiabetic agent group (p=0.004
and p<0.001, respectively). Additionally, the diabetic year in insulin group was significantly higher
in the insulin group than the oral antidiabetic agent group (p<0.001). The mean fetuin-A level
was 65.5 ± 27.8 ng/mL in the control group and 86.3 ± 26.1 ng/mL in the diabetic group, as well
fetuin-A levels were significantly lower in the control group than the diabetic group (p=0.003).
Besides, the mean fetuin-A level was 88.6 ± 23.3 ng/mL in the oral antidiabetic agent group and
84.8 ± 27.8 ng/mL in the insulin group, but it was not statistically significant (p=0.570).
Conclusion: Fetuin-A level was significantly higher in the diabetic group, but there was no statistically significant difference between
the oral antidiabetic agent group and the insulin group. Among the other biochemical parameters, only the ALT level was higher in
the diabetic group than the control group, but this difference was not related to insulin therapy or oral antidiabetic agent. This is the
first study to investigate the effect of treatment on fetuin-a levels in type-2 diabetic patients.
Keywords
References
- Referans1: Satman I, et al. Twelve-year trends in the prevalence and risk factors of diabetes and prediabetes in Turkish adults. TURDEP-II Study Group. Eur J Epidemiol. 2013 Feb;28(2):169-80.
- Referans2: Auberger P, et al.; Characterization of a natural inhibitor of the insulin receptor tyrosine kinase: cDNA cloning, purification, and anti-mitogenic activity. Cell. 1989;58:631–640.
- Referans3: Mathews ST, et al Improved insulin sensitivity and resistance to weight gain in mice null for the Ahsg gene. Diabetes. 2002;51:2450–2458.
- Referans4: Ix JH, et al. Association between human fetuin-A and the metabolic syndrome: data from the Heart and Soul Study. Circulation. 2006;113:1760-67.
- Referans5: Song A, et al. Serum fetuin-A associates with type 2 diabetes and insulin resistance in Chinese adults. PLoS One. 2011;6(4): e19228.
- Referans6: Stefan N, et al. Plasma fetuin-A levels and the risk of type 2 diabetes. Diabetes 2008;57(10);2762-7.
- Referans7: Yilmaz Y, et al. Serum fetuin-A/a2HS-glycoprotein levels in patients with non-alcoholic fatty liver disease: relation with liver fibrosis. Ann Clin Biochem. 2010;47:549–553.
- Referans8: Huang Y, et al.Serum Fetuin-A Associated With Fatty Liver Index, Early Indicator of Nonalcoholic Fatty Liver Disease: A Strobe-Compliant Article. Medicine (Baltimore). 2015 Sep;94(39):e1517.
- Referans9: Ou HY, et al. Serum fetuin-A concentrations are elevated in subjects with impaired glucose tolerance and newly-diagnosed type 2 diabetes. Clin Endocrinol(oxf) 2011 Oct;75(4):450-5.
There are 9 citations in total.
Details
| Primary Language | English |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Research Article |
| Authors | |
| Publication Date | April 30, 2020 |
| Acceptance Date | April 29, 2020 |
| Published in Issue | Year 2020 Volume: 4 Issue: 1 |
Medical Journal of Western Black Sea is a scientific publication of Zonguldak Bulent Ecevit University Faculty of Medicine.
This is a refereed journal, which aims at achieving free knowledge to the national and international organizations and individuals related to medical sciences in publishedand electronic forms.
This journal is published three annually in April, August and December.
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