Abstract
BackgroundApelin is an adipokine that plays a role in the regulation of glucose homeostasis and in obesity. The relationship between apelin serum concentration and dysmetabolic conditions such as type 2 diabetes (T2D) is still controversial. Aims of our study are: 1) determine the circulating levels of apelin in a large cohort of Italian subjects with T2D, T1D and in non-diabetic controls; 2) identify putative metabolic determinants of modified apelin concentrations, in order to search possible mechanism of apelin control; 3) investigate changes in apelin levels in response to sharp modifications of glucose/insulin metabolism in T2D obese subjects before and 3 days after bariatric surgery.MethodsWe recruited 369 subjects, 119 with T2D, 113 with T1D and 137 non-diabetic controls. All subjects underwent a complete clinical examination, including anthropometric and laboratory measurements. Serum apelin levels were determined by EIA (immunoenzyme assay).ResultsPatients with T2D had significantly higher serum apelin levels compared to controls (1.23±1.1 ng/mL vs 0.91±0.7 ng/mL, P<0.001) and to T1D subjects (0.73±0.39 ng/mL, P<0.001). Controls and T1D subjects did not differ significantly in apelin levels. Apelin concentrations were directly associated with fasting blood glucose (FBG), body mass index (BMI), basal Disposition Index (DI-0), age, and diagnosis of T2D at bivariate correlation analysis. Multiple regression analysis confirmed that diagnosis of T2D, basal DI-0 and FBG were all determinants of serum apelin levels independently from age and BMI. Bariatric surgery performed in a subgroup of obese diabetic subjects (n = 12) resulted in a significant reduction of apelin concentrations compared to baseline levels (P = 0.01).ConclusionsOur study demonstrates that T2D, but not T1D, is associated with increased serum apelin levels compared to non-diabetic subjects. This association is dependent on impaired glucose homeostasis, and disappears after bariatric surgery, providing further evidence regarding the relationship between apelin and the regulation of glucose metabolism.
Highlights
Insulin resistance is a major characteristic of type 2 diabetes mellitus (T2D) and is often linked to obesity [1]
Patients affected by T2D had significantly higher age, fasting blood glucose (FBG), fasting insulin, body mass index (BMI), HbA1c, homeostasis model assessment of insulin resistance (HOMA-IR), total-cholesterol, Lowdensity lipoprotein (LDL)-cholesterol, transaminases, systolic and diastolic blood pressure and lower HDL-cholesterol compared to non-diabetic control, as expected
Serum apelin levels were significantly higher in T2D patients compared to controls (1.2361.1 ng/mL vs 0.9160.7 ng/mL, P,0.001) and to T1D subjects (0.7360.39 ng/mL P,0.001)
Summary
Insulin resistance is a major characteristic of type 2 diabetes mellitus (T2D) and is often linked to obesity [1]. In combination, these events increase the risk of cardiovascular diseases and obesity-associated morbidity. Apelin gene is widely expressed in adipose tissue, heart, stomach, placenta and breast, as well as in different brain areas, suggesting an important role of this molecule in the central regulation of metabolic pathways [5]. Aims of our study are: 1) determine the circulating levels of apelin in a large cohort of Italian subjects with T2D, T1D and in non-diabetic controls; 2) identify putative metabolic determinants of modified apelin concentrations, in order to search possible mechanism of apelin control; 3) investigate changes in apelin levels in response to sharp modifications of glucose/insulin metabolism in T2D obese subjects before and 3 days after bariatric surgery
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