The Effects of Insulin Therapy on Fetuin-A Levels in Type-2 Diabetic Patients

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.