Shelbaya Salah, Abu Shady Manal Mohamed, Nasr Merhan Samy, Bekhet Meram Mohamed, Mageed Yasmine Abd-Al, Abbas Magdy
Internal Medicine Endocrinology and Metabolism Department, Ain Shams University, Cairo, Egypt.
Chemistry Department, Ain Shams University Hospital, Cairo, Egypt.
Curr Diabetes Rev. 2018;14(5):481-486. doi: 10.2174/1573399813666170829163442.
Type 2 diabetic patients with diabetic nephropathy are associated with multifactorial abnormal energy metabolism. Irisin has been recently introduced as a hormone that is exercise-induced and is secreted by skeletal muscles. It is hypothesized that patients with chronic kidney disease usually have abnormal irisin levels.
We aimed to study the level of Irisin hormone in patients with type 2 diabetes and to document that it is related to diabetic nephropathy.
The current study included 60 subjects with type 2 diabetes and 30 healthy subjects as a control group. Diabetic subjects were divided into 30 without diabetic complications and 30 with diabetic nephropathy (DN). Serum Irisin levels, fasting blood glucose (FBG), 2hours plasma glucose (2hPG), hemoglobin A1c (HbA1c), kidney functions including serum creatinine and albumin/ creatinine ratio were assessed.
There was a statistically significant decrease in Irisin levels in diabetic patients compared to controls (34.46 ± 15.28 ng/ml vs. 152.600 ± 39.581 ng/ml, p<0.001). Irisin levels were lower in diabetic patients with DN than in those without complications (20.967 ± 4.476 ng/ml vs. 47.967 ± 8.853 ng/ml, p<0.01). There was a statistically significant negative correlation between irisin and serum creatinine (r=-0.729), systolic blood pressure (r=-0.493), diastolic blood pressure (r=-0.625), duration of diabetes (r=-0.942), BMI(r=-0.396), albumin/creatinine ratio (r=-0.696), and HbA1c (r=-0.305) in all type 2 diabetic patients (p<0.05). On performing multivariate regression analysis, we found that the duration of diabetes was the only independent determinant of irisin level.
There is a decrease in serum irisin level in type 2 diabetic patients with even more significant reduction in patients with diabetic nephropathy.
2型糖尿病合并糖尿病肾病患者存在多因素能量代谢异常。鸢尾素是一种最近被发现的由骨骼肌分泌的运动诱导激素。据推测，慢性肾病患者的鸢尾素水平通常异常。
我们旨在研究2型糖尿病患者体内鸢尾素激素水平，并证明其与糖尿病肾病有关。
本研究纳入60例2型糖尿病患者和30例健康受试者作为对照组。糖尿病患者分为30例无糖尿病并发症者和30例糖尿病肾病（DN）患者。评估血清鸢尾素水平、空腹血糖（FBG）、餐后2小时血糖（2hPG）、糖化血红蛋白（HbA1c）以及包括血清肌酐和白蛋白/肌酐比值在内的肾功能。
与对照组相比，糖尿病患者的鸢尾素水平有统计学意义的降低（34.46±15.28 ng/ml对152.600±39.581 ng/ml，p<0.001）。DN糖尿病患者的鸢尾素水平低于无并发症患者（20.967±4.476 ng/ml对47.967±8.853 ng/ml，p<0.01）。在所有2型糖尿病患者中，鸢尾素与血清肌酐（r=-0.729）、收缩压（r=-0.493）、舒张压（r=-0.625）、糖尿病病程（r=-0.942）、体重指数（r=-0.396）、白蛋白/肌酐比值（r=-0.696）和HbA1c（r=-0.305）之间存在统计学意义的负相关（p<0.05）。进行多因素回归分析时，我们发现糖尿病病程是鸢尾素水平的唯一独立决定因素。
2型糖尿病患者血清鸢尾素水平降低，糖尿病肾病患者降低更显著。
