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Is Neuregulin‐4 a predictive marker of microvascular complications in type 2 diabetes mellitus?
Author(s) -
Kocak Mehmet Zahid,
Aktas Gulali,
Atak Burcin M.,
Duman Tuba T.,
Yis Ozgur Mehmet,
Erkus Edip,
Savli Haluk
Publication year - 2020
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1111/eci.13206
Subject(s) - medicine , type 2 diabetes mellitus , neuregulin 1 , diabetes mellitus , type 2 diabetes , neuregulin , cardiology , endocrinology , receptor
Background and Aims Neuregulin‐4 (Nrg‐4) is a new adipokine released from brown adipose tissue. It plays pivotal role in regulating systemic energy balance, glucose and lipid metabolism and in reducing chronic inflammation. We aimed to investigate the relation between diabetic microvascular complications (DMC) and serum (Nrg‐4) levels in patients with type 2 diabetes mellitus. Methods Patients with type 2 diabetes mellitus were divided into DMC and diabetic patients without microvascular complications (non‐DMC). Nrg‐4 levels of the patients were compared. Results Fifty and 29 patients enrolled to the DMC and non‐DMC groups, respectively. Nrg‐4 was 1.23 (0.02‐5.1) ng/mL and 2.5 (0.21‐6.01) ng/mL in DMC and in non‐DMC groups, respectively ( P < .001). In patients with DMC, FPG was 189.5 (89‐446) mg/ dL, whereas it was 128 (95‐278) mg/dL in non‐DMC diabetic patients ( P < .001). HbA1c was also significantly higher in the DMC group than in the non‐DMC group ( P < .001). Negative correlation was found between Nrg‐4 and FPG ( r = −0.231, P = .03), HBA1c ( r = −0.312, P = .003) and microalbuminuria ( r = −0.277, P = .009). Logistic regression analysis showed a 1‐unit decrease in Nrg‐4 to increase the presence of DMC by 1.9 times. The best cut‐off value of Nrg‐4 was 1.56 ng/mL with 82.1% sensitivity and 64% specificity, in predicting DMC. Conclusion In patients with diabetes, Nrg‐4 levels may be a good predictor of early detection of one or more DMC, as microvascular dysfunction in an organ system is considered to be an initial onset of subclinical systemic damage.