Öz
Aim: Diabetic neuropathy (DN) is one of the most common chronic complications of diabetes mellitus (DM). The aim of this study was to investigate plasma spexin, visfatin and leptin levels of patients with Type 2 DM who developed DN as a complication and patients who did not develop DN and to determine whether any significant differences existed between the groups. Method: The study included 93 patients diagnosed with type 2 DM. Electromyography (EMG) was performed as an electrophysiologic nerve conduction study. According to EMG results, patients were divided into two groups: those with DN (n=55) and those without (n=38). Two tubes of venous blood samples (5 ml each) were collected from each patient. HbA1c levels of patients were checked in the first blood sample. According to HbA1c levels, the groups were divided into two subgroups as HbA1c between 6.5-8.4 and ≥8.5, and a total of four study groups were formed. The second blood sample was separated into plasma, spexin, visfatin and leptin levels were determined by ELISA method. The results were compared between the groups. Results: Of the participants with DN, 31 were female and 24 were male. Of those without DN, 29 were female and 9 were male. DN patients had significantly higher glucose and HbA1c values than those without (p<0.05). When lipid profiles were compared, although total cholesterol and triglyceride levels were high in both groups, the difference was not statistically significant (p>0.05). There was no significant difference between groups in terms of High Density Lipoprotein (HDL) levels. Low Density Lipoprotein (LDL) levels were higher in the non-DN group, but not significantly (p>0.05). Body mass index (BMI), glucose, triglycerides, total cholesterol, HDL, LDL, spexin, visfatin and leptin values of patients with and without DN with HbA1c levels between 6.5-8.4 did not show statistically significant difference according to the diagnosis of neuropathy (p>0.05). Among patients with HbA1c level ≥8.5, there was no statistically significant difference between BMI, glucose, triglyceride, HDL, spexin, visfatin and leptin levels of patients with and without DN (p>0.05), whereas there was a statistically significant difference between total cholesterol and LDL levels of the same group (p<0.05). LDL levels were higher in patients with DN. When the correlation between spexin, visfatin, and leptin levels of patients with and without DN was examined, a strong and statistically significant positive correlation was found between them (p<0.01).Conclusion: Plasma levels of spexin, visfatin and leptin did not differ significantly between the groups of patients with and without DN. However, a significant positive correlation was found between plasma spexin, visfatin and leptin levels of the patients. This result suggests that plasma levels of spexin, visfatin and leptin act together and may be clinically important.
Anahtar Kelimeler
Diabetic Neuropathy Spexin Visfatin Leptin Diabetes Meliitus
Etik Beyan
This study was approved by Başkent University Non-Interventional Clinical Research Ethics Committee (Decision Number: 22/90, Date: 20.04.2022).
Destekleyen Kurum
This study was approved by the Başkent University Medical and Health Sciences Research Board and Ethics Committee (Project no: KA22/202) and supported by the Başkent University Research Fund.
Proje Numarası
KA22/202
Kaynakça
- Tesfaye S, Chaturvedi N, Eaton SEM, Ward JD, Manes C, Ionescu-Tirgoviste C, et al. Vascular Risk Factors and Diabetic Neuropathy. The New England Journal of Medicine. 2005 Apr. 352.
- Dillon BR, Ang L, Pop-Busui R. Spectrum of Diabetic Neuropathy: New Insights in Diagnosis and Treatment. Annu Rev Med. 2024 Jan;75:293-306.
- Strand N, Anderson MA, Attanti S, Gill B, Wie C, Dawodu A, et al. Diabetic Neuropathy: Pathophysiology Review. Curr Pain Headache Rep. 2024 Jun;28(6):481-487.
- Fang P, She Y, Yu M, Yan J, Yu X, Zhao J, et al. Novel hypothalamic pathways for metabolic effects of spexin. Pharmacol Res. 2024 Oct;208:107399.
- Tran A, He W, Chen JTC, Belsham DD. Spexin: Its role, regulation, and therapeutic potential in the hypothalamus. Pharmacol Ther. 2022 May;233:108033.
- Yu M, Wang M, Han S, Han L, Kan Y, Zhao J, et al. Spexin ameliorates skeletal muscle insulin resistance through activation of GAL2 receptor. Eur J Pharmacol. 2022 Feb;917:174731.
- Zhu S, Hu X, Bennett S, Charlesworth O, Qin S, Mai Y, et al. Galanin family peptides: Molecular structure, expression and roles in the neuroendocrine axis and in the spinal cord. Front Endocrinol. 2022 Dec;13:1019943.
- Chang YC, Chang TJ, Lee WJ, Chuang LM. The relationship of visfatin/pre-B-cell colony-enhancing factor/nicotinamide phosphoribosyltransferase in adipose tissue with inflammation, insulin resistance, and plasma lipids. Metabolism. 2010 Jan;59(1):93-99.
- Roth B, Myllyvainio J, D’amato M, Larsson E, Ohlsson B. A Starch- and Sucrose-Reduced Diet in Irritable Bowel Syndrome Leads to Lower Circulating Levels of PAI-1 and Visfatin: A Randomized Controlled Study. Nutrients. 2022 May;14(9):1688.
- Zhao S, Li N, Xiong W, Li G, He S, Zhang Z, et al. Leptin Reduction as a Required Component for Weight Loss. Diabetes. 2024 Feb;73(2):197–210.
- Türkiye Endokrinoloji ve Metabolizma Derneği. Diabetes Mellitus ve Komplikasyonlarının Tanı, Tedavi ve İzlem Klavuzu. 2022. 54.
- Chang KC, Pai YW, Lin CH, Lee I Te, Chang MH. Glycemic variability’s impact on painful diabetic peripheral neuropathy in type 2 diabetes patients. Sci Rep. 2024 Sep 27;14(1):22276.
- Callaghan BC, Little AA, Feldman EL, Hughes RA. Enhanced glucose control for preventing and treating diabetic neuropathy. Cochrane Database Syst Rev. 2012 Jun ;2012(6):CD007543.
- Nozawa K, Ikeda M, Kikuchi S. Association Between HbA1c Levels and Diabetic Peripheral Neuropathy: A Case–Control Study of Patients with Type 2 Diabetes Using Claims Data. Drugs Real World Outcomes. 2022 Sep; 9(3):403-414.
- Su J bin, Zhao L hua, Zhang X lin, Cai H li, Huang H yan, Xu F, et al. HbA1c variability and diabetic peripheral neuropathy in type 2 diabetic patients. Cardiovasc Diabetol. 2018 Mar;17(1):47.
- Karaca A, Bakar-Ates F, Ersoz-Gulcelik N. Decreased Spexin Levels in Patients with Type 1 and Type 2 Diabetes. Med Princ Pract. 2018 Mar;27(6):549–554.
- Gu L, Ma Y, Gu M, Zhang Y, Yan S, Li N, et al. Spexin peptide is expressed in human endocrine and epithelial tissues and reduced after glucose load in type 2 diabetes. Peptides. 2015 Sep;71:232–239.
- Liu Y, Wu D, Zheng H, Ni Y, Zhu L, Jiang Y, et al. Serum Spexin Level Is Negatively Associated With Peripheral Neuropathy and Sensory Pain in Type 2 Diabetes. J Diabetes Res. 2024 May;2024:4538199.
- Bahar MR, Orhan SÜ, Özcan M, Tekin S. Diyabetik Nöropati Modelinde Speksinin Hücre Canlılığı Üzerine Etkisi: İn vitro bir çalışma. 49. Ulusal Fizyoloji Kongresi. 2024.
- Buyukaydin B, Guler EM, Karaaslan T, Olgac A, Zorlu M, Kiskac M, et al. Relationship between diabetic polyneuropathy, serum visfatin, and oxidative stress biomarkers. World J Diabetes. 2020 Jul;11(7):309-312.
- Mohammed HA, Ghudhaib KK, Mohsen FY. Determination of Visfatin Level in Patients with Diabetes and Peripheral Neuropathy as Early Predicted Factor. Ibn AL-Haitham Journal For Pure and Applied Sciences. 2023 Jan;36(1):236–245.
- Jung CH, Kim BY, Mok JO, Kang SK, Kim CH. Association between serum adipocytokine levels and microangiopathies in patients with type 2 diabetes mellitus. J Diabetes Investig. 2013 Oct;5(3):333–339.
- Chen Z, Fu S, Lai S, Fu M, Du G. Association of circulating adiponectin and leptin levels with the risk of diabetic peripheral neuropathy. Front Endocrinol. 2024 Dec;15:1505082.
- Sari R, Balci MK, Apaydin C. The relationship between plasma leptin levels and chronic complication in patients with type 2 diabetes mellitus. Metab Syndr Relat Disord. 2010 Dec; 8(6):499–503.
Öz
Amaç: Diyabetik nöropati (DN), Diabetes Mellitus’un (DM) en sık görülen kronik komplikasyonlarından biridir. Bu çalışmada, Tip 2 DM’li olup komplikasyon olarak DN gelişen hastalar ile DN gelişmeyen hastaların plazma speksin, visfatin ve leptin değerlerinin incelenmesi ve gruplar arasında farklılık olup olmadığının araştırılması amaçlanmıştır.
Yöntem: Çalışmaya Tip 2 DM tanısı almış olan 93 yetişkin hasta dahil edildi. Elektrofizyolojik sinir ileti çalışması olarak elektromiyografi (EMG) yapıldı. EMG bulgularına göre hastalar DN olan (n = 55) ve DN olmayanlar (n = 38) olarak iki gruba ayrıldı. Her hastadan, biri 5 ml olacak şekilde iki tüp venöz kan örneği alındı. İlk kan örneğinde hastaların HbA1c düzeyleri kontrol edildi. HbA1c düzeylerine göre gruplar kendi aralarında, HbA1c 6,5-8,4 arası ve ≥8,5 olmak üzere iki alt gruba ayrılarak toplam dört çalışma grubu oluşturuldu. Diğer kan örneği plazmaya ayrıldıktan sonra ELISA yöntemi ile speksin, visfatin ve leptin düzeyleri belirlendi. Sonuçlar gruplar arasında karşılaştırıldı.Bulgular: Katılımcılardan DN olanların 31’i kadın, 24’ü erkektir. DN olmayanların ise 29 kadın, 9’u erkektir. DN olan hastaların, olmayan hastalara göre glikoz ve HbA1c değerlerinin anlamlı derecede daha yüksek değerlere sahip olduğu görüldü (p<0,05). Lipid profilleri karşılaştırıldığında, her iki grupta da total kolesterol ve trigliserid seviyeleri yüksek olmasına rağmen, aralarındaki fark istatistiksel olarak anlamlı değildi (p>0,05). Yüksek Yoğunluklu Lipoprotein (HDL) düzeyleri açısından gruplar arasında net bir farklılık tespit edilemedi. Düşük Yoğunluklu Lipoprotein (LDL) seviyeleri genel olarak DN olmayan grupta daha yüksek bulundu ancak anlamlı değildi (p>0,05). HbA1c düzeyleri 6,5-8,4 arasında yer alan DN olan ve olmayan hastaların beden kitle indeksi (BKİ), glikoz, trigliserid, total kolesterol, HDL, LDL, speksin, visfatin ve leptin değerleri, nöropati tanısı alma durumuna göre istatistiksel olarak anlamlı bir farklılık göstermedi (p>0,05). HbA1c düzeyi ≥8,5 olan hastalardan, DN olan ve olmayanların BKİ, glikoz, trigliserid, HDL, speksin, visfatin ve leptin düzeyleri arasında istatistiksel olarak anlamlı bir fark bulunmazken (p>0.05), aynı gruptaki hastaların total kolesterol ve LDL düzeyleri arasında istatistiksel olarak anlamlı bir fark bulundu (p<0.05). LDL düzeyleri DN olan hastalarda daha yüksekti. DN olan ve olmayan hastaların speksin, visfatin ve leptin düzeyleri arasındaki korelasyon incelendiğinde ise, aralarında yüksek pozitif ve anlamlı bir ilişki tespit edildi (p<0,01).
Sonuç: Speksin, visfatin ve leptinin plazma düzeyleri, DN olan ve olmayan hasta grupları arasında anlamlı farklılık göstermemiştir. Ancak, hastaların plazma speksin, visfatin ve leptin düzeyleri arasında anlamlı düzeyde pozitif korelasyon tespit edilmiştir. Bu sonuç, speksin, visfatin ve leptinin plazma düzeylerinin birlikte hareket ettiğini ve klinik olarak önemli olabileceğini düşündürmektedir.
Anahtar Kelimeler
Diyabetik nöropati Speksin Visfatin Leptin Diyabetes Mellitus
Etik Beyan
Başkent Üniversitesi Tıp ve Sağlık Bilimleri Araştırma Kurulu ve Girişimsel Olmayan Klinik Araştırmalar Etik Kurulu'nun 20/04/2022 tarih ve 22/90 sayılı kararı ile etik izin alınmıştır.
Destekleyen Kurum
Bu çalışma Başkent Üniversitesi Tıp ve Sağlık Bilimleri Araştırma Kurulu ve Etik Kurulu tarafından onaylanmış (Proje no: KA22/202) ve Başkent Üniversitesi Araştırma Fonunca desteklenmiştir.
Proje Numarası
KA22/202
Kaynakça
- Tesfaye S, Chaturvedi N, Eaton SEM, Ward JD, Manes C, Ionescu-Tirgoviste C, et al. Vascular Risk Factors and Diabetic Neuropathy. The New England Journal of Medicine. 2005 Apr. 352.
- Dillon BR, Ang L, Pop-Busui R. Spectrum of Diabetic Neuropathy: New Insights in Diagnosis and Treatment. Annu Rev Med. 2024 Jan;75:293-306.
- Strand N, Anderson MA, Attanti S, Gill B, Wie C, Dawodu A, et al. Diabetic Neuropathy: Pathophysiology Review. Curr Pain Headache Rep. 2024 Jun;28(6):481-487.
- Fang P, She Y, Yu M, Yan J, Yu X, Zhao J, et al. Novel hypothalamic pathways for metabolic effects of spexin. Pharmacol Res. 2024 Oct;208:107399.
- Tran A, He W, Chen JTC, Belsham DD. Spexin: Its role, regulation, and therapeutic potential in the hypothalamus. Pharmacol Ther. 2022 May;233:108033.
- Yu M, Wang M, Han S, Han L, Kan Y, Zhao J, et al. Spexin ameliorates skeletal muscle insulin resistance through activation of GAL2 receptor. Eur J Pharmacol. 2022 Feb;917:174731.
- Zhu S, Hu X, Bennett S, Charlesworth O, Qin S, Mai Y, et al. Galanin family peptides: Molecular structure, expression and roles in the neuroendocrine axis and in the spinal cord. Front Endocrinol. 2022 Dec;13:1019943.
- Chang YC, Chang TJ, Lee WJ, Chuang LM. The relationship of visfatin/pre-B-cell colony-enhancing factor/nicotinamide phosphoribosyltransferase in adipose tissue with inflammation, insulin resistance, and plasma lipids. Metabolism. 2010 Jan;59(1):93-99.
- Roth B, Myllyvainio J, D’amato M, Larsson E, Ohlsson B. A Starch- and Sucrose-Reduced Diet in Irritable Bowel Syndrome Leads to Lower Circulating Levels of PAI-1 and Visfatin: A Randomized Controlled Study. Nutrients. 2022 May;14(9):1688.
- Zhao S, Li N, Xiong W, Li G, He S, Zhang Z, et al. Leptin Reduction as a Required Component for Weight Loss. Diabetes. 2024 Feb;73(2):197–210.
- Türkiye Endokrinoloji ve Metabolizma Derneği. Diabetes Mellitus ve Komplikasyonlarının Tanı, Tedavi ve İzlem Klavuzu. 2022. 54.
- Chang KC, Pai YW, Lin CH, Lee I Te, Chang MH. Glycemic variability’s impact on painful diabetic peripheral neuropathy in type 2 diabetes patients. Sci Rep. 2024 Sep 27;14(1):22276.
- Callaghan BC, Little AA, Feldman EL, Hughes RA. Enhanced glucose control for preventing and treating diabetic neuropathy. Cochrane Database Syst Rev. 2012 Jun ;2012(6):CD007543.
- Nozawa K, Ikeda M, Kikuchi S. Association Between HbA1c Levels and Diabetic Peripheral Neuropathy: A Case–Control Study of Patients with Type 2 Diabetes Using Claims Data. Drugs Real World Outcomes. 2022 Sep; 9(3):403-414.
- Su J bin, Zhao L hua, Zhang X lin, Cai H li, Huang H yan, Xu F, et al. HbA1c variability and diabetic peripheral neuropathy in type 2 diabetic patients. Cardiovasc Diabetol. 2018 Mar;17(1):47.
- Karaca A, Bakar-Ates F, Ersoz-Gulcelik N. Decreased Spexin Levels in Patients with Type 1 and Type 2 Diabetes. Med Princ Pract. 2018 Mar;27(6):549–554.
- Gu L, Ma Y, Gu M, Zhang Y, Yan S, Li N, et al. Spexin peptide is expressed in human endocrine and epithelial tissues and reduced after glucose load in type 2 diabetes. Peptides. 2015 Sep;71:232–239.
- Liu Y, Wu D, Zheng H, Ni Y, Zhu L, Jiang Y, et al. Serum Spexin Level Is Negatively Associated With Peripheral Neuropathy and Sensory Pain in Type 2 Diabetes. J Diabetes Res. 2024 May;2024:4538199.
- Bahar MR, Orhan SÜ, Özcan M, Tekin S. Diyabetik Nöropati Modelinde Speksinin Hücre Canlılığı Üzerine Etkisi: İn vitro bir çalışma. 49. Ulusal Fizyoloji Kongresi. 2024.
- Buyukaydin B, Guler EM, Karaaslan T, Olgac A, Zorlu M, Kiskac M, et al. Relationship between diabetic polyneuropathy, serum visfatin, and oxidative stress biomarkers. World J Diabetes. 2020 Jul;11(7):309-312.
- Mohammed HA, Ghudhaib KK, Mohsen FY. Determination of Visfatin Level in Patients with Diabetes and Peripheral Neuropathy as Early Predicted Factor. Ibn AL-Haitham Journal For Pure and Applied Sciences. 2023 Jan;36(1):236–245.
- Jung CH, Kim BY, Mok JO, Kang SK, Kim CH. Association between serum adipocytokine levels and microangiopathies in patients with type 2 diabetes mellitus. J Diabetes Investig. 2013 Oct;5(3):333–339.
- Chen Z, Fu S, Lai S, Fu M, Du G. Association of circulating adiponectin and leptin levels with the risk of diabetic peripheral neuropathy. Front Endocrinol. 2024 Dec;15:1505082.
- Sari R, Balci MK, Apaydin C. The relationship between plasma leptin levels and chronic complication in patients with type 2 diabetes mellitus. Metab Syndr Relat Disord. 2010 Dec; 8(6):499–503.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Fizyopatoloji |
| Bölüm | Araştırma Makalesi |
| Yazarlar | |
| Proje Numarası | KA22/202 |
| Yayımlanma Tarihi | 30 Haziran 2025 |
| Gönderilme Tarihi | 29 Ocak 2025 |
| Kabul Tarihi | 15 Mayıs 2025 |
| Yayımlandığı Sayı | Yıl 2025 Cilt: 8 Sayı: 2 |
