Estimation of Preptin Serum level, Insulin Resistance and other biochemical parameters in Pre-diabetic and Newly Diagnosed Type 2 Diabetic Mellitus

Abstract

Background: The term diabetes mellitus (DM) describes metabolic disorder of multiple causes characterized by high levels of blood glucose resulting from defects in insulin secretion, insulin action, or both. Preptin is a recently isolated 34-amino acid peptide hormone that is co-secreted with insulin, amylin and pancreastatin from the pancreatic β-cells. Preptin heighten glucose-mediated insulin secretion. There are few studies on preptin in Type2DM patients and this is the first study observed on plasma preptin in pre-diabetic subjects and done to compare plasma preptin levels in patients with newly diagnosed and pre-diabetic with control groups. Objectives: To study the relationship between serum preptin and some biochemical parameters in pre-diabetes and newly diagnosed type 2 diabetes mellitus subjects as compared with control healthy groups. Subjects, material and methods: This case control study have included 180 subjects, matched for age ranged (36-75 years) and sex ratio were enrolled male (90) and female(90) those subjects divided into three sub groups, 60 subjects having per-diabetic, 60 patients having newly-diagnosed and 60 healthy control group. Serum insulin and preptin levels were measured by using commercial ELISA kits, and Homeostatic Model Assessment for Insulin Resistance (HOMO IR) was calculated. The anthropometric measured BMI, and biochemical serum (FBS, Lipid profile) levels measured by automated method by using Abbott Architect 4000. Serum HbA1c level was measured by boronated affinity assay by using NYCOCARD TM reader II. Results: The preptin showed a significant increased levels in pre-diabetic, but non-significant increased levels in newly-diagnosed as compared with control groups(132.2±14.8 vs. 83.5±8.6 pg /ml, p≤ 0.004) ,(89.3.0±8.0 vs. 83.5I±8.6 pg /ml p≤0.09) respectively, Serum preptin levels in all three groups showed a significant decreased in males than females (69±11.6 , 128±10.9 , 79±12.91 vs. 97.19±12.39 , 132.9±17.9 , 89.1±18 , p≤0.01) respectively..Preptin levels showed a significant negative correlation with age in control groups (r= - o.29,p≤0.03) and non-significant positive correlation in pre-diabetic and in newly diagnosed patients,(r=0.163 ,p≥0.23, r= -0.18 , p≥0.191).BMI level showed non-significant negative correlation with preptin in pre-diabetic and control groups (r = - 0.24 ,p≥0.07 ,r = - 0.01 p≥0.93),while non-significant positive correlation in newly diagnosed (r= 0.12 , p≥0.39). Sugar were non-significant positive correlation with preptin in control, pre-diabetic groups (r= 0.02, 0.031, p≥ 0.87, 0.82) while significant positive correlation with newly –diagnosed (r= 0.35, p≤ 0.01). HbA1c showed significant positive correlation with preptin in newly diagnosed groups (r = 0.28, p≤ 0.04) and non-significant positive correlation with pre-diabetic subjects (r = 0.81, p≥ 0.19), while non-significant positive correlation in controls (r = 0.14, p ≥ 0.32). Insulin showed non-significant positive correlation in all three groups (control r=0.20, p≥0.15, pre-diabetic r=0.04, p≥0.79) and newly diagnosed r=0.11, p≥0.41). HOMA-IR correlate with preptin positive non-significantly in the controls (r=0.12, p ≥0.374), and significant positive correlation in pre-diabetic and newly diagnosed groups (r= 0.28, 0.38, p≤ 0.04, ≤0.001). Conclusion: The current study conclude that the insulin level is higher in pre-diabetic cases while HOMA-IR is higher in newly diagnosed cases and that’s results accompanied with higher level of preptin, this result can show a positive relation between preptin and insulin resistance.