Can Fetuin-A Be a Marker for Insulin Resistance and Poor Glycemic Control in Children with Type 1 Diabetes Mellitus?

• DOI: 10.4274/jcrpe.4532
• Publication Date: 2017-05-22T06:52:14Z
• Authors: Ülkü Gül Şiraz; Murat Doğan; Nihal Hatipoğlu; Sabahattin Muhtar...; Selim Kurtoğlu
• Keywords: Blood Glucose; Male; 0301 basic medicine; Adolescent; alpha-2-HS-Glycoprotein; Reproducibility of Results; Atherosclerosis; Prognosis; 3. Good health; 03 medical and health sciences; Diabetes Mellitus, Type 1; 0302 clinical medicine; Non-alcoholic Fatty Liver Disease; Case-Control Studies; Humans; Original Article; Female; Treatment Failure; Insulin Resistance; Child; Biomarkers

Metabolic impairment in type 1 diabetes mellitus (T1DM) with poor glycemic control causes insulin resistance, non-alcoholic fatty liver disease (NAFLD), atherosclerosis, and increased carotid intima-media thickness (CIMT). Fetuin-A has a protective effect in cardiovascular disorders and is increased in hepatosteatosis. We aimed to investigate the reliability of fetuin-A levels in early detection of diabetic complications in children with T1DM and to identify a cut-off value that may show poor metabolic control.The study included 80 patients who had T1DM for at least 5 years and who had no chronic complications or an auto-immune disorder. Blood samples were drawn to measure hemoglobin A1c (HbA1c), biochemical parameters, and fetuin-A levels. Anthropometric parameters were also measured. Percent body fat was calculated. Hepatosteatosis and CIMT were assessed by sonography.Mean age of the patients was 13.5 years. Grade 1 hepatosteatosis was detected in 10%. Patients were stratified into 2 groups based on presence of NAFLD. Fetuin-A level was increased in patients with NAFLD. We identified a fetuin-A cut-off value (514.28 ng/mL; sensitivity: 47.34; specificity: 96.72) that may predict NAFLD. HbA1c and total cholesterol levels were found to be higher in patients with fetuin-A levels above higher the cut-off value.Fetuin-A is a reliable parameter in the prediction of complications and poor glycemic control in patients with T1DM.