Endocrine Abstracts

Background and aims: In patients with type 2 diabetes, elevated tumor necrosis factor α (TNFα), C-reactive protein (CRP), chemerin, fetuin-A, have been reported. However, it is not entirely clear whether these alterations in adipokine serum concentrations are already present in prediabetic states and in type 1 diabetes. The aim of the study was to investigate whether adipokine profiles (chemerin, fetuin-A, TNFα) and inflammatory markers (CRP) are associated with decreases in insulin sensitivity and beta cell function in first degree relatives of patients with type 1 diabetes (T1D) and their usefulness in the assessment of the risk of development of diabetes.

Material and methods: The study was conducted in 90 first- degree relatives of the patients with T1D (mean age 27.1±15.48 years; mean BMI 24.6±4.95 kg/m²) and 60 healthy individuals (mean age 29.9±13.7 years; mean BMI 22.8±2.3 kg/m²). TNFα, chemerin and fetuin-A concentrations were determined using ELISA method, CRP by turbidimetric method. HOMAIR and HOMA%B indices were calculated using computer calculator from the Website Oxford Centre for Diabetes, Endocrinology and Metabolism.

Results: CRP and TNF-alpha concentrations were significantly higher in the relatives compared to the controls (3.27±2.48 vs 1.14±1.39 mg/l; P<0.007; 8.58±15.49 vs 0.63±0.79 pg/ml, P<0.005 respectively). We found significantly higher chemerin concentration (0.6848±28.67 vs 0.5112±32.41, P<0.006) and fetuin-A concentration (276.92±30.9 vs 214.66±34.2; P<0.001) in the study group as compared to the healthy controls. Significantly higher HOMAIR (1.16±0.63 vs 0.79±0.34, P<0.002) and significantly lower HOMA%B index (92.84±29.39 vs 114.0±47.06, P<0.015) were found in the relatives as compared to the controls. HOMAIR correlated positively with TNFα (r=0.430, P<0.001), chemerin (0.732, P<0.0001) fetuin-A (0.454, P<0.0001) and CRP (r=0.445, P<0.0001). HOMA%B negatively correlated with TNFα (r=−0.431, <0.0001) and CRP (r=−0.460; P<0.0001).

Conclusions: Alterations in chemerin, fetuin-A, CRP and TNFα are already detectable in first degree relatives of T1D, and may reflect to identify insulin resistance as an early pathogenetic event before T1D development. Fasting levels of chemerin, fetuin-A, CRP and TNFα probably will be used as biomarkers to identify insulin resistance and decrease of beta cell function in healthy individuals with higher risk of T1D.