Endocrine Abstracts (2018) 56 P377 | DOI: 10.1530/endoabs.56.P377

TWEAK levels in patients with prediabetes and diabetes mellitus

Yildiz Okuturlar1, Hakan Kocoglu1, Sibel Ocak Serin2, Tarik Ercan1, Mehmet Hursitoglu1, Meral Mert1, Bahar Ozdemir1, Betul Erismis1, Asuman Gedikbasi1 & Ozlem Harmankaya1


1University of Health Sciences, Bakirkoy Dr. Sadi Konuk Education and Research Hospital, Istanbul, Turkey; 2University of Health Sciences, Umraniye Education and Research Hospital, Istanbul, Turkey.


Introduction: Tumor necrosis factor-like weak inducer of apoptosis (TWEAK) belongs to TNF family and is released from inflammatory cells. It has been reported that TWEAK has several biological actions ranging from cell proliferation to stimulation of apoptosis. In in vitro studies, it was reported that TWEAK has alleviating effect on insulin resistance in hepatocytes. TWEAK decreases insulin resistance induced by TNF-a through activation of phosphatase 2A pathway in adipocytes. In our study, the relationship between TWEAK levels and biochemical parameters was assessed in patients with prediabetes and diabetes mellitus.

Material and method: The study recruited overall 90 patients including 32 patients with diabetes mellitus (17 men, 15 women), 32 patients with prediabetes (14 men, 18 women) and 26 controls (12 men, 14 women). The diagnosis of prediabetes was made according to fasting blood glucose measurement (100–126 mg/dl) and 75-gr OGTT (2 h glucose: 140–199). Diabetes group included patients with newly diagnosed type II diabetes mellitus. Biochemical evaluations were performed in all patients. Homeostasis Model Assessment (HOMA) was calculated by using following formula: HOMA-IR=Fasting Blood Glucose (mg/dl) × Fasting Insulin (uIU/ml)/405. Spearman’s correlation analysis was used to assess correlations.

Findings: There were significant differences in TWEAK among three groups (P=0.001). There was no significant difference between prediabetes and diabetes groups (P=0.867) while there was significant difference in controls when compared to prediabetes or diabetes groups (P=0.001).

Discussion: In our study, the finding presence of significant difference between controls and prediabetes or diabetes groups but not between prediabetes and diabetes groups suggests that TWEAK levels can be affected even at early phase of insulin resistance. The negative correlation between TWEAK and insulin resistance or inflammation markers may be a clue indicating that TWEAK levels can be used as a novel, early marker for metabolic syndrome. The decreased TWEAK levels by increasing insulin resistance and inflammation raises the likelihood of using TWEAK as an early marker for metabolic syndrome which is now considered as a common public health issue.

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