Sirtuin, irisin, and vitamin D as predictors of diabetes mellitus with uncontrolled glycemia in Indonesian patients

Abstract

The incidence of type 2 diabetes mellitus is increasing in developing countries, including Indonesia. Insulin resistance is a significant contributor to elevated blood glucose levels in type-2 diabetes patients. Low levels of serum sirtuin-1, irisin, and vitamin D have been linked to insulin resistance. This study aimed to identify risk factors that could predict uncontrolled glycemia and insulin resistance in Indonesian type-2 diabetes patients. We conducted a cross-sectional study with 73 adults from South Jakarta, Indonesia, in which we examined type-2 diabetes risk factors and biomarkers, including sex, age, body mass index, waist circumference, waist–to–hip ratio, fasting blood glucose (FBG) levels, fasting insulin, sirtuin-1, irisin, and vitamin D levels. The subjects were categorized into two groups based on their glycated hemoglobin (HbA1c) level and homeostatic model assessment for insulin resistance (HOMA-IR) index to assess glycemic control and insulin resistance, respectively. We compared risk factor profiles between groups and analyzed multivariate relationships with logistic regression. Our findings revealed that 54 % of the subjects had uncontrolled glycemia, whereas only 11 % had insulin resistance. There was a significant association between uncontrolled glycemia and reduced sirtuin-1 levels (odds ratio = 4.07; p = 0.03), which was confirmed in the multivariate analysis (beta = 5.41, p = 0.014) along with FBG (beta = 36.88, p = 0.001). Irisin showed a marginal association with insulin resistance in both univariate (odds ratio = 0.12; p = 0.027) and multivariate analyses (beta = 0.09; p = 0.049). In conclusion, sirtuin-1, in addition to FBG, is a potential marker for assessing glycemic control in type-2 diabetes patients.