High Serum Levels of Irisin, Visfatin and Adiponectin as Potential Independent Risk Factors for Diabetic Nephropathy Progression in Patients With Type 2 Diabetes Mellitus.

Abstract

Background/aim: Diabetic nephropathy (DN) is a common devastating complication in type 2 diabetes mellitus (T2DM). In order to investigate novel DN biomarkers, we evaluated serum levels of irisin, adiponectin, visfatin and interleukin 4 (IL-4) in patients with T2DM with normo-, micro- and macro-albuminuria and compared their means with non-diabetic controls.

Patients and methods: Clinical data and routine laboratory parameters of metabolic and renal function status were determined in blood and urine samples obtained from 169 participants, divided into four groups according to the presence of diabetes and albuminuria using appropriate biochemical assays/calculations. Serum levels of irisin, adiponectin, visfatin and interleukin 4 (IL4) were assessed using enzyme-linked immunosorbent assay. Means of all tested parameters and biomarkers were compared using appropriate statistical methods. Logistic regression was used to determine albuminuria risk factors in T2DM as an indicator for DN.

Results: All tested parameters differed significantly among T2DM groups and controls (p<0.001). Irisin, adiponectin, visfatin and IL4 significantly increased in T2DM patients with significant increasing albuminuria. Along with hemoglobin A1C, irisin was the most highly significant risk factor for development and progression of albuminuria (p<0.001). Adiponectin was also a significant independent risk factor (p=0.009), whilst visfatin and IL4 conferred no significant risk.

Conclusion: High irisin levels in normo-albuminuric patients indicates their potential to develop DN even prior to detectable albuminuria. Both irisin and adiponectin may be considered as potential biomarkers indicating risk for DN progression in T2DM that might be therapeutically targeted.