Association of Insulin Resistance, β-Cell Function Impairment and Calcium, Magnesium, and Fetuin-A Concentrations in Women with Type 2 Diabetes Mellitus

Open access

Summary

Insulin resistance and β-cell function impairment play a role in the pathogenesis of type 2 diabetes (T2DM). Insulin signaling is inhibited by fetuin-A, an abundant plasma protein. Fetuin-A is also a candidate marker of the T2DM risk. This case-control study aimed to determine whether fetuin-A serum level is related to insulin resistance, β-cell function impairment, and total and ionized Ca and Mg serum levels in Erbil patients with T2DM.

A total of 60 patients with T2DM were recruited, and 30 healthy persons were included in the control group. Fetuin-A and insulin concentrations were measured through ELISA. Other biochemical parameters were determined spectrophotometrically. Insulin resistance (HOMA2IR), insulin sensitivity (HOMA2%S), and β-cell function were examined by using a homeostatic model assessment 2 (HOMA2).

Fasting serum insulin, fetuin-A serum levels, and HOMA2IR were significantly increased. HOMA2%S of the patients with diabetes was significantly lower than that of the control group. The total serum and ionized Ca and Mg contents and the Ca/Mg ratio were reduced in the patients.

Therefore, fetuin-A is related to T2DM pathogenesis and is strongly associated with insulin resistance and glycemic control in T2DM patients. Future large-scale studies are necessary to validate fetuin-A as an indicator of IR in T2DM patients.

If the inline PDF is not rendering correctly, you can download the PDF file here.

  • 1. Wild S Rolic C Green A. Global prevalence of diabetes: Estimates for the year 2000 and projection for 2030. Diabetes Care 2004;37:1047-53 http://dx.doi.org/10.2337/diacare.27.5.1047

  • 2. Rasic MZ Perunicic PG Pljexa S et al. Magnesium deficiency in type 2 diabetes. Hippokratia 2004;8(4):179-81.

  • 3. Stumvoll M Goldstein BJ van Haeften TW. Type 2 diabetes: principles of pathogenesis and therapy. Lancet 2005; 365: 1333-46. http://dx.doi.org/10.1016/S0140-6736(05)61032-X

  • 4. Stefan N Hennige AM Staiger H et al. α2- Heremans-Schmid glycoprotein/fetuin-A is associated with insulin resistance and fat accumulation in the liver in humans. Diabetes Care 2006; 29: 853-57. http://dx.doi.org/10.2337/diacare.29.04.06.dc05-1938

  • 5. Cintrón VJ Ko MS Chi KD et al. Genetic mapping and functional studies of a natural inhibitor of the insulin receptor tyrosine kinase: the mouse ortholog of human alpha2-HS glycoprotein. Int J Exp Diabetes Res 2001; 1(4): 249-63. http://dx.doi.org/10.1155/EDR.2000.249

  • 6. Stefan N Fritsche A Weikert C et al. Plasma Fetuin-A Levels and the Risk of Type 2 Diabetes.Diabetes 2008; 57(10): 2762-7. http://dx.doi.org/10.2337/db08-0538

  • 7. Ketteler M Bongartz P Westenfeld R et al. Association of low fetuin-A (AHSG) concentrations in serum with cardiovascular mortality in patients on dialysis: a crosssectional study. Lancet 2003; 361: 827-33. http://dx.doi.org/10.1016/S0140-6736(03)12710-9

  • 8. Zeitz U Weber K Soegiarto DW et al. Impaired insulin secretory capacity in mice lacking a functional vitamin Dreceptor. FASEB J 2003; 17:509-11

  • 9. Pham PCT Pham PMT Pham SV Miller JM and Pham PTT. Hypomagnesemia in patients with Type 2 Diabetes.Clin J Am SocNephrol2007; 2:366-73. http://dx.doi.org/10.2215/CJN.02960906

  • 10. Kobrin SM and Goldfarb S. Magnesium Deficiency. SeminNephrol 1990; 10: 525-35.

  • 11. Hua H Gonzales J Rude RK. Magnesium transport induced ex vivo by a pharmacological dose of insulin is impaired in non-insulindependent diabetes mellitus. Magnes-Res 1995; 8 (4): 359-66.

  • 12. van Dam RM Hu FB Rosenberg L et al. Dietary calcium and magnesium major food sources and risk of type 2 diabetes in U.S. black women. Diabetes Care 2006; 29:2238-43. http://dx.doi.org/10.2337/dc06-1014

  • 13. Paolisso G Sgambato S Pizza G et al. Improved insulin response and action by chronic magnesium administration in aged NIDDM subjects. Diabetes Care 1989;12:262-9. http://dx.doi.org/10.2337/diacare.12.4.265

  • 14. 14-Wang H Sama AE. Anti-inflammatory role of fetuin-A in injury and infection. Curr Mol Med 2012; 12:625-633. http://dx.doi.org/10.2174/156652412800620039

  • 15. Bonora E Targher G Alberiche M et al. Homeostasis model assessment closely mirrors the glucose clamp technique in the assessment of insulin sensitivity: studies in subjects with various degrees of glucose tolerance and insulin sensitivity. Diabetes Care 2000; 23: 57-63. http://dx.doi.org/10.2337/diacare.23.1.57

  • 16. Dickerson RN Alexander KH Minard G Croce MA Brown RO. Accuracy of methods to estimate ionized and"corrected" serum calcium concentrations in critically ill multiple trauma patients receiving specialized nutrition support. JPEN J Parenter Enteral Nutr 2004; 28(3):133-41.2004; 28:133-141.

  • 17. Koch SM Warters D Mehlhorn U. Thesimulaneous measurement of ionized and total calcium and ionized and total magnesium in intensive care unit patients. J Crit Care 2002; 17(3):203-5. http://dx.doi.org/10.1053/jcrc.2002.35813

  • 18. Laughlin GA Barrett-Connor E Cummins KM et al. Sex-Specific Association of Fetuin-A With Type 2 Diabetes in Older Community-Dwelling Adults.The Rancho Bernardo Study. Diabetes Care2013; 36(7): 1994-2000. http://dx.doi.org/10.2337/dc12-1870

  • 19. Dasgupta S BhattacharyaS BiswasA. NF-κB mediates lipid-induced fetuin-A expression in hepatocytes that impairs adipocyte function effecting insulin resistance. Biochem J 2010; 429:451-62. http://dx.doi.org/10.1042/BJ20100330

  • 20. SunQ CornelisMC Manson JE HuFB. Plasma levels of fetuin-A and hepatic enzymes and risk of type 2 diabetes in women in the U.S. Diabetes 2013;62(1):49-55.

  • 21. Ahmed LI Mousa SG Mohamed NA et al. Fetuin-A and type II diabetes mellitus. Egypt J Intern Med 2014;26:157-61. http://dx.doi.org/10.4103/1110-7782.148140

  • 22. Song A Xu M Bi Y et al. Serum fetuin-A associates with type 2 diabetes and insulin resistance in Chinese adults. PLoS ONE2011; 6(4): e19228. doi:

    • Crossref
    • Export Citation
  • 23. Katsuhito Mori Masanori Emoto Hisayo Yokoyama et al. Association of serum fetuin-A with insulin resistance in type 2 diabetic and nondiabetic subjects. Diabetes Care 2006; 29(2): 468. http://dx.doi.org/10.2337/diacare.29.02.06.dc05-1484

  • 24. Ishibashi A Ikeda Y Ohguro T et al. Serum fetuin-A is an independent marker of insulin resistance in Japanese men. J Atheroscler Thromb 2010; 17(9):925-33 http://dx.doi.org/10.5551/jat.3830

  • 25. Lorenzo C Wagenknecht LE D'Agostino RB Jr et al. Insulin resistance β-cell dysfunction and conversion to type 2 diabetes in a multiethnic population: The Insulin Resistance Atherosclerosis Study. Diabetes Care 2010; 33(1): 67-72. http://dx.doi.org/10.2337/dc09-1115

  • 26. Mathews ST Chellam N Srinivas PR et al. Alpha2-HSG a specific inhibitor of insulin receptor autophosphorylation interacts with the insulin receptor. Mol Cell Endocrinol 2000; 164(1-2):87-98. http://dx.doi.org/10.1016/S0303-7207(00)00237-9

  • 27. Vionnet N Hani EH Dupont S et al. Genomewide search for type 2 diabetessusceptibility genes in French whites: evidence for a novel susceptibility locus for early-onset diabetes on chromosome 3q27-qter and independent replication of a type 2-diabetes locus on chromosome 1q21-q24. Am J Hum Genet 2000; 67: (6):1470-80. http://dx.doi.org/10.1086/316887

  • 28. Siddiq A Lepretre F Hercberg S at al. A synonymous coding polymorphism in the α2- Heremans-Schmid glycoprotein gene is associated with type 2 diabetes in French Caucasians. Diabetes 2005; 54(8): 2477-81. http://dx.doi.org/10.2337/diabetes.54.8.2477

  • 29. Schulze MB Schulz M Heidemann C et al. Carbohydrate intake and incidence of type 2 diabetes in the European Prospective Investigation into Cancer and Nutrition (EPIC)- Potsdam Study. Br J Nutr 2008; 99(5): 1107-16. http://dx.doi.org/10.1017/S0007114507853360

  • 30. Ix JH Wassel CL Kanaya AM et al. Health ABC Study. Fetuin-A and Incident Diabetes Mellitus in Older Persons: The Health Aging and Body Composition (Health ABC) Study. JAMA 2008; 300(2):182-8. http://dx.doi.org/10.1001/jama.300.2.182

  • 31. Jassem WE and FarahanAR. The Effect of Age and Gender on Fetuin-A and Some Biochemical parameters in Blood Sera of Iraqi patients with T2DM: A comparative study. Baghdad Sci J 2015; 12(1):197-203.

  • 32. Dabrowskaa AM Taracha JS Wojtysiak-Dumab B Dumac D. Fetuin-A (AHSG) and its usefulness in clinical practice. Review of the literature. Biomed Pap Med FacUnivPalacky Olomouc Czech Repub 2015; 159(3):352-35.

  • 33. KanchanaN Saikumar P. Serum calcium levels In Type 2 Diabetes Mellitus. IOSR-JDMS 2014; 13(8): 01-03.

  • 34. Hu FB Meigs JB Li TY et al. Inflammatory markers and risk of developing type 2 diabetes in women. Diabetes 2004;53(3):693-700. http://dx.doi.org/10.2337/diabetes.53.3.693

  • 35. Milner RD Hales CN. The role of calcium and magnesium in insulin secretion from rabbit pancreas studied in vitro. Diabetologia 1967; 3(1):47-9. http://dx.doi.org/10.1007/BF01269910

  • 36. Pittas AG Harris SS Stark PC Dawson-Hughes B. The effects of calcium and vitamin D supplementation on blood glucose and markers of inflammation in nondiabetic adults. Diabetes Care 2007;30:980-6. http://dx.doi.org/10.2337/dc06-1994

  • 37. Nadler JL Buchanan T Natarajan R et al. Magnesium deficiency produces insulin resistance and increased thromboxane synthesis. Hypertension 1993; 21(6 Pt 2): 1024-9. http://dx.doi.org/10.1161/01.HYP.21.6.1024

  • 38. Guerrero-Romero F Tamez-Perez HE Gonzalez-Gonzalez G et al. Oral magnesium supplementationimproves insulin sensitivity in non-diabetic subjectswith insulin resistance. A double-blind placebo controlled randomized trial. Diabetes Metab 2004;30 (3): 253-8. http://dx.doi.org/10.1016/S1262-3636(07)70116-7

  • 39. Walti MK Zimmermann MB Spinas GA Hurrell RF. Low plasma magnesium in type 2 diabetes. Swiss Med Wkly 2003; 133(19-20): 289-92.

  • 40. Kareem I Jaweed SA Bardapurkar JS Patil VP. Study of magnesium Glycosylated hemoglobin and lipid profile in diabetic retinopathy. Indian J Clin Biochem 2004; 19(2):124-7. http://dx.doi.org/10.1007/BF02894270

Search
Journal information
Impact Factor


Cite Score 2018: 0.33

SCImago Journal Rank (SJR) 2018: 0.134
Source Normalized Impact per Paper (SNIP) 2018: 0.287

Metrics
All Time Past Year Past 30 Days
Abstract Views 0 0 0
Full Text Views 362 173 3
PDF Downloads 157 89 1