Comparison of betatrophin and cerebelline levels in diabetic nephropathy diseases and evaluation of the relationship between insulin resistance

ABSTRACT COMPARISON OF BETATROPHIN AND CEREBELLINE LEVELS IN DIABETIC NEPHROPATHY DISEASES AND EVALUATION OF THE RELATIONSHIP BETWEEN INSULIN RESISTANCE Diabetic nephropathy is the leading cause of end-stage renal failure in the world and in our country. In the United States, 40% of patients entering regular dialysis treatment constitute ESRD due to DM. According to Turkish Nephrology Society 2009, among the dialysis patients, DM is in the first place among the causes of ESRD by 35% in our country. In this study, we tried to clarify the effects of betatrophin and cerebelline molecules in diabetic nephropathy patients on the pathophysiology of diabetic nephropathy and their relationship with insulin resistance. Fifty patients diabetic nephropathy patients with or without CKD , 50 patients with type 1 or type 2 DM, and 50 controls with healthy subjects were included in this study, which was performed in outpatient clinics of Department of Internal Medicine, Department of Internal Medicine, Nephrology Department of Endocrinology and Metabolism and Department of Internal Medicine, Fırat University Medical Faculty.. Patients were divided into 3 groups (control) consisting of diabetic nephropathy patients, patients with diabetes mellitus and healthy subjects. Blood and urine samples were taken from the patients. Blood and urine samples were taken from healthy individuals with diabetes mellitus. Betatrophin, cerebelline, HOMA-IR levels were studied in the present samples. Comparisons between groups were made. Betatrophin and cerebellin levels were compared to blood and urine. A statistically significant difference was found increased serum betatrophin levels between diabetic nephropathy patients when compared with healthy control group (p <0,05). There was a statistically significant difference in serum betatrophin levels between patients with diabetic nephropathy and patients with diabetes mellitus (p<0,05). When diabetes mellitus patients were compared with healthy control group, betatrophin level was found to be increased statistically (p<0.005) When the urine betatrophine levels were compared with the diabetic nephropathy patients and the healthy control group, the betatrophine level decreased but this difference was not statistically significant (p>0,05). When diabetic nephropathy patients and diabetes mellitus patients were compared, the betatrophin level increased, there was a statistically significant difference (p <0,005). Urinary betatrophine levels of patients with diabetes mellitus were found to be decreased statistically significant as compared to control group (p <0,05). Although serum cerebelline levels were increased in both groups of patients compared to the healthy control group, no statistically significant difference was found (p> 0,05). Urinary cerebelline levels were significantly increased when diabetic nephropathy patients and healthy subjects were compared (p <0,005). When compared to patients with diabetes mellitus, it was found to be increased but no statistically significant difference was found (p> 0,05). Urinary cerebelline level were found increased, when the compared patients with diabetes mellitus and healthy control group but this difference was not statistically significant (p>0,05). The insulin resistance of the patients was calculated by HOMA score. HOMA-IR = Fasting Glucose (mg / dL) X Fasting Insulin (uIU/mL)/405 formula was used, statistically significant difference was observed in diabetic nephropathy patients compared to healthy subjects, insulin resistance was increased (p< 0,05). And statistically significant difference was observed in diabetes mellitus patients compared to healthy subjects, insülin resistance was increased (p<0,05). When diabetic nephropathy group and diabetes mellitus group were compared, there was no statistically significant difference even though insulin resistance was higher (p> 0,05). It was thought that betatrophin and cerebelline levels were associated with insulin resistance in diabetic nephropathy patients and may play a role in the pathophysiology of diabetic nephropathy. Key Words: Diabetic nephropathy, cerebellin, betatrophin, HOMA-IR