Examination of netrin-1 and netrin-4 levels in patients with metabolic syndrome

Metabolic Syndrome (MetS) is a lethal endocrinopathy that begins with insulin resistance and results from the combination of systemic disorders such as obesity, glucose intolerance, diabetes, atherogenic dyslipidemia, hypertension, and coronary artery disease. MetS is a health problem with increasing prevalence worldwide. Conditions such as chronic inflammation, endothelial dysfunction and oxidative stress play a role in the pathophysiology of MetS. Netrin-1 and netrin-4, known for their guidance properties to neurons, are understood to be involved in processes such as chronic inflammation and endothelial dysfunction. A review of the literature reveals no studies examining MetS in conjunction with netrin proteins. Accordingly, this study aims to investigate levels of netrin-1 and netrin-4 in the serum of individuals with MetS along with various biochemical and anthropometric measurements to explore correlations between these parameters. Forty volunteers who applied to the Endocrine and Metabolism Polyclinic of the Republic of Turkey Malatya Training and Research Hospital and were diagnosed with MetS and 40 healthy volunteers without any disease were included in the study and their anthropometric measurements (body mass index, waist and hip measurements) were performed. Additionally, levels of various clinical biochemical parameters used in the diagnosis of MetS were measured in serum blood samples of all volunteers. Netrin-1 and netrin-4 levels in the serum samples of the volunteers were determined by commercial ELISA kits. According to the results of our study, netrin-1 and netrin-4 levels in patients with MetS were determined to be statistically significantly higher compared to the control group (p<0.001). According to the ROC analysis, netrin-1, which was found to have high sensitivity and specificity, was determined to be a distinguishing parameter in the diagnosis of MetS. Additionally, according to the results of binary logistic regression analysis, netrin-4 was determined to be a significant risk factor for MetS. Accordingly, it was revealed that each unit increase in netrin-4 increased the risk of MetS by approximately 1.09 times. In conclusion, our findings showed that high netrin-1 and netrin-4 levels in MetS are associated with this disease. It was concluded that netrin-1 could be a potential biomarker for MetS, while an increase in netrin-4 levels could increase the risk of developing MetS. In addition, it was revealed that these proteins could be important biomarkers for examining the course of the disease and could be used as a potential therapeutic target in the management of complications that may be seen in MetS. KEYWORDS: Metabolic Syndrome, chronic inflammation, diabetes, endothelial dysfunction, netrin-1, netrin-4