The relationship between serum adropin, asprosin and irisin levels and cardiovascular disease risk in healthy individuals, prediabetic and type 2 diabetes patients

Objective: Type 2 diabetes is a chronic metabolic disorder with increasing prevalence and significant social and individual burdens. Adropin, asprosin, and irisin, which attract attention due to their effects on metabolism, have not yet been clearly established in terms of their relationship with cardiovascular disease risk and diabetes and are not included in guidelines. The aim of this study was to investigate the relationship between serum adropin, asprosin, and irisin levels and cardiovascular disease risk in healthy individuals, prediabetes, and type 2 diabetes patients. Materials and Methods: The study included 30 patients diagnosed with type 2 diabetes mellitus, 30 patients diagnosed with prediabetes, and 29 healthy individuals who applied to the Family Medicine Outpatient Clinic of Selçuk University Faculty of Medicine between July 1, 2024, and December 31, 2024. Sample size calculation was performed using the G-Power protocol. The study was approved by the Ethics Committee of Selçuk University Faculty of Medicine on May 7, 2024, with decision number 2024/252. Participants completed a sociodemographic questionnaire, and the Framingham risk score was calculated. Height, weight, waist circumference, blood pressure measurements, and biochemical tests (complete blood count, fasting blood glucose, insulin, HbA1c, lipid profile) were recorded. Serum adiponectin, asprosin, and irisin levels were measured using an ELISA kit. All data were analyzed using the SPSS 21.0 statistical software package. Results: The Framingham risk score, waist circumference, systolic blood pressure, WBC, glucose, HbA1c, and HOMA-IR values were higher in the diabetes group (p<0.001, p=0.019, p=0.003, p=0.042, p<0.001, p=0.023, p<0.001). There were no statistically significant differences in circulating levels of adropin, asprosin, and irisin when compared to both Framingham risk level and diabetes status. The Framingham risk score was found to be positively correlated with age, BMI, waist circumference, systolic and diastolic blood pressure, glucose, triglycerides, HOMA-IR, and HbA1c levels, and negatively correlated with HDL levels (r=0.560; p<0.001, r=0.301; p=0.004, r=0.267; p=0.011, r=0.626; p<0.001, r=0.294; p=0.005, r=0.607; p<0.001), r=0.371; p<0.001, r=0.235; p=0.026, r=0.665; p<0.001, r=-0.382; p<0.001). In the linear regression analysis, a one-unit increase in BMI reduced adropin by 30.622 units; a one-unit increase in waist circumference reduced adropin by 8.694 units; a one-unit increase in the Framingham score reduced adropin by 10.70 units; a one-unit increase in HOMA-IR reduced adropin by 24.89 units; a one-unit increase in age reduced irisin by 0.49 units; and a one-unit increase in BMI reduced asprosin by 2.24 units. When the tertiles of adropin, irisin, and asprosin were compared according to the patients' diabetes status, no statistically significant differences were found. Conclusion: In our study, we found that circulating adropin, asprosin, and irisin levels did not show a statistically significant trend in glucose metabolism disorders and determining cardiovascular risk. Since there are many factors affecting the levels of these proteins, we think that their use alone will not be sufficient in predicting cardiovascular risk in diabetic patients or in the early diagnosis of diabetes. Instead of limiting the sample in our study with very strict exclusion criteria, we decided that our study would represent the real clinical population that we may encounter. The presented study is very important for the literature in terms of evaluating these three parameters related to metabolism together and seeing the effects of these proteins on cardiovascular risk assessment in diabetic patient groups. Keywords: Type 2 Diabetes Mellitus, Prediabetes, Adropin, Asprosin, Irisin, Framingham Risk Score