Evaluation of the relationship of apelin 13 levels with thepresence of nephropathy in patients with type 2 diabetes

Background and aim: Kidneys begin to be damaged early in patients with Type 2 diabetes mellitus (DM) and may develop diabetic nephropathy (DN). There are conflicting results in the literature, although there are many laboratory parameters showing renal damage and disease progression in diabetic patients. The Apel; is a peptide hormone secreted from adipose tissue. While there are many studies in the literature on diabetic nephropathy and apelin levels in animals, studies on humans are limited. In this study, we aimed to investigate whether there is a relationship between apelin level and severity of the disease in patients with DN. Material and Methods: Thirty healthy volunteers and 120 patients diagnosed with type 2 DM who applied to endocrinology polyclinic and clinic and nephrology polyclinic were included in the study between 01 April 2019 - 01 September 2019. Four cc venous blood samples were taken in all patients from the forearm antecubital vein, and routine labaratory parameters and apelin-13 levels were studied. Microalbumin / creatinine ratios in spot urine was calculated. Patients without a history of diabetes were defined as healthy group (group 1). Diabetic patients; The patients with normal creatinine level and spot urine microalbumin values <30 mg were group 2, 30-300 mg group 3 and> 300 mg group 4. The patients with high creatinine value (>1.1 mg / dl) and microalbumin level> 300 mg were identified as group 5. Results: A total of 150 persons (30 patients from each group) were included in the study. Fasting blood glucose was significantly lower in group 1 (p <0.001). Urea, creatinine, potassium, uric acid values were significantly higher in group 5 and glomerular filtration rate (GFR) values were significantly lower (p <0.001 for each). Albumin levels were significantly lower in group 5 (p = 0.032), phosphorus (p = 0.002) and HDL (p = 0.007) significantly higher. Hemoglobin A1c, microalbumin / creatinine and HOMA-IR values were significantly lower in group 1 (p <0.001 for each). Apelin- 13 levels were significantly higher in group 4 and group 5 (p <0.001). There was a negative correlation between apelin-13 and GFR (r = -0.286, p = 0.003), HOMA-IR (r = 0.309, p = 0.009) and microalbumin / kr (r = 0.296, p <0.001). Conclusion: The increase of the disease stage in patients with diabetic nephropathy is closely related to the increase of serum apelin-13 level