The Level Of Netrin-1 And Its Correlation With Inflammation In Newly Diagnosed Patients With Type 2 Diabetes Mellitus

ObjectivesThe pathogenesis of type 2 diabetes mellitus(T2DM)is complicated and is not be fully elucidated.Overwhelming evidence suggests that T2DM is an inflammatory disease characterized by high levels of multifarious inflammatory factors.Of the total,infiltration of macrophages and the continue inflammation play important role in varieties processes of DM.Monocyte chemoattractant protein-1(MCP-1)is the essential inflammatory protein recruiting macrophages.And Netrin-1 has been shown to play a positively regulatory role during inflammatory process which probably has protective function on histocytes.However,there is little research about the relations between Netrin-1 and T2DM.In the research,we plan to choose healthy people and newly diagnosed type 2 diabetes and the levels of Netrin-1 and MCP-1 in serum were detected.The possible role of Netrin-1 in chronic inflammation and and clinical significance are discussed.MethodsA total of 56 subjects were enrolled in the study.The sample consisted of 30 patients with newly diagnosed T2DM who had a glycosylated hemoglobin(HbA1c)level ranging from 7.5%(58 mmol/mol)to 10.5%(91 mmol/mol).The control group consisted of 26 healthy individuals matched for age and body mass index.Netrin-1 and MCP-1 levels were determined using commercially available human enzyme-linked immunosorbent assay(ELISA)kits.The homeostasis model assessment of insulin resistance(HOMA-IR)was used as an index to measure insulin resistance.We also tested the indexes of body and blood biochemical indexes of metabolism.The relativity between Netrin-1 levels and above indexes was analyzed by statistical method.ResultsCompared to healthy subjects,patients with newly diagnosed T2DM exhibited higher fasting blood glucose(FBG),postprandial blood glucose(PBG),fasting insulin(FINS),postprandial insulin(PINS),HbAlc and HOMA-IR.The Netrin-1 level of T2DM patients was significantly lower than that of healthy controls(p<0.01).No correlation was found between Netrin-1 and HDL-C,LDL-C,TC and BMI.Netrin-1 levels showed significant negative correlation with FBG(r=-0.471,p=0.000),PBG(r=-0.3 80,p=0.004),HbAlc(r=-0.380,p=0.004),FINS(r=0.371,p=0.005),TG(r=-0.296,p=0.027),HOMA-IR(r=-0.499,p=0.000)and MCP-1(r=-0.408,p=0.002).HOMA-IR was the main influencing factor of Netrin-1 by multiple linear regression analysis in patients with newly diagnosed type 2 diabetes.ConclusionsThe Netrin-1 levels of the T2DM group were significantly lower than those of the control group.Netrin-1 was associated the glucose metabolism and insulin resistance.Netrin-1 also has effect on production of inflammatory cytokines and chemokines.Therefore,Netrin-1 may be involved in the inflammatory mechanism of IR.