4.3 Article

Association of Protein Z with Prediabetes and Type 2 Diabetes

Journal

ENDOCRINOLOGY AND METABOLISM
Volume 36, Issue 3, Pages 637-646

Publisher

KOREAN ENDOCRINE SOC
DOI: 10.3803/EnM.2021.962

Keywords

Protein Z; Prediabetic state; Diabetes mellitus; type 2; Biomarkers; Cytokines

Funding

  1. Korean Diabetes Association
  2. Korea Health technology R&D project through the Korea Health Industry Development Institute (KHIDI) - Ministry of Health & Welfare, Republic of Korea [HI14C1324]
  3. Basic Science Research Program through the National Research Foundation of Korea (NRF) - Ministry of Education [NRF-2018R1D1A1B07043990]

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The study identified protein Z (PROZ) as a potential biomarker for prediabetes and T2DM, with significantly decreased plasma levels in patients with these conditions and negative correlations with fasting plasma glucose and hemoglobin A1c. Further large-scale studies are needed to explore the relationship and mechanism between PROZ and prediabetes and T2DM.
Background: Type 2 diabetes mellitus (T2DM) is a progressive metabolic disease. Early detection of prediabetes is important to reduce the risk of T2DM. Some cytokines are known to be associated with T2DM. Therefore, we aimed to identify cytokines as novel biomarkers of glucose dysmetabolism. Methods: The fast stage of the study included 43 subjects (13 subjects with newly diagnosed T2DM, 13 with prediabetes. and 16 with normoglycemia) for cytokine microarray analysis. Blood samples of the subjects were assessed for 310 cytokines to identify potential indicators of prediabetes. The second stage included 142 subjects (36 subjects with T2DM, 35 with prediabetes, and 71 with normoglycemia) to validate the potential cytokines associated with prediabetes. Results: We identified 41 cytokines that differed by 1.5-fold or more in at least one out of the three comparisons (normoglycemia vs. prediabetes, normoglycemia vs. T2DM, and prediabetes vs. T2DM) among 310 cytokines. Finally, we selected protein Z (PROZ) and validated this finding to determine its association with prediabetes. Plasma PROZ levels were found to be decreased in patients with prediabetes (1,490.32 +/- 367.19 pg/mL) and T2DM (1,583.34 +/- 465.43 pg/mL) compared to those in subjects with normoglycemia (1,864.07 +/- 450.83 pg/mL) (P<0.001). There were significantly negative correlations between PROZ and fasting plasma glucose (P =0.001) and hemoglobin Alc (P=0.010). Conclusion: PROZ levels were associated with prediabetes and T2DM. We suggest that PROZ may be a promising biomarker for the early detection of prediabetes. Further large-scale studies are needed to evaluate the relationship and mechanism between PROZ and prediabetes and T2DM.

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