A case-control study to determination FBXW7 and Fetuin-A levels in patients with type 2 diabetes in Iraq

Background diabetes mellitus (type 2) is a chronic disease characterized by hyperglycemia resulting either from a deficiency of insulin, or decrease insulin action or both. This study focused on determining the new marker F- box and WD repeat domain containing protein 7 (FBXW7) as well as Fetuin -A and their correlation with other parameters in Diabetes mellitus type 2. Methods Sixty diabetes type2 patients were recruited from (National diabetes Center for treatment and Research) at Al Mustansriya University in Iraq during the period (from November 2018-March 2019) with an age range (37-69) years. The patient group was subdivided into two groups: group I (30) newly diagnosed T2DM and group II (30) T2DM (on metformin monotherapy), for comparison, 30 healthy individuals were included as a control. The protein levels (FBXW7, and Fetuin-A) were estimated using quantitative enzyme-linked immunesorbent assay (ELISA). Biochemical parameters; fasting serum glucose (FSG), and lipid profile were measured through spectrophotometrically. Insulin was determined using ELISA kit finally, HbA1c was determined using HPLC. Result Serum levels of FBXW7 protein were significantly higher (p-value = 0.01), whereas, there was no significant difference (p > 0.05) in the level of Fetuin-A in group I as compared to control group. There was no significant difference (p > 0.05) in the levels of both proteins who group II was compared with the control group. On the other hand, FBXW7 level were significantly lower in group II as compared to group I. Fasting blood sugar FSG, glycated hemoglobin HbA1c, body mass index BMI, waist- to-height ratio WHtR, and lipid profile were significantly elevated, except for high density lipoproteins, HDL was decreased in Group I as compared to control group, whereas insulin appeared non-significant (P > 0.05). FBXW7 Protein was negatively correlated to Fetuin -A, HOMA-IR, Insulin concentration, and BMI, whereas positive correlate to FSG, HbA1c, lipid profile, and atherogenic index. According to ROC analysis, the optimal cutoff value for FBXW7 protein was (1.455) ng/ml. Conclusions Levels of FBXW7 and Fetuin-A proteins in sera of Diabetic patients were elevated. FBXW7 was significantly correlated with newly diagnosed patients. Metformin reduces FBXW7 and Fetuin-A levels.

Automated summary

The study found that serum levels of FBXW7 protein were significantly elevated in newly diagnosed patients, while the level of Fetuin-A showed no significant difference compared to the control group. There was also no significant difference in the levels of both proteins in patients on metformin monotherapy compared to the control group.