Fetuin A in Adolescents with Early-Onset and Long-Duration Type 1 Diabetes

Presentation Number: MON 507
Date of Presentation: April 3rd, 2017

Christina Reinauer1, Thomas Reinehr2, Christina Bächle3, Beate Karges4, Julia Seyfarth1, Katharina Förtsch1, Martin Schebek5, Joachim Wölfle6, Michael W. Roden7, Reinhard W. Holl8, Joachim Rosenbauer9 and Thomas Meissner*10
1University Children's Hospital, Heinrich Heine University Düsseldorf, Düsseldorf, Germany, 2University of Witten-Herdecke, Datteln, Germany, 3German Diabetes Center, Leibniz Center at Heinrich Heine University, Düsseldorf, Germany, 4RWTH Aachen University, German Center for Diabetes Research (DZD), Aachen, Germany, 5Children’s Hospital Kassel, Kassel, Germany, 6University Hospital Bonn, Bonn, Germany, 7German Diabetes Center, Leibniz Center at Heinrich Heine University Düsseldorf, German Center for Diabetes Research (DZD), Düsseldorf, Germany, 8University of Ulm, German Center for Diabetes Research (DZD), Ulm, Germany, 9German Diabetes Center, Leibniz Center at Heinrich Heine University, German Center for Diabetes Research (DZD), Düsseldorf, Germany, 10University Children's Hospital, Heinrich Heine University Düsseldorf, German Center for Diabetes Research (DZD), Düsseldorf, Germany

Abstract

Introduction:

The hepatokine Fetuin A is upregulated in hepatic steatosis, insulin resistance, the metabolic syndrome and in type 2 diabetes (T2D). Its possible involvement in the pathogenesis of insulin resistance and T2D or cardiovascular disease has been discussed controversially. The role of Fetuin A in pubertal insulin resistance in normal weight and overweight patients with type 1 diabetes (T1D) is unclear.

Hypothesis and underlying questions the research addresses:

Does Fetuin A correlate with metabolic control or cardiovascular comorbidities in adolescent T1D patients? Is the Fetuin A level associated with insulin requirement?

Overview of experimental design and methodology:

We performed a cross sectional study of circulating Fetuin A in serum from the German pediatric diabetes biobank of 172 adolescent T1D patients with onset of diabetes within the first five years of life and at least ten years’ duration (mean age 16.4 +/- 2.1 years, mean diabetes duration 13.7 +/- 1.9 years). Clinical data were obtained from the German nationwide DPV registry (Diabetes Patienten Verlaufsdokumentation). We assessed the relationships between Fetuin A and metabolic control, insulin treatment, as well as anthropometric data, baseline C-peptide, lipid profile and blood pressure. Fetuin A levels were compared to data from adolescent obese patients with T2D (n=74, mean age 15.3 +/- 1.7 years, [1]).

Major results:

In T1D circulating Fetuin A levels (mean 0.267 ± 0.043 g/l) did not show a correlation with A1c levels, residual c-peptide, age, duration of diabetes, gender, BMI, cholesterol or triglyceride levels, systolic and diastolic RR, nephropathy or retinopathy. Only in overweight (BMI > 90th centile) T1D patients (n=25), we found a positive correlation of Fetuin A levels with insulin dose (r=0.439, p=0.028). Fetuin A levels were higher in overweight patients with insulin requirements above (n=10) than below (n=15) 1 IU/kg bodyweight/d (p=0.043). Both normal weight (0.270 +/- 0.044) and overweight or obese T1D patients (0.253 +/- 0.035) showed significantly lower Fetuin A levels (p<0.0001) than obese T2D adolescents (mean 0.298 +/- 0.041 g/l).

Interpretation of results and conclusions:

In normal weight adolescent T1D patients with early-onset and long-duration disease, Fetuin A levels were not associated with metabolic control. Only in the subgroup of overweight and obese T1D patients, Fetuin A levels correlated with insulin requirements, and might therefore be involved in insulin resistance. Obese patients with T2D showed distinctly higher Fetuin A levels than T1D patients.

 

Nothing to Disclose: CR, TR, CB, BK, JS, KF, MS, JW, MWR, RWH, JR, TM