Serum osteocalcin, fibronectin and insulin autoantibodies in patients with diabetes mellitus

ABSTRACT

This study included 80 patients with diabetes mellitus. They were subdivided into 40 patients with IDDM and 40 patients with NIDDM. Each were classified into two groups, 20 patients with complications and 20 without. Ten healthy subjects were also included as controls. Serum osteocalcin was significantly lower [p < 0.001] in all diabetic patients compared with controls, and there was no significant difference between diabetics with complications and patients without complications. No significant correlations were found between serum osteocalcin and either HbA1c, post-prandial blood glucose or the disease duration among the studied patients. Serum fibronectin was significantly higher [p < 0.001] compared with controls, and higher in IDDM than NIDDM and also in complicated than non-complicated patients [p < 0.001]. A significantly positive correlation was found between serum fibronectin with post-prandial blood glucose and duration of the disease. A significant correlation was found between serum fibronectin and HbA1c. Insulin autoantibodies were detected in 67.5% of all IDDM and in 20% NIDDM. Significantly increased levels of IAA in IDDM were found compared with either NIDDM or controls, but no significant difference was found between complicated and non- complicated patients. In conclusion, a decreased serum level of osteocalcin below normal level may be an indicator of diabetic osteopenia and an increased serum fibronectin above normal value can be used to predict early diabetic microvascular complications. IAA can be used to discriminate IDDM patients and determine immunogenecity of insulin used. So, in those with high IAA levels, a non-immunogenic insulin [human insulin] should be used in order to decrease the level of IAA