Two Important Players for Type 2 Diabetes Mellitus: Metrnl and Asprosin.

BACKGROUND: The prevalence of diabetes mellitus (DM) is rapidly increasing worldwide. Metrnl and asprosin are the new adipomyokins that can increase glucose tolerance and affect insulin resistance. Based on this information, we aimed to identify the possible relationship between T2DM and asprosin, Metrnl levels and insulin resistance. METHODS: Our study consisted of a group of 60 patients (female: 30/male: 30) who were newly diagnosed with T2DM and did not take any medications and a control group of 60 healthy (female: 31 - male: 29) individuals. RESULTS: We found that serum Metrnl levels were significantly lower in the diabetic group than in the control group (p < 0.01). In contrast, serum asprosin levels were significantly higher in the diabetic group compared to the control group (p < 0.01). We found a positive correlation between asprosin levels and HOMA-IR, insulin, BMI, and triglyceride levels in the patient group. On the contrary, we found a negative correlation between Metrnl levels and HOMA-IR, insulin, triglyceride, glucose levels. CONCLUSIONS: In the literature review, we could not find a comparison study on the relationship between T2DM, Metrnl, asprosin levels, and HOMA-IR in humans. As far as we know, this study will be the first report in which both adipokine/adipomyokine are compared and associated with HOMA-IR. Asprosin levels in patients with T2DM are higher than healthy people, and Metrnl levels are lower. These two molecules (Metrnl and asprosin) have the ability to be an early warning signal of insulin resistance for T2DM.

Clinical review of 23 patients with tuberculous peritonitis: presenting features and diagnosis.

OBJECTIVE: To better identify which clinical, laboratory, radiological and invasive procedures were most useful in diagnosing tuberculous peritonitis and to assess the methods in order to reach the diagnosis in future cases. METHODS: Tuberculous peritonitis cases diagnosed between 2000 and 2006 were reviewed retrospectively. Their clinical presentation, physical examination, laboratory and diagnostic methods were evaluated. RESULTS: Twenty-three cases oftuberculous peritonitis were diagnosed. The mean age of the patients were 30 +/- 11 years and 16 were women. The mean duration of symptoms prior to diagnosis was 3.6 months. All patients presented with abdominal pain. Abdominal swelling (91.3%), loss of appetite (87%) and weight loss (82.6%) were the other commonest symptoms. The major physical findings were ascites (78.3%) and fever (60.9%). The serum ascites albumin gradient was < 1.1 g/dL in all. An ascites fast bacilli smear was positive in 12 (52.2%) patients. Skin tests with purified protein derivative, adenosine deaminase and polymerase chain reaction were performed in seven, four and five patients, respectively. The tuberculous culture was positive in only two. The most common radiological findings were ascites (100%) and omental involvement (65.2%). A laparoscopy was performed in nine of 23 patients. A total of 22 patients completed anti-tuberculous therapy successfully and were cured, except one with cirrhosis. CONCLUSION: Tuberculous peritonitis may be fatal but is medically cured if diagnosed in a timely fashion. Although both non-invasive and invasive tests have additional benefits, clinician suspicion is still the first step for the diagnosis of tuberculous peritonitis.