title: Relation of Osteoprotegerin, Visfatin and Ghrelin to Metabolic Syndrome in Type 2 Diabetic Patients.
abstract: BACKGROUND
  It is now realized that insulin resistance plays a principal role in initiating the pathologic manifestations of the metabolic syndrome (MetS).
  
  
  OBJECTIVE
  The aim of this study was to assess the possible role of osteoprotegerin, visfatin and ghrelin in the pathogenesis of MetS among type 2 diabetes mellitus (T2DM).
  
  
  METHODS
  Serum blood samples were obtained from 116 subjects (39 T2DM; 48 T2DM with MetS; 29 healthy controls). Glycemic status and lipid profile were assessed by enzymatic method. Osteoprotegerin, visfatin, ghrelin and insulin were measured by ELISA method.
  
  
  RESULTS
  Osteoprotegerin and visfatin were significantly higher, while ghrelin was significantly lower in diabetic patients compared to healthy control group (p<0.05). Moreover, Osteoprotegerin and visfatin showed significant higher levels in T2DM patients with MetS than those without MetS (p<0.05). The best cut-off values for the investigated markers were determined by ROC curve. Osteoprotegerin (1.06 ng/mL), visfatin (32.27 ng/mL) and ghrelin (33.65 pg/mL) presented sensitivity of 76%, 92% and 39.1%; respectively and specificity of 41%, 69.2% and 62.9%; respectively, in predicting MetS among T2DM. Among the investigated parameters, Visfatin was the one which predicts MetS among diabetic patients [AUC=0.88, p<0.05].
  
  
  CONCLUSIONS
  Osteoprotegerin, visfatin and ghrelin might be implicated in the pathogenesis of diabetes. Moreover, osteoprotegerin and visfatin may have additional potential role in the development of the metabolic syndrome. Visfatin was superior among studied parameters in predicting MetS among T2DM.
authors: Department of Biochemistry, Faculty of Medicine, Qassim University, KSA, Permanent address: Medical Biochemistry Dept., Faculty of Medicine, Ain Shams University Cairo, Egypt.
authors: Manal Basyouni
authors: MB
authors: Ahmed
authors: Department of Biochemistry, Faculty of Medicine, Qassim University, KSA, Permanent address: Medical Biochemistry Dept., Faculty of Medicine, Ain Shams University Cairo, Egypt.
authors: Maha Imam Ahmed
authors: MI
authors: Ismail
authors: Department of Biochemistry, Faculty of Medicine, Assuit University, Assuit, Egypt.
authors: Abdel-Raheim M
authors: AR
authors: Meki
keywords: Diabetes; Ghrelin; Insulin Resistance; Osteoprotegerin; Type 2 diabetes mellitus and Metabolic Syndrome; Visfatin