title: Effect of Metformin Therapy on Serum Fetuin Levels in Insulin Resistant Type 1 Diabetics.
abstract: BACKGROUND
  Insulin resistance may develop with Type 1 diabetes. Insulin resistance is currently recognized by the estimated glucose disposal rate. Serum fetuin has been accused as a risk factor for metabolic syndrome.
  
  
  OBJECTIVE
  To determine the relationship between the serum fetuin and insulin resistance in Type 1 diabetes subjects and the effect of short-term Metformin therapy on this relationship.
  
  
  METHODS
  40 T1DM male ≥ 18 years of age were screened for insulin resistance (defined using estimated glucose disposal rate). 20 subjects (Group I) were insulin resistant with a mean estimated glucose disposal rate of (7.15±0.37 mg/kg/min) while 20 subjects (Group II) were non-insulin resistant with a mean estimated glucose disposal rate of (9.08±0.42 mg/kg/min). Fasting blood sugar, 2 hours-post prandial blood sugar, HbA1c%, C-peptide, lipid profile, highly sensitive-C reactive protein, and serum fetuin were assessed. Group I were given 1gm Metformin twice daily for 3 months as an add-on to their insulin regimen. All anthropometric and laboratory parameters were reassessed at the end of the 3 months.
  
  
  RESULTS
  Group I had a higher age, BMI and waist/hip ratio, FBS, PPBS, HbA1c%, TC, LDL-C, TG, Hs-CRP and serum fetuin (ρ ≤ 0.001), and a lower C-peptide (ρ=0.001). Fetuin showed a positive correlation with age, FBS, HbA1c%, and Hs-CRP. After Metformin therapy, FBS, PPB and HbA1c%, Hs- CRP and fetuin decreased (ρ≤0.001) while eGDR and insulin dose in units/kg increased (ρ <0.001). Correlation after Metformin therapy within Group I showed that eGDR was inversely related with FBS and PPBS and fetuin showed a positive correlation with Hs-CRP.
  
  
  CONCLUSIONS
  Serum fetuin was elevated in insulin resistant T1DM, yet this was not associated with eGDR. Levels of fetuin-A and HsCRP decreased after Metformin therapy.
authors.affiliation: Internal Medicine - Endocrinology and Metabolism unit, Ain-Shams University, Cairo, Egypt.
authors.forename: Nermin A
authors.initials: NA
authors.lastname: Sheriba
authors.affiliation: Internal Medicine - Endocrinology and Metabolism unit, Ain-Shams University, Cairo, Egypt.
authors.forename: Iman Z
authors.initials: IZ
authors.lastname: Ahmed
authors.affiliation: Internal Medicine - Endocrinology and Metabolism unit, Ain-Shams University, Cairo, Egypt.
authors.forename: Mona M
authors.initials: MM
authors.lastname: Abdelsalam
authors.affiliation: Internal Medicine - Endocrinology and Metabolism unit, Ain-Shams University, Cairo, Egypt.
authors.forename: Yara M
authors.initials: YM
authors.lastname: Eid
authors.affiliation: Internal Medicine - Endocrinology and Metabolism unit, Ain-Shams University, Cairo, Egypt.
authors.forename: Maram M
authors.initials: MM
authors.lastname: Mahdy
authors.affiliation: Internal Medicine - Endocrinology and Metabolism unit, Ain-Shams University, Cairo, Egypt.
authors.forename: Hany K
authors.initials: HK
authors.lastname: Mansour
mesh_terms: D000293:Adolescent; D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism*; D004359:Drug Therapy, Combination; D060748:Fetuins / Q000378:metabolism*; D006801:Humans; D007328:Insulin / Q000008:administration & dosage; D007333:Insulin Resistance; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism; D008687:Metformin / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D060748:Fetuins; D007328:Insulin; D008687:Metformin
keywords: Diabetes mellitus type 1; HsCRP; cardiovascular
  diseases; estimated glucose disposal rate; fetuin-A; insulin resistance.