title: Assessment of Serum VASPIN Levels among Type 2 Diabetes Mellitus Patients with or without Acute Coronary Syndrome.
abstract: BACKGROUND
  Type 2 Diabetes Mellitus (DM) is on the verge of becoming a pandemic in India. Type 2 DM patient have two to four times increased risk of carotid artery disease. Adipokines have been regarded recently as direct link between diabetes and atherosclerosis. Visceral Adipose Tissue Derived Serine Protease Inhibitor (VASPIN); one of the most recently discovered adipokine, inhibits the proteases responsible for insulin resistance, carotid plaque development and rupture. In literature, few studies have addressed the role of VASPIN in pathogenesis of Acute Coronary Syndrome (ACS) in patients with type 2 DM.
  
  
  OBJECTIVE
  To find association between serum VASPIN with lipid profile, creatine kinase-total, creatine kinase-MB, troponin-I, age, height, weight, blood pressure, smoking, family history of ACS and to prove the hypothesis of low serum VASPIN level as predictor of ACS in patients with type 2 DM.
  
  
  METHODS
  Forty-one type 2 DM patients (controls) and 41 type 2 DM patients with ACS (cases) were enrolled in the study. Anthropometric measurements were performed and fasting serum biochemical parameters and VASPIN were measured. The results of cases and controls were compared by student t-test or Mann-Whitney test. All the parameters were correlated with serum VASPIN by Pearson's or Spearman's correlation.
  
  
  RESULTS
  Fasting serum VASPIN concentration was significantly (p< 0.0001) lower in the cases (0.43±0.22 pg/ml) than in the controls (0.83±0.29 pg/ml). Correlation analysis undertaken on all type 2 DM showed that serum VASPIN concentration was negatively correlated with age, waist circumference, hip circumference, systolic and diastolic blood pressure, duration of diabetes, serum Creative Kinase-Total, CK-MB and urea (p< 0.05). Utilizing Receiver Operating Characteristic (ROC) curve, the serum VASPIN level of less than 0.594pg/ml showed greatest risk of ACS among type 2 DM patients (p< 0.0001).
  
  
  CONCLUSIONS
  Type 2 DM patients with low serum vaspin concentration were at risk of ACS independent of other cardiovascular risk factors.
authors.affiliation: Student, Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research , Puducherry, India .
authors.forename: Aswathy Jaya
authors.initials: AJ
authors.lastname: Sathyaseelan
authors.affiliation: Assistant Professor, Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research , Puducherry, India .
authors.forename: Prashant Shankarrao
authors.initials: PS
authors.lastname: Adole
authors.affiliation: Associate Professor, Department of Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research , Puducherry, India .
authors.forename: Mukta
authors.initials: M
authors.lastname: Wyawahare
authors.affiliation: Associate Professor, Department of Medicine, Kanachur Institute of Medical Sciences & Research Center , Mangalore, Andhra Pradesh, India .
authors.forename: Rama Prakasha
authors.initials: RP
authors.lastname: Saya
keywords: Adipokines; Coronary artery disease; Diabetic patients