Tip 2 Diyabetli Obez Kadınlarda Serum Fetuin-A Düzeyi ve Diyetin İnflamatuar Yükü Arasındaki İlişkinin Değerlendirilmesi
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This study was conducted to investigate the relationship between inflammatory character of diet and type 2 diabetes risk in diabetic obese women, to examine the possible role of fetuin-A in this relationship, and to determine the effect of fetuin-A on type 2 diabetes risk. The study was conducted in Ankara Dışkapı Yıldırım Beyazıt Training and Research Hospital with a total of 80 people, including voluntary obese diabetic women (case group:40) and obese women without diabetes (control group:40) aged between 30-50 years, with a body mass index (BMI) between 30-35 kg/m2. General nutritional habits, physical activity status, some biochemical and inflammation parameters, nutritional status and dietary inflammatory potential of the diets of the case and control groups were compared. Dietary Inflammatory Index (DII) was used to determine the inflammatory potential of the diet. DII scores of individuals were computed based on dietary intake assessed using a quantitative food consumption frequency questionnaire. In addition to serum fetuin-A levels of individuals, IL-6, hs-CRP and TNF-α were also analyzed. DII scores of the individuals in the case and control groups was found 0,340,84 and -0,260,90, respectively (p<0.05). Fetuin-A (66,5214,87mg/dL), IL-6 (45,4443,32 pg/mL) and TNF-α (3,251,50 pg/mL) levels of individuals in the case group were found to be higher than the control group (p<0,05). A positive correlation was found between DII scores and serum HbA1c, fetuin-A, IL-6 and hs-CRP values of individuals in the case group, and between serum IL-6 and hs-CRP values of individuals in the control group. (p<0.05). A positive significant relationship was determined between the DII scores of the individuals in the case group and consumption of red and processed meat, fruit and oil seeds (p<0.05). A low, negative significant relationship was determined between DII scores of individuals in the case group and dietary polyunsaturated fatty acids, omega-3 and omega-6 fatty acids, vitamin A, vitamin E, thiamine, niacin, vitamin B6 and folic acid, and carotene. (p<0.05). After multivariate adjustment, higher DII scores (consuming a high pro-inflammatory diet) were found to have 2 times higher risk of developing type 2 diabetes (OR=2.043; 95% CI:0.955, 4.371, p=0.066). Higher fetuin-A levels were found to have 1.2 times higher risk of developing type 2 diabetes (OR=1.155; %95 CI: 1.030, 1.296, p=0.014). It has been determined that both fetuin-A and hs-CRP have a significant mediator role in the relationship between DII and HOMA-IR [β=0.371 (95% CI:-0.029-0.770), β=0.424(95% CI:-0.007-0.856), respectively]. Research results, suggest that DII is an effective index in determining the inflammatory character of the diet, that a proinflammatory diet measured by DII affects glucose metabolism, especially insulin resistance through these markers and causes type 2 diabetes. In addition, it has been determined that fetuin-A acts as an important mediator between diet and type 2 diabetes by inducing insulin resistance. As a result, DII may be an important tool for calculating the dietary inflammatory burden of different populations and reducing the risk of chronic inflammation-related diseases, including diabetes. Moreover, prospective longitudinal studies with large sample sizes are needed to investigate the effects of fetuin-A on insulin resistance and its mediator role between diet and type 2 diabetes.