Association between Nesfatin-1 Levels and C-Peptide in Sera of Obese / Non-Obese Type 2 Diabetic Women

Objective: The aim of the presented word was to assess the diagnostic accuracy of serum Nesfatin-1 in type 2 diabetes mellitus and its relationship with C-peptide level in obese and non-obese type-2 diabetic women of Iraqi population. Methods:  A case-control study was performed on 50 type 2 diabetic patients admitted in Al-Hussein Teaching Hospital and Al-Hassan center of diabetes and endocrinology unit / Kerbala health directorate – Iraq and another 50 control individuals, during the period from April, 2022 – Jan. 2023). The T2DM groups were divided into two groups 25 obese and 25 non-obese; also the control group was divided into 25 obese and 25 non-obese as apparently healthy groups. The ELISA Kit was used to measure serum Nesfatin-1 and C-peptide, and random serum glucose was measured by enzymatic colorimetric method, and lipid profile test were measured through spectrophotometric technique, instead of HbA1c% was determined using HPLC method. Results: The results observed indicated that Nesfatin-1 levels shown a non-significant decrease in all of type 2 diabetic groups as compared with apparently healthy control group, while the C-peptide were significantly decreased in type 2 diabetic patients when compared with apparently control group. In addition, the random blood glucose and HbA1c% were shown significant elevation in type 2 diabetic patients as compared with apparently healthy control groups. The observed data indicated that Nesfatin-1 and C-peptide levels when comparing between type 2 diabetic patients and control in obese groups shown a risk factors depending upon the odd ratio observed (OR = 1.064 (1.011-1.119), 1.0200 (0.992-1.08)) respectively, but only Nesfatin-1 was shown to be significant. In BMI the levels of Nesfatin-1 and C-peptide, as shown the Nesfatin-1 was significant in obese groups, while the C-peptide as shown significant in normal weight groups. The optimal diagnostic points for Nesfatin-1 were (sensitivity = 98%, specificity = 90%) at a level (Cut-off points) = 39.13, while C-Peptide levels: (sensitivity = 98%, specificity = 94%) at a level (Cut-off points) = 15.99.  Both markers have p-values of the AUC were <0.001 and statistically significant. Conclusion: Accordingly, it was concluded that a significant relationship between circulating Nesfatin-1 levels and type 2 diabetes. Nesfatin-1 appears to be able to contribute to the treatment of obesity and diabetes because of its anorexigenic and antihyperglycemic effects. In addition, C-peptide is a known biomarker of insulin resistance and beta-cell function. High specificity and sensitivity analyzed results were obtained by ROC analysis for both markers in T2DM.