Circulating IRAPe, Irisin, and IL-34 in Relation to Insulin Resistance in Patients With Type 2 Diabetes.

Abstract Purpose This study aimed to evaluate the role of the extracellular part of insulin-regulated aminopeptidase (IRAPe), interleukin (IL)-34, irisin, and visfatin in the development of insulin resistance (IR) in patients with type 2 diabetes mellitus (T2DM). Methods This observational parallel-group study was conducted in 60 subjects without T2DM who served as a control group and 60 patients with newly diagnosed T2DM. The 2 groups were matched for age, sex ratio, and body mass index. Anthropometric parameters; fasting blood glucose; fasting plasma insulin; Homeostatic Model Assessment for IR (HOMA-IR) index; glycated hemoglobin (HbA1c); and circulating levels of IL-34, visfatin, irisin, and IRAPe were assessed. Results The group with T2DM showed significantly higher IL-34 and visfatin levels and significantly lower irisin and IRAPe levels as compared to the healthy control group. IL-34 and visfatin were significantly positively correlated with fasting blood glucose, fasting plasma insulin, HOMA-IR, and HbA1c. On the other hand, irisin and IRAPe were significantly negatively correlated with fasting blood glucose, fasting plasma insulin, HOMA-IR, and HbA1c. IL-34 was positively associated with visfatin, while negatively associated with both irisin and IRAPe. Implications IL-34, visfatin, irisin, and IRAPe may play a vital role in T2DM and in diabetes-associated IR. Additionally, IRAPe may represent a useful and direct marker for use in the detection of IR in the diabetic population. ClinicalTrials.gov identifier: NCT04107259.