Key words: Diabetes mellitus; insulin resistance; oncostatin M; metabolic syndrome

Background: Much research has demonstrated that there is a relation between depression and chronic diseases. Type 2 diabetes mellitus (T2DM) is one of the most common chronic diseases, and it is an expanding global health problem. This study aims to explore the relationship between glycemic control (GC), antidiabetic agents, and depression in T2DM, focusing on how depression affects treatment adherence and GC. Methods: This prospective study included 250 patients with T2DM. Demographic information and laboratory results were obtained from the patients as well as from the hospital’s laboratory system. Beck’s Depression Inventory (BDI) scores, GC indicator HbA1c levels, and antidiabetic agents used by the patients were compared. Results: Upon analyzing the findings, we found a statistically significant positive correlation between the severity of depression and HbA1c levels (p < 0.001). Additionally, no significant relationship was observed between depression and the use of oral antidiabetic medications, except for metformin. However, a significant association between depression and insulin use was found even in patients with good GC (p < 0.001), regardless of whether HbA1c was high. Conclusions: Regardless of the type of antidiabetic treatment, diabetic patients receiving intensive insulin therapy, whether they have good or poor GC, should be carefully evaluated for depressive symptoms. Appropriate psychiatric support should be provided to help achieve GC and enhance their quality of life. Our study is the first to emphasize the importance of close monitoring for diabetic patients using insulin, even those with good GC. Understanding these interactions may improve disease management, patient outcomes, and quality of life.

Apelin is a peptide known for its insulin-sensitizing effect. This study aimed to examine the relationship between apelin and fatty liver disease. Non-diabetic patients were evaluated by ultrasound in this prospective, single-center, case-control study between 1 April 2020 and 1 April 2021. Serum apelin levels were measured, and the relationship with ultrasonography results and degree of hepatosteatosis was examined. Statistical analysis was carried out using NCSS 2007. This study was conducted with 80 non-diabetic participants, 53 females and 27 males. The mean age of the cases was 40.55 ± 13.82 (interquartile range = 27–51) years, and their mean body mass index (BMI) was 29.34 ± 7.44 (interquartile range = 23.4–35.2) kg/m². There was no hepatosteatosis according to ultrasound in 42% (n = 34) of the cases. When patients with or without hepatosteatosis were compared, there was no difference in terms of gender, alanine aminotransferase (ALT), and hemoglobin levels, whereas fasting blood glucose (FBG), HOMA-IR, triglycerides, LDL-cholesterol, BMI, creatinine, and age were higher in the group with hepatosteatosis. Apelin was found to be lower in patients with non-diabetic hepatosteatosis than in those without hepatosteatosis ( p = .001). As the degree of fatty liver increased, the apelin level decreased further. There was also a negative correlation between apelin and age. However, the relationship between apelin and hepatosteatosis was independent of age. In non-diabetic patients with fatty liver disease, compared to those without fatty liver disease, serum apelin level was lower and was negatively correlated with the degree of steatosis, independent of age.

Background: Laminin, one of the largest glycoproteins of the basement membrane, is an important component of the extracellular matrix. Functions of the basement membrane include regulation of cell signaling behaviors and structural support. Laminin plays a critical role in the regulation of insulin action in muscle, liver, and adipose tissue. The study mainly investigates an association between the change in serum laminin levels and insulin resistance and non-alcoholic hepatosteatosis. Methods: This prospective study included a total of 90 participants; 60 patients diagnosed with Grade 2–3 non-alcoholic hepatosteatosis and 30 age- and sex-matched healthy controls between December 2019 and December 2020. Routine laboratory tests including glucose, insulin, homeostatic model of assessment-insulin resistance (HOMA-IR), alanine aminotransferase (ALT), aspartate aminotransferase (AST), triglyceride, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and C-reactive protein and laminin levels were measured in the serum of the patient and control groups. Enzyme-linked immunosorbent assay was used for the measurement of laminin levels. Results: The median serum laminin levels were lower in patients with hepatic steatosis, compared to the control group (72 ng/L vs. 82 ng/L, respectively; p = 0.003). In the patients with insulin resistance, median laminin levels were lower, regardless of the presence of non-alcoholic hepatosteatosis (67 ng/L vs. 85 ng/L, respectively; p = 0.007). There was a weak, negative correlation between the laminin levels and HOMA-IR. Conclusions: Our study results suggest that, although there is no exact link between laminin and non-alcoholic hepatosteatosis, serum laminin levels are lower in patients with insulin resistance by regulating the insulin effect through integrins.