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Estimation of Apelin Levels in Iraqi Patients with Type II Diabetic Peripheral Neuropathy


  • Hadel Khalid Jaid Department of Chemistry, College of Science for Women, University of Baghdad, Baghdad, Iraq
  • Fayhaa Muqdad Khaleel Department of Chemistry, College of Science for Women, University of Baghdad, Baghdad, Iraq
  • Isam Noori Salman The National Diabetes Center, Mustansiriyah University, Baghdad, Iraq
  • Baydaa Ahmed Abd National Diabetes Center, Mustansiriyah University, Baghdad, Iraq



Apelin, Body Mass Index, Diabetic Peripheral neuropathy, Glycosylated hemoglobin, Lipid profile, Type 2 Diabetes mellitus


Diabetes mellitus type 2 (T2DM) is a chronic and progressive condition, which affects people all around the world. The risk of complications increases with age if the disease is not managed properly. Diabetic neuropathy is caused by excessive blood glucose and lipid levels, resulting in nerve damage. Apelin is a peptide hormone that is found in different human organs, including the central nervous system and adipose tissue. The aim of this study is to estimate Apelin levels in diabetes type 2 and Diabetic peripheral Neuropathy (DPN) Iraqi patients and show the extent of peripheral nerve damage. The current study included 120 participants: 40 patients with Diabetes Mellitus, 40 patients with Diabetic peripheral Neuropathy, and 40 healthy persons as control, the age range of 34-66 years, matched in age and sex. For all groups, fasting blood sugar, lipid profile (Cholesterol, Triglyceride, High-density lipoprotein, Low-density lipoprotein, and very-low-density lipoprotein), HbA1c, serum total Apelin levels, BMI, and Waist to Hip Ratio were calculated. The results showed highly increase in Apelin levels in neuropathy patients 670.4 ± 41.67 pg/ml compared to diabetes patients 247.6 ± 20.37 pg/ml nd healthy people 208.02 ± 8.30 pg/ml with a P value=0.001. Body Mass Index showed increase in diabetic and neuropathy patients compared with control group 31.05 ± 1.01 kg/m2, 31.05 ± 0.73 kg/m2, versus 23.92 ± 0.16 kg/m2, respectively, with a P value=0.001. The result showed a significant increase in lipid profile with p≤0.05, except HDL which showed a significant decrease p≤0.05. The present study concluded that incremented Apelin levels have an important role in Neuropathy pathogenesis and could determine the extent of peripheral nerve damage by the high levels in the blood due to their presence in the central nervous system. Also, increasing BMI, excessive lipid, and duration of disease showed a progressive role in DM and neuropathy and cause damage to the nerves, and play roles in the development of complications.


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Type 2 diabetes: demystifying the global epidemic. Diabetes. 2017 Jun 1; 66(6): 1432-42.

Abed BA, Al-AAraji SB, Salman IN. Estimation of Galanin hormone in patients with newly thyroid dysfunction in type 2 diabetes mellitus. Biochem Cell Arch.2021; 21: 1317

Mellitus D. Diagnosis and classification of diabetes mellitus. Diabetes care. 2005 Jan 1; 28(S37): S5-10.

Khaleel FM, N-Oda N, A Abed B. Disturbance of Arginase Activity and Nitric Oxide Levels in Iraqi Type 2 Diabetes Mellitus. Baghdad Sci J. 2018 Dec 28; 15(2): 189-91.

Liu X, Xu Y, An M, Zeng Q. The risk factors for diabetic peripheral neuropathy: A meta-analysis. PloS one. 2019 Feb 20; 14(2): e0212574

Feldman EL, Nave KA, Jensen TS, Bennett DL. New horizons in diabetic neuropathy: mechanisms, bioenergetics, and pain. Neuron. 2017 Mar 22; 93(6): 1296-313

Su JB, Zhao LH, Zhang XL, Cai HL, Huang HY, Xu F, et al. HbA1c variability and diabetic peripheral neuropathy in type 2 diabetic patients. Cardiovasc Diabetol. 2018 Dec; 17(1): 1-9.

Sun J, Ren J, Zuo C, Deng D, Pan F, Chen R, et al. Circulating apelin, chemerin and omentin levels in patients with gestational diabetes mellitus: a systematic review and meta-analysis. Lipids Health Dis. 2020 Dec; 19(1): 1-5.

Elsehmawy AA, El-Toukhy SE, Seliem NM, Moustafa RS, Mohammed DS. Apelin and chemerin as promising adipokines in children with type 1 diabetes mellitus. Diabetes Metab Syndr Obes. 2019; 12: 383.

Adam F, Khatib AM, Lopez JJ, Vatier C, Turpin S, Muscat A, et al. Apelin: an antithrombotic factor that inhibits platelet function. Blood. 2016 Feb 18; 127(7): 908-20.

Sentinelli F, Capoccia D, Bertoccini L, Barchetta I, Incani M, Coccia F, et al. Search for genetic variant in the apelin gene by resequencing and association study in European subjects. Genet Test Mol Biomark. 2016 Feb 1; 20(2): 98-102.

Kołodziejski PA, Pruszyńska-Oszmałek E, Wojciechowicz T, Sassek M, Leciejewska N, Jasaszwili M, et al. The Role of Peptide Hormones Discovered in the 21st Century in the Regulation of Adipose Tissue Functions. Genes. 2021 May; 12(5): 756.

Hosny SS, Nasr MS, Ibrahim RH, YousryHelal Z. Relation between plasma Apelin level and peripheral neuropathy in Type 2 diabetic patients. Diabetes Metab Syndr. 2019 Jan 1; 13(1): 626-9.

Ali L, Khaleel FM, Emad Ali F. Role of Apelin-13 and Its Relationship with Hormones levels and other Parameters in Iraqi Polycystic Ovary Syndrome patients. Ann Romanian Soc Cell Biol. 2021 Jun 5; 25(6): 8018-24.

Ali SE, Khaleel FM, Ali FE. A Study of Apelin-36 and GST Levels with Their Relationship to Lipid and Other Biochemical Parameters in the Prediction of Heart Diseases in PCOS Women Patients. Baghdad Sci J. 2020 Sep 8; 17(3): 0924-.

Noh H, Lee H, Kim S, Joo J, Suh D, Kim K, et al. The Efficacy of Body Mass Index and Total Body Fat Percent in Diagnosis Obesity according to Menopausal Status. J Menopausal Med. 2019 Apr 1; 25(1): 55-62.

Ubah JC, Nnolim UA, Onyeidu BU. Image-Based Waist-To-Hip Ratio Determinant. IOSR J Comput. Eng. 2020 Oct, 22(5): 28-35

Abdulahi AM, Aguade AE, Yohannis HK. Longitudinal modeling of fasting blood sugar variation over time among adult diabetic patients in case of Adama. Res Sq. 2021.

Fasil A, Biadgo B, Abebe M. Glycemic control and diabetes complications among diabetes mellitus patients attending at University of Gondar Hospital, Northwest Ethiopia. Diabetes Metab Syndr Obes.: targets and therapy. 2019; 12: 75.

Grisold A, Callaghan BC, Feldman EL. Mediators of diabetic neuropathy-is hyperglycemia the only culprit. Curr Opin Endocrinol Diabetes Obes. 2017 Apr; 24(2): 103.

Sangeetha M, and Manikandan R. Prevalence of peripheral neuropathy among diabetic patients in a tertiary care hospital. Int Arch Integr Med. 2019; 6(2): 28-33.

Weykamp C. HbA1c: a review of analytical and clinical aspects. Ann Lab Med. 2013 Nov 1; 33(6): 393-400.

Butler AE, English E, Kilpatrick ES, Östlundh L, Chemaitelly HS, Abu-Raddad LJ, et al. Diagnosing type 2 diabetes using Hemoglobin A1c: a systematic review and meta-analysis of the diagnostic cutpoint based on microvascular complications. Acta Diabetol. 2020 Nov 3: 1-22.

Selvi NM, Nandhini S, Sakthivadivel V, Lokesh S, Srinivasan AR, Sumathi S. Association of Triglyceride–Glucose Index (TyG index) with HbA1c and Insulin Resistance in Type 2 Diabetes Mellitus. Mædica. 2021 Sep; 16(3): 375.

Zhang Y, Yang J, Ye J, Guo Q, Wang W, Sun Y, Zeng Q. Separate and combined associations of physical activity and obesity with lipid-related indices in non-diabetic and diabetic patients. Lipids Health Dis. 2019 Dec; 18(1): 1-9

Al-Fartosy AJ, Awad NA, Abdalemam DJ. Biochemical study of the effect of insulin resistance on adiponectin, lipid profile and some antioxidants elements with relation to obesity in type 2 diabetic patients/Basrah-Iraq. Am J Biochem. 2017; 7(4): 73-82.

Tesfaye S, Chaturvedi N, Eaton SE, Ward JD, Manes C, Ionescu-Tirgoviste C, et al. Vascular risk factors and diabetic neuropathy. N Engl J Med. 2005 Jan 27; 352(4): 341-50.

Lv SY, Chen WD, Wang YD. The apelin/APJ system in psychosis and neuropathy. Front Pharmacol. 2020 Mar 13; 11: 320.

Castan-Laurell I, Dray C, Knauf C, Kunduzova O, Valet P. Apelin, a promising target for type 2 diabetes treatment. Trends Endocrinol Metab. 2012 May 1; 23(5): 234-41.

Chen H, Liu C, Cheng C, Zheng L, Huang K. Effects of apelin peptides on diabetic complications. Curr Protein Pept Sci. 2018 Feb 1; 19(2): 179-89.

Abo El-Hassan MH, El-Kafrawy NA, Korany MA, and Nouh MZ. Evaluation of Apelin Level in Type 2 Diabetic Patients with Peripheral Neuropathy and Nephropathy. Med J Cairo Univ. 2018 Sep 1; 86(September): 2303-9.

Erdem G, Dogru T, Tasci I, Sonmez A, Tapan S. Low plasma apelin levels in newly diagnosed type 2 diabetes mellitus. Exp Clin Endocrinol Diabetes. 2008 May; 116(05): 289-92.

Zhang Y, Shen C, Li X, Ren G, Fan X, Ren F, et al. Low plasma apelin in newly diagnosed type 2 diabetes in Chinese people. Diabetes Care. 2009 Dec 1; 32(12): e150-.

Al-Kuraishy HM, Al-Gareeb AI, Waheed HJ, Al-Maiahy TJ. Differential effect of metformin and/or glyburide on apelin serum levels in patients with type 2 diabetes mellitus: Concepts and clinical practice. J Adv Pharm Technol Res. 2018 Jul; 9(3): 80.

Castan-Laurell I, Dray C, Valet P. The therapeutic potentials of apelin in obesity-associated diseases. Mol Cell Endocrinol. 2021 Jun 1; 529: 111278.

Helmy MY, Hamdy N, Abd El Ghaffar N. Connection between the Plasma Level of Apelin and Diabetic Nephropathy in Type 2 Diabetic Patients. A Case Control Study. Indian J Endocrinol Metab. 2021 Sep; 25(5): 418.

Al-Zaidy GH, Ahmed HS. Study the Role of Serum Apelin, Obesity, and Duration of the Disease in Type 2 Diabetes Mellitus. Iraqi J Comm Med. 2018; 31(4): 148-152.