Serum Preptin as a Potential Hormonal Biomarker of Bone Metabolic Abnormalities in Children with Type1 Diabetes Mellitus

Abstract

Type1 diabetes mellitus (T1DM) is linked to multiple systemic complications, including disruptions in bone metabolism complications, such as disruptions in bone metabolism, especially in children at critical stages of growth. Preptin, a peptide hormone released alongside insulin, has recently been identified as a possible regulator of bone formation    possible bone formation regulator. The purpose of the study was to assess the potential of serum preptin as a hormonal biomarker used to detect bone metabolic abnormalities in children with type 1 diabetes mellitus and to determine the relationship between serum preptin and the biochemical parameters and glycemic status. A case-control study was carried out among 50 Iraqi children comprising of 30 T1DM patients and 20 healthy controls. ELISA was used to measure serum preptin levels and by spectrophotometer to measure fasting blood glucose (FBS), alkaline phosphatase (ALP), calcium, and phosphate.  The Student's t-test was used for statistical analysis the statistical significance and receiver operating characteristic (ROC) curve was used to assess the diagnostic performance of preptin. The level of serum preptin was considerably lower in T1DM patients than in controls (p < 0.0001) whereas the level of ALP and FBS were significantly higher (p = 0.0003 and p < 0.0001, respectively). The level of calcium was significantly decreased in patients (p = 0.0249), but no significant difference was observed in phosphate levels. Correlation analysis showed weak correlations between preptin and FBS, and an inverse correlation between preptin and ALP in the patients. ROC analysis showed that preptin has excellent diagnostic performance (AUC = 0.924, sensitivity = 100% and specificity = 93.3%). Preptin levels are significantly reduced in children with T1DM and can be a potential biomarker to detect bone metabolic abnormalities early. Its diagnostic quality and relating to bone-related variables underscores its possible clinical application in the detection of bone metabolic abnormalities associated with T1DM patients.