J Endocrinol Metab

Journal of Endocrinology and Metabolism, ISSN 1923-2861 print, 1923-287X online, Open Access

Article copyright, the authors; Journal compilation copyright, J Endocrinol Metab and Elmer Press Inc

Journal website https://www.jofem.org

Original Article

Volume 13, Number 2, June 2023, pages 81-87

Serum Apelin Level in Type 2 Diabetic Mellitus Patients and Its Association With Metabolic Syndrome Components

**Table 1.** Distribution of Frequency and Percentage of Metabolic Syndrome Components in Study Subjects
Metabolic syndrome components	Total subjects (n = 196)
HDL-C: high-density lipoprotein cholesterol.
No abnormal components, n (%)	11 (5.61)
One component (%)	28 (14.28)
High waist circumference	11 (5.61)
Hyperglycemia	5 (2.55)
Hypertriglyceridemia	6 (3.06)
Low HDL-C	6 (3.06)
Two components, n (%)	59 (30.1)
High waist circumference + hyperglycemia	14 (7.14)
High waist circumference + hypertension	2 (1.02)
High waist circumference + hypertriglyceridemia	14 (7.14)
High waist circumference + low HDL-C	16 (8.16)
Hyperglycemia + hypertension	3 (1.53)
Hyperglycemia + hypertriglyceridemia	2 (1.02)
Hyperglycemia + low HDL-C	1 (0.51)
Hypertriglyceridemia + low HDL-C	7 (3.57)
Three components, n (%)	34 (17.34)
High waist circumference + hypertension + hyperglycemia	6 (3.06)
High waist circumference + hyperglycemia + hypertriglyceridemia	5 (2.55)
High waist circumference + hyperglycemia + low HDL-C	5 (2.55)
Hypertension + hyperglycemia + hypertriglyceridemia	6 (3.06)
Hypertension + hyperglycemia + low HDL-C	4 (2.04)
Hyperglycemia + hypertriglyceridemia + low HDL-C	8 (4.08)
Four components, n (%)	53 (27.04)
High waist circumference + hypertension + hyperglycemia + hypertriglyceridemia	8 (4.08)
High waist circumference + hypertension + hyperglycemia + low HDL-C	5 (2.55)
High waist circumference + hyperglycemia + hypertriglyceridemia + low HDL-C	36 (18.36)
Hypertension + hyperglycemia + hypertriglyceridemia + low HDL-C	4 (2.04)
Five components, n (%)	11 (5.61)
High waist circumference + hypertension + hyperglycemia + hypertriglyceridemia + low HDL-C	11 (5.61)

Table 1. Distribution of Frequency and Percentage of Metabolic Syndrome Components in Study Subjects

Metabolic syndrome components

Total subjects (n = 196)

HDL-C: high-density lipoprotein cholesterol.

No abnormal components, n (%)

11 (5.61)

One component (%)

28 (14.28)

High waist circumference

11 (5.61)

Hyperglycemia

5 (2.55)

Hypertriglyceridemia

6 (3.06)

Low HDL-C

6 (3.06)

Two components, n (%)

59 (30.1)

High waist circumference + hyperglycemia

14 (7.14)

High waist circumference + hypertension

2 (1.02)

High waist circumference + hypertriglyceridemia

14 (7.14)

High waist circumference + low HDL-C

16 (8.16)

Hyperglycemia + hypertension

3 (1.53)

Hyperglycemia + hypertriglyceridemia

2 (1.02)

Hyperglycemia + low HDL-C

1 (0.51)

Hypertriglyceridemia + low HDL-C

7 (3.57)

Three components, n (%)

34 (17.34)

High waist circumference + hypertension + hyperglycemia

6 (3.06)

High waist circumference + hyperglycemia + hypertriglyceridemia

5 (2.55)

High waist circumference + hyperglycemia + low HDL-C

5 (2.55)

Hypertension + hyperglycemia + hypertriglyceridemia

6 (3.06)

Hypertension + hyperglycemia + low HDL-C

4 (2.04)

Hyperglycemia + hypertriglyceridemia + low HDL-C

8 (4.08)

Four components, n (%)

53 (27.04)

High waist circumference + hypertension + hyperglycemia + hypertriglyceridemia

8 (4.08)

High waist circumference + hypertension + hyperglycemia + low HDL-C

5 (2.55)

High waist circumference + hyperglycemia + hypertriglyceridemia + low HDL-C

36 (18.36)

Hypertension + hyperglycemia + hypertriglyceridemia + low HDL-C

4 (2.04)

Five components, n (%)

11 (5.61)

High waist circumference + hypertension + hyperglycemia + hypertriglyceridemia + low HDL-C

11 (5.61)

**Table 2.** Demographic and Biochemical Characteristics of the Study Population
Parameters	With MetS (n = 98)	Without MetS (n = 98)	P-value
Data are presented as mean ± standard deviation. Mann-Whitney tests were applied. *P-value < 0.01 is highly significant. BMI: body mass index; DBP: diastolic blood pressure; FBG: fasting blood glucose; HDL-C: high-density lipoprotein cholesterol; MetS: metabolic syndrome; SBP: systolic blood pressure; TG: triglyceride; WC: waist circumference.
Age (years)	47.24 ± 10.70	46.75 ± 14.80	0.234
BMI (kg/m²)	26.68 ± 5.30	26.5 ± 5.10	0.762
WC (cm)	105.10 ± 10.40	97.68 ± 13.60	< 0.001*
SBP (mm Hg)	126.0 ± 20.10	118.05 ± 15.18	0.002*
DBP (mm Hg)	81.90 ± 10.62	6.44 ± 6.94	< 0.001*
FBG (mg/dL)	173.80 ± 61.51	118.87 ± 65.20	< 0.001*
TG (mg/dL)	197.17 ± 88.10	128.84 ± 55.20	< 0.001*
HDL-C (mg/dL)	42.41 ± 9.29	46.7 ± 9.70	< 0.001*
Apelin (ng/mL)	229.18 ± 151. 24	429.90 ± 167.06	< 0.001*

Table 2. Demographic and Biochemical Characteristics of the Study Population

Parameters

With MetS (n = 98)

Without MetS (n = 98)

P-value

Data are presented as mean ± standard deviation. Mann-Whitney tests were applied. *P-value < 0.01 is highly significant. BMI: body mass index; DBP: diastolic blood pressure; FBG: fasting blood glucose; HDL-C: high-density lipoprotein cholesterol; MetS: metabolic syndrome; SBP: systolic blood pressure; TG: triglyceride; WC: waist circumference.

Age (years)

47.24 ± 10.70

46.75 ± 14.80

0.234

BMI (kg/m²)

26.68 ± 5.30

26.5 ± 5.10

0.762

WC (cm)

105.10 ± 10.40

97.68 ± 13.60

< 0.001*

SBP (mm Hg)

126.0 ± 20.10

118.05 ± 15.18

0.002*

DBP (mm Hg)

81.90 ± 10.62

6.44 ± 6.94

< 0.001*

FBG (mg/dL)

173.80 ± 61.51

118.87 ± 65.20

< 0.001*

TG (mg/dL)

197.17 ± 88.10

128.84 ± 55.20

< 0.001*

HDL-C (mg/dL)

42.41 ± 9.29

46.7 ± 9.70

< 0.001*

Apelin (ng/mL)

229.18 ± 151. 24

429.90 ± 167.06

< 0.001*

**Table 3.** Demographic and Biochemical Characteristics of Male Subjects
Parameters	With MetS (n = 27)	Without MetS (n = 31)	P-value
Data are presented as mean ± standard deviation. Mann-Whitney tests were applied. P-value < 0.01 is highly significant. *P-value < 0.05 is significant. BMI: body mass index; DBP: diastolic blood pressure; FBG: fasting blood glucose; HDL-C: high-density lipoprotein cholesterol; MetS: metabolic syndrome; SBP: systolic blood pressure; TG: triglyceride; WC: waist circumference.
Age (years)	47.8 ± 11.6	44.03 ± 4.59	0.307
BMI (kg/m²)	28.77 ± 5.98	26.33 ± 4.65	0.058
WC (cm)	104.63 ± 9.17	99.58 ± 12.14	0.144
SBP (mm Hg)	124.26 ± 18.23	119.35 ± 15.3	0.097
DBP (mm Hg)	80.41 ± 9.93	75.9 ± 6.89	0.055
FBG (mg/dL)	171.5 ± 58.5	126.6 ± 79.5	< 0.001*
TG (mg/dL)	214.4 ± 108.68	151.68 ± 61.5	0.008*
HDL-C (mg/dL)	37.93 ± 6.0	41.58 ± 6.49	0.046**
Apelin (ng/mL)	203.66 ± 130.82	433.82 ± 209.32	< 0.001*

Table 3. Demographic and Biochemical Characteristics of Male Subjects

Parameters

With MetS (n = 27)

Without MetS (n = 31)

P-value

Data are presented as mean ± standard deviation. Mann-Whitney tests were applied. *P-value < 0.01 is highly significant. **P-value < 0.05 is significant. BMI: body mass index; DBP: diastolic blood pressure; FBG: fasting blood glucose; HDL-C: high-density lipoprotein cholesterol; MetS: metabolic syndrome; SBP: systolic blood pressure; TG: triglyceride; WC: waist circumference.

Age (years)

47.8 ± 11.6

44.03 ± 4.59

0.307

BMI (kg/m²)

28.77 ± 5.98

26.33 ± 4.65

0.058

WC (cm)

104.63 ± 9.17

99.58 ± 12.14

0.144

SBP (mm Hg)

124.26 ± 18.23

119.35 ± 15.3

0.097

DBP (mm Hg)

80.41 ± 9.93

75.9 ± 6.89

0.055

FBG (mg/dL)

171.5 ± 58.5

126.6 ± 79.5

< 0.001*

TG (mg/dL)

214.4 ± 108.68

151.68 ± 61.5

0.008*

HDL-C (mg/dL)

37.93 ± 6.0

41.58 ± 6.49

0.046**

Apelin (ng/mL)

203.66 ± 130.82

433.82 ± 209.32

< 0.001*

**Table 4.** Demographic and Biochemical Characteristics of Female Subjects
Parameters	With MetS (n = 71)	Without MetS (n = 67)	P-value
Data are presented as mean ± standard deviation. Mann-Whitney tests were applied. *P-value < 0.01 is highly significant. BMI: body mass index; DBP: diastolic blood pressure; FBG: fasting blood glucose; HDL-C: high-density lipoprotein cholesterol; MetS: metabolic syndrome; SBP: systolic blood pressure; TG: triglyceride; WC: waist circumference.
Age (years)	49.62 ± 10.23	47.90 ± 14.96	0.114
BMI (kg/m²)	27.16 ± 5.12	26.60 ± 5.34	0.241
WC (cm)	105.30 ± 10.97	96.80 ± 14.53	< 0.001*
SBP (mm Hg)	126.6 ± 20.96	117.40 ± 15.18	0.003*
DBP (mm Hg)	82.50 ± 10.98	76.60 ± 7.0	0.002*
FBG (mg/dL)	174.60 ± 63	115.20 ± 57.85	< 0.001*
TG (mg/dL)	190.50 ± 78.8	118.20 ± 49.0	< 0.001*
HDL-C (mg/dL)	47.30 ± 26.7	50.20 ± 13.59	0.002*
Apelin (ng/mL)	238.90 ± 158.8	428.20 ± 145.2	< 0.001*

Table 4. Demographic and Biochemical Characteristics of Female Subjects

Parameters

With MetS (n = 71)

Without MetS (n = 67)

P-value

Age (years)

49.62 ± 10.23

47.90 ± 14.96

0.114

BMI (kg/m²)

27.16 ± 5.12

26.60 ± 5.34

0.241

WC (cm)

105.30 ± 10.97

96.80 ± 14.53

< 0.001*

SBP (mm Hg)

126.6 ± 20.96

117.40 ± 15.18

0.003*

DBP (mm Hg)

82.50 ± 10.98

76.60 ± 7.0

0.002*

FBG (mg/dL)

174.60 ± 63

115.20 ± 57.85

< 0.001*

TG (mg/dL)

190.50 ± 78.8

118.20 ± 49.0

< 0.001*

HDL-C (mg/dL)

47.30 ± 26.7

50.20 ± 13.59

0.002*

Apelin (ng/mL)

238.90 ± 158.8

428.20 ± 145.2

< 0.001*

**Table 5.** Correlations of Apelin With Study Parameters in Subjects With and Without MetS
Parameters	With MetS (n = 98)	Without MetS (n = 98)
Correlation-Spearman tests were applied. *P-value < 0.01 is highly significant. BMI: body mass index; DBP: diastolic blood pressure; FBG: fasting blood glucose; HDL-C: high-density lipoprotein cholesterol; MetS: metabolic syndrome; SBP: systolic blood pressure; TG: triglyceride; WC: waist circumference.
Age (years)	0.276	0.345	-0.357	0.245
BMI (kg/m²)	0.030	0.767	0.130	0.201
WC (cm)	0.290	0.778	-0.021	0.838
SBP (mm Hg)	-0.003	0.975	-0.126	0.214
DBP (mm Hg)	0.079	0.443	0.113	0.270
FBG (mg/dL)	-0.294	0.003*	-0.166	0.129
TG (mg/dL)	-0.005	0.957	0.384	0.364
HDL-C (mg/dL)	0.199	0.086	-0.045	0.661

Table 5. Correlations of Apelin With Study Parameters in Subjects With and Without MetS

Parameters

With MetS (n = 98)

Without MetS (n = 98)

P-value

Correlation-Spearman tests were applied. *P-value < 0.01 is highly significant. BMI: body mass index; DBP: diastolic blood pressure; FBG: fasting blood glucose; HDL-C: high-density lipoprotein cholesterol; MetS: metabolic syndrome; SBP: systolic blood pressure; TG: triglyceride; WC: waist circumference.

Age (years)

0.276

0.345

-0.357

0.245

BMI (kg/m²)

0.030

0.767

0.130

0.201

WC (cm)

0.290

0.778

-0.021

0.838

SBP (mm Hg)

-0.003

0.975

-0.126

0.214

DBP (mm Hg)

0.079

0.443

0.113

0.270

FBG (mg/dL)

-0.294

0.003*

-0.166

0.129

TG (mg/dL)

-0.005

0.957

0.384

0.364

HDL-C (mg/dL)

0.199

0.086

-0.045

0.661

**Table 6.** Correlation of Apelin With Study Parameters According to Sex With MetS
Parameters	Male	Female
Correlation-Spearman tests were applied. *P-value < 0.01 is highly significant. BMI: body mass index; DBP: diastolic blood pressure; FBG: fasting blood glucose; HDL-C: high-density lipoprotein cholesterol; MetS: metabolic syndrome; SBP: systolic blood pressure; TG: triglyceride; WC: waist circumference.
Age (years)	-0.235	0.076	-0.111	0.197
BMI (kg/m²)	0.009	0.949	-0.135	0.114
WC (cm)	-0.067	0.618	-0.201	0.180
SBP (mm Hg)	-0.138	0.301	-0.269	0.128
DBP (mm Hg)	-0.143	0.285	-0.089	0.300
FBG (mg/dL)	-0 .473	< 0.001*	-0.311	< 0.001*
TG (mg/dL)	-0.222	0.094	-0.124	0.148
HDL-C (mg/dL)	0.313	0.067	0.105	0.219

Table 6. Correlation of Apelin With Study Parameters According to Sex With MetS

Parameters

Male

Female

P-value

Age (years)

-0.235

0.076

-0.111

0.197

BMI (kg/m²)

0.009

0.949

-0.135

0.114

WC (cm)

-0.067

0.618

-0.201

0.180

SBP (mm Hg)

-0.138

0.301

-0.269

0.128

DBP (mm Hg)

-0.143

0.285

-0.089

0.300

FBG (mg/dL)

-0 .473

< 0.001*

-0.311

< 0.001*

TG (mg/dL)

-0.222

0.094

-0.124

0.148

HDL-C (mg/dL)

0.313

0.067

0.105

0.219