Association of plasma endocan levels with metabolic parameters and predictive value of endocan for the development of complications in patients with type 2 diabetes mellitus: An observational study

Kenana Ljuca; Mensura Aščerić; Olivera Batić-Mujanović; Svjetlana Loga-Zec; Nadina Ljuca; Emir Bećirović; Samir Bejić; Predrag Jovanović; Minela Bećirović

doi:10.17305/bb.2024.11512

Authors

Kenana Ljuca Department of Gynecology and Obstetrics, University Clinical Center Ljubljana, Ljubljana, Slovenia; Health Center of Sarajevo Canton, Sarajevo, Bosnia and Herzegovina; School of Medicine, University of Tuzla, Tuzla, Bosnia and Herzegovina https://orcid.org/0009-0004-9478-3284
Mensura Aščerić Department of Pharmacology, School of Medicine, University of Tuzla, Tuzla, Bosnia and Herzegovina
Olivera Batić-Mujanović Department of Family Medicine, Health Center of Tuzla, Tuzla, Bosnia and Herzegovina https://orcid.org/0000-0002-1002-0692
Svjetlana Loga-Zec Department of Pharmacology, School of Medicine, University of Sarajevo, Sarajevo, Bosnia and Herzegovina https://orcid.org/0000-0003-1743-5492
Nadina Ljuca School of Medicine, University of Tuzla, Tuzla, Bosnia and Herzegovina https://orcid.org/0009-0008-0832-3644
Emir Bećirović Internal Medicine Clinic, University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina https://orcid.org/0000-0002-4134-987X
Samir Bejić Health Center of Sarajevo Canton, Sarajevo, Bosnia and Herzegovina
Predrag Jovanović Internal Medicine Clinic, University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina https://orcid.org/0000-0001-5547-5159
Minela Bećirović Internal Medicine Clinic, University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina https://orcid.org/0009-0007-4391-5226

DOI:

https://doi.org/10.17305/bb.2024.11512

Keywords:

Endocan, diabetes mellitus type 2, DMT2, metabolic parameters, predictive value

Abstract

The aim of the current research was to investigate the association between plasma endocan levels and metabolic control parameters, as well as to evaluate its predictive value for clinical complications in patients with type 2 diabetes mellitus (DMT2). A total of 100 DMT2 patients participated in this prospective observational study. Plasma endocan levels were significantly elevated in DMT2 patients with HbA1c > 7% (1.38 ± 0.33 vs 0.68 ± 0.23 ng/mL; P < 0.0001), compared to patients with HbA1c ≤ 7%. Patients with plasma endocan concentrations >1.10 ng/mL (median value of 1.10 ng/mL) demonstrated significantly higher levels of metabolic parameters: body mass index (BMI), HbA1c (%), fasting glucose level, LDL cholesterol, total cholesterol, triglycerides, along with significantly lower HDL cholesterol levels. Furthermore, patients with plasma endocan levels >1.10 ng/mL were found to have an increased risk for the following complications: retinopathy (relative risk [RR]: 2.7500; 95% confidence interval [CI]: 1.2150–6.2244; P = 0.0152, nephropathy (RR: 2.0952; 95% CI: 1.2294–3.5710; P = 0.0065), neuropathy (RR: 1.9945; 95% CI: 1.2025–3.3081; P = 0.0075), angina pectoris (RR: 2.4881; 95% CI: 1.0865–5.6979; P = 0.0311, hypertension (RR: 1.1372; 95% CI: 1.0060–1.2856; P = 0.0398), cardiomyopathy (RR: 2.6190; 95% CI: 1.1507–5.9612; P = 0.0218), myocardial infarction (RR: 9.4286; 95% CI: 1.2742–69.7697; P = 0.0280) and stroke (RR: 4.4638; 95% CI: 1.3765–14.4758; P = 0.0127). Correlation analysis revealed that plasma endocan levels were positively correlated with HbA1c (%) (r = 0.856, P < 0.0001), fasting glucose level (r = 0.631, P < 0.0001), LDL (r = 0.347, P = 0.0004), cholesterol (r = 0.282, P = 0.0045), and triglycerides (r = 0.366, P = 0.0002). Conversely, plasma endocan levels were negatively correlated with HDL cholesterol (r = −0.429, P < 0.0001). In conclusion, higher plasma endocan levels were strongly associated with poor metabolic control in DMT2 patients and exhibited significant predictive value for both microvascular and macrovascular complications.