Amylin and parameters of carbohydrate and lipid metabolism in patients with type 2 diabetes mellitus in the Azerbaijani population

Background. Type 2 diabetes mellitus (T2DM) and obesity are two interrelated and mutually aggravating metabolic diseases that are attracting more and more attention of researchers every day. Insulin and amylin in relation to glucose perform the same role. But in relation to lipids, the action of these hormones is contradictory: insulin as an anabolic increases fat mass, and amylin, on the contrary, reduces weight. Perhaps, this can explain the absence of T2DM in some patients with obesity. The purpose of the study was to evaluate the level of amylin and its association with the parameters of carbohydrate and lipid metabolism in patients with T2DM in the Azerbaijani population. Materials and methods. The study involved 88 patients with T2DM and obesity, the average age was 51.01 ± 7.34 years. The duration of T2DM was 7.14 ± 2.14 years. Results. Amylin in patients with T2DM was on average significantly lower (by 71.4 %) compared to the control value (p < 0.001). Hypoamylinemia was observed in 89.7 % of patients, and hyperamylinemia — in 10.3 % of patients. In hypoamylinemia, the amylin level is significantly reduced (21.10 ± 7.05 pmol/l) compared to both the control (50.40 ± 3.12) and the hyperamylinemia group (50.83 ± 6.75; p < 0.05). This is expected, since this indicator is the basis for identifying the groups. In both groups of patients (with hypo- and hyperamylinemia), the insulin concentration is higher than in the control (22.99 and 22.37 vs. 13.5 μU/ml). Hypo- and hyperamylinemia are associated with severe disorders of carbohydrate and lipid metabolism, but the nature of these disorders differs. Correlation analysis revealed a more active participation of amylin in metabolic regulation, as evidenced by positive relationships with body mass index, C-peptide, total cholesterol, low-density lipoprotein and a particularly pronounced positive correlation with high-density lipoprotein, as well as negative relationships with triglycerides and insulin. Conclusions. Hypo- and hyperamylinemia represent different stages of the pathogenetic process: from compensatory hypersecretion of amylin against the background of insulin resistance to subsequent depletion of β-cells and the development of hypoamylinemia with severe metabolic decompensation.