Serum periostin as a novel biomarker of metabolic and atherogenic risk in newly diagnosed type 2 diabetes mellitus with dyslipidemia

Abstract

Periostin is an extracellular matrix protein that participates in tissue remodeling and inflammation and may be related to cardiometabolic abnormalities. However, its association with metabolic and lipid disorders in newly diagnosed type 2 diabetes mellitus (T2DM) patients with dyslipidemia is poorly defined. This study evaluated serum periostin and its associations with glycemic, lipid, and atherogenic measures. We also performed exploratory molecular docking to investigate its predicted interactions with metformin and atorvastatin. This was a case-control study with 45 newly diagnosed T2DM patients with dyslipidemia and 45 healthy controls. Serum periostin levels were determined by enzyme-linked immunosorbent assay. Glycemic parameters, lipid profile, markers of kidney function and atherogenic indices were assessed. Between-group comparisons, Pearson correlation analysis, receiver operating characteristic (ROC) analysis and multivariable logistic regression were performed. As an exploratory computational analysis, molecular docking was performed. Serum periostin level was significantly higher in patients with T2DM and dyslipidemia than in healthy control subjects. In the patient group, periostin was positively correlated with fasting blood glucose, HbA1c, total cholesterol, triglycerides, LDL-C, VLDL-C, non-HDL-C and atherogenic index of plasma and negatively correlated with HDL-C. There was no significant association with BMI or creatinine. ROC analysis demonstrated good discrimination ability between patients with T2DM and dyslipidemia and healthy controls (AUC = 0.881). At a cutoff of 9.05 ng/mL, sensitivity was 91.1%, and specificity was 62.2%. Multivariable logistic regression demonstrated a significant association between periostin and case status (OR = 1.833, p < 0.001). Molecular docking indicated interactions with both metformin and atorvastatin. Serum periostin was elevated and correlated with several glycemic and atherogenic lipid parameters in newly diagnosed T2DM with dyslipidemia. These results support the further investigation of periostin as a potential cardiometabolic marker. However, the design of the study is not able to distinguish the independent contributions of T2DM and dyslipidemia. Larger studies in T2DM patients without dyslipidemia and independent validation cohorts are needed. Serum periostin levels were significantly elevated in newly diagnosed T2DM patients with dyslipidemia. Periostin was significantly associated with metabolic and atherogenic risk markers. Serum periostin demonstrated good diagnostic performance for identifying T2DM-related metabolic risk. ROC analysis showed an AUC of 0.881 for serum periostin. Periostin may represent a promising biomarker of metabolic and atherogenic risk in T2DM.