Irisin level in type 2 diabetic patients and its relation to glycemic control and diabetic complications

  • Hemmat El Haddad
  • Heba Sedrak
  • Mervat NaguibEmail author
  • Elham Yousief
  • Dalia R. Ibrahim
  • Rasha M. Abdel Samie
  • Ahmed Hamdy
Original Article



Irisin is a new myokin and adipokine related to human obesity and insulin resistance status.


To investigate whether serum irisin is related to glycemic indicators and micro and macrvascular complications in patients with T2DM.


The study included 60 T2DM patients and 30 healthy controls. Anthropometric measures, neurological assessment, and fundus examination were done to all patients. Correlations of serum irisin and blood glucose, glycosylated hemoglobin (HbA1C), urinary albumin, estimated glomerular filtration rat (eGFR), C-reactive protein (CRP), and carotid intima media thickness (CIMT) were analyzed using Spearman’s correlation coefficient.


In diabetic patients, there was negative correlation between irisin level and duration of diabetes(r = − 0.302, p = 0.023), body mass index (BMI) (r = − 0.663, p < 0.001), HbA1C (r = − 0.528, p < 0.001), urinary albumin (r = − 0.439, p < 0.001), CRP (r = − 0.692, p < 0.001), and CIMT (r = − 0.807, p < 0.001). Levels of irisin were significantly lower in patients with peripheral diabetic neuropathy (PDN) compared to those without PDN (0.11 ± 0.05 vs. 0.22 ± 0.11 ng/ml, p < 0.001). Levels of irisin were not significantly different between patients with diabetic retinopathy and those with normal fundi.


In T2DM patients, negative correlations between irisin and HbA1C, urinary albumin, and CIMT were found. Moreover, patients with diabetic neuropathy had lower irisin levels.


Type 2 diabetes Irisin Carotid intima media thickness Nephropathy Neuropathy 



All authors acknowledge their gratitude to the staff members of inpatient and clinics of internal medicine department for their help and support.

Compliance with ethical standards

Ethical approval

This cross-sectional study was conducted from April 2014 till April 2015 after approval of the institutional ethical committee. All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000.

Informed consent

Informed consent was obtained from all patients for being included in the study.


  1. 1.
    Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care. 2004;27:1047–53.CrossRefGoogle Scholar
  2. 2.
    Boström P, Wu J, Jedrychowski MP, Korde A, Ye L, Lo JC, et al. A PGC1-alpha-dependent myokine that drives brown-fat-like development of white fat and thermogenesis. Nature. 2012;481:463–8.CrossRefGoogle Scholar
  3. 3.
    Erickson HP. Irisin and FNDC5 in retrospect: an exercise hormone or a transmembrane receptor? Adipocyte. 2013;2:289–93.CrossRefGoogle Scholar
  4. 4.
    Huh JY, Panagiotou G, Mougios V, Brinkoetter M, Vamvini MT, Schneider BE, et al. FNDC5 and irisin in humans: I. Predictors of circulating concentrations in serum and plasma and II. mRNA expression and circulating concentrations in response to weight loss and exercise. Metabolism. 2012;61:1725–38.CrossRefGoogle Scholar
  5. 5.
    Mahmoodnia L, Sadoughi M, Ahmadi A, Kafeshani M. Relationship between serum irisin, glycemic indices, and renal function in type 2 diabetic patients. J Renal Inj Prev. 2017;6:88–92.CrossRefGoogle Scholar
  6. 6.
    Wen MS, Wang CY, Lin SL, Hung KC. Decrease in irisin in patients with chronic kidney disease. PLoS One. 2013;8:e64025.CrossRefGoogle Scholar
  7. 7.
    Arias-Loste MT, Ranchal I, Romero-Gómez M, Crespo J. Irisin, a link among fatty liver disease, physical inactivity and insulin resistance. Int J Mol Sci. 2014;15:23163–78.CrossRefGoogle Scholar
  8. 8.
    Højlund K, Boström P. Irisin in obesity and type 2 diabetes. J Diabetes Complicat. 2013;27:303–4.CrossRefGoogle Scholar
  9. 9.
    Yang S, Xiao F, Pan L, Zhang H, Ma Z, Liu S, et al. Association of serum irisin and body composition with chronic kidney disease in obese Chinese adults: a cross-sectional study. BMC Nephrol. 2015;16:16.CrossRefGoogle Scholar
  10. 10.
    Efe TH, Açar, Ertem AG, Yayla KG, Algül E, Yayla C, et al. Serum irisin level can predict the severity of coronary artery disease in patients with stable angina. Korean Circ J. 2017;47:44–9.CrossRefGoogle Scholar
  11. 11.
    Zhang M, Chen P, Chen S, Sun Q, Zeng QC, Chen JY, et al. The association of new inflammatory markers with type 2 diabetes mellitus and macrovascular complications: a preliminary study. Eur Rev Med Pharmacol Sci. 2014;18:1567–72.Google Scholar
  12. 12.
    American Diabetes Association. Standards of medical care in diabetes. Diabetes Care. 2014;37:887.Google Scholar
  13. 13.
    Moreno-Navarrete JM, Ortega F, Serrano M, Guerra E, Pardo G, Tinahones F, et al. Irisin is expressed and produced by human muscle and adipose tissue in association with obesity and insulin resistance. J Clin Endocrinol Metab. 2013;98:E769–78.CrossRefGoogle Scholar
  14. 14.
    Choi YK, Kim MK, Bae KH, Seo HA, Jeong JY, Lee WK, et al. Serum irisin levels in new-onset type 2 diabetes. Diabetes Res Clin Pract. 2013;100:96–101.CrossRefGoogle Scholar
  15. 15.
    Liu JJ, Wong MD, Toy WC, Tan CS, Liu S, Ng XW, et al. Lower circulating irisin is associated with type 2 diabetes mellitus. J Diabetes Complicat. 2013;27:365–9.CrossRefGoogle Scholar
  16. 16.
    Timmons JA, Baar K, Davidsen PK, Atherton PJ. Is irisin a human exercise gene? Nature. 2012;488:E9–10.CrossRefGoogle Scholar
  17. 17.
    Mehrabian S, Taheri E, Karkhaneh M, Qorbani M, Hosseini S. Association of circulating irisin levels with normal weight obesity, glycemic and lipid profile. J Diabetes Metab Disord. 2016;15:17.CrossRefGoogle Scholar
  18. 18.
    Huh JH, Ahn SV, Choi JH, Koh SB, Chung CH. High serum Irisin level as an independent predictor of diabetes mellitus: a longitudinal population-based study. Medicine (Baltimore). 2016;95:e3742.CrossRefGoogle Scholar
  19. 19.
    Xin C, Liu J, Zhang J, Zhu D, Wang H, Xiong L. Irisin improves fatty acid oxidation and glucose utilization in type 2 diabetes by regulating the AMPK signaling pathway. Int J Obes. 2016;40:443–51.CrossRefGoogle Scholar
  20. 20.
    Huh JY, Dincer F, Mesfum E, Mantzoros CS. Irisin stimulates muscle growth-related genes and regulates adipocyte differentiation and metabolism in humans. Int J Obes. 2014;38:1538–44.CrossRefGoogle Scholar
  21. 21.
    Yan B, Shi X, Zhang H, Pan L, Ma Z, Liu S, et al. Association of serum irisin with metabolic syndrome in obese Chinese adults. PLoS One. 2014;9:e94235.CrossRefGoogle Scholar
  22. 22.
    Hee PK, Zaichenko L, Brinkoetter M, Thakkar B, Sahin-Efe A, Joung KE, et al. Circulating irisin in relation to insulin resistance and the metabolic syndrome. J Clin Endocrinol Metab. 2013;98:4899–907.CrossRefGoogle Scholar
  23. 23.
    Stengel A, Hofmann T, Goebel-Stengel M, Elbelt U, Kobelt P, Klapp BF. Circulating levels of irisin in patients with anorexia nervosa and different stages of obesity–correlation with body mass index. Peptides. 2013;39:125–30.CrossRefGoogle Scholar
  24. 24.
    Lu J, Xiang G, Liu M, Mei W, Xiang L, Dong J. Irisin protects against endothelial injury and ameliorates atherosclerosis in apolipoprotein E-null diabetic mice. Atherosclerosis. 2015;243:438–48.CrossRefGoogle Scholar
  25. 25.
    Lee MJ, Lee SA, Nam BY, Park S, Lee SH, Ryu HJ, et al. Irisin, a novel myokine is an independent predictor for sarcopenia and carotid atherosclerosis in dialysis patients. Atherosclerosis. 2015;242:476–82.CrossRefGoogle Scholar
  26. 26.
    Icli A, Cure E, Cure MC, Uslu AU, Balta S, Arslan S. Novel myokine: irisin may be an independent predictor for subclinic atherosclerosis in Behçet’s disease. J Investig Med. 2016;64:875–81.CrossRefGoogle Scholar
  27. 27.
    Sesti G, Andreozzi F, Fiorentino TV, Mannino GC, Sciacqua A, Marini MA, et al. High circulating irisin levels are associated with insulin resistance and vascular atherosclerosis in a cohort of nondiabetic adult subjects. Acta Diabetol. 2014;51:705–13.CrossRefGoogle Scholar
  28. 28.
    Oelmann S, Nauck M, Völzke H, Bahls M, Friedrich N. Circulating Irisin concentrations are associated with a favourable lipid profile in the general population. PLoS One. 2016;11:e0154319.CrossRefGoogle Scholar
  29. 29.
    Gupta S, Gupta VK, Gupta R, Arora S, Gupta V. Relationship of high-sensitive C-reactive protein with cardiovascular risk factors, clinical presentation and angiographic profile in patients with acute coronary syndrome: an Indian perspective. Indian Heart J. 2013;65:359–65.CrossRefGoogle Scholar
  30. 30.
    Hu W, Wang R, Li J, Zhang J, Wang W. Association of irisin concentrations with the presence of diabetic nephropathy and retinopathy. Ann Clin Biochem. 2016;53:67–74.CrossRefGoogle Scholar
  31. 31.
    Wang HH, Zhang XW, Chen WK, Huang QX, Chen QQ. Relationship between serum irisin levels and urinary albumin excretion in patients with type 2 diabetes. J Diabetes Complicat. 2015;29:384–9.CrossRefGoogle Scholar
  32. 32.
    Liu JJ, Liu S, Wong MD, Tan CS, Tavintharan S, Sum CF, et al. Relationship between circulating irisin, renal function and body composition in type 2 diabetes. J Diabetes Complicat. 2014;28:208–13.CrossRefGoogle Scholar
  33. 33.
    Ebert T, Focke D, Petroff D, Wurst U, Richter J, Bachmann A, et al. Serum levels of the myokine irisin in relation to metabolic and renal function. Eur J Endocrinol. 2014;170:501–6.CrossRefGoogle Scholar
  34. 34.
    Wang C, Wang L, Liu J, Song J, Sun Y, Lin P. Irisin modulates the association of interleukin-17A with the presence of non-proliferative diabetic retinopathy in patients with type 2 diabetes. Endocrine. 2016;53:459–64.CrossRefGoogle Scholar
  35. 35.
    Van den Oever IA, Raterman HG, Nurmohamed MT, Simsek S. Endothelial dysfunction, inflammation, and apoptosis in diabetes mellitus. Mediat Inflamm. 2010;2010:15.Google Scholar

Copyright information

© Research Society for Study of Diabetes in India 2019

Authors and Affiliations

  1. 1.Department of Internal Medicine, Kasr Al-AinyCairo UniversityCairoEgypt
  2. 2.Department of Biological Applications, Nuclear Research Center, Atomic Energy AuthorityInshasEgypt

Personalised recommendations