, Volume 17, Issue 2, pp 247–253 | Cite as

The low levels of bone morphogenic protein-4 and its antagonist noggin in type 2 diabetes

  • Banu Sarer YurekliEmail author
  • Gokcen Unal Kocabas
  • Murat Aksit
  • Nilufer Ozdemir Kutbay
  • Aslı Suner
  • Ismail Yurekli
  • Habib Cakir
  • Giray Bozkaya
  • Sevki Cetinkalp
Original Article



Bone morphogenic protein-4 (BMP-4) is a proinflammatory cytokine which is controlled by BMP-4 antagonists. Our aim was to investigate the levels of BMP-4 and its antagonists, noggin and matrix Gla protein (MGP), in prediabetes and diabetes.


One hundred and forty-two type 2 diabetic, 32 prediabetic, and 58 control subjects participated in this cross-sectional study. BMP-4, noggin, and MGP were measured with the ELISA method.


There was a significant difference between the three groups in relation to sex, hypertension, fasting plasma glucose, HbA1c, lipid profiles, and diastolic blood pressure (p < 0.05). BMP-4 levels were significantly lower in the diabetic group compared to the control group (108.5 and 127.5 ng/mL, respectively, p < 0.001 diabetes vs. control). Noggin levels were significantly lower in the diabetic group compared to the prediabetic and control groups (10.5, 11.5, and 12.0 ng/mL, as median, respectively, p < 0.001; diabetes vs. control, p = 0.002; diabetes vs. prediabetes). BMP-4 was associated significantly with noggin in the entire study population (ß coefficient = 0.796, p < 0.001). Receiver operating characteristic (ROC) curve analysis showed that the area under the ROC curve was 0.708 (95% CI 0.551–0.864, p = 0.011) for BMP-4 levels. The optimal cutoff value of BMP-4 for detecting albuminuria was 118.5 ng/mL for which sensitivity was 71.4% and specificity was 66.4%.


BMP-4 and noggin levels were lower in the diabetic group. High BMP-4 levels were significantly associated with albuminuria. Further studies are warranted to determine the role of BMP-4 in the pathogenic processes underlying albuminuria and hyperglycemia in patients with type 2 diabetes.


BMP-4 Antagonists Urinary albumin excretion 


Funding information

This work was supported by the Ege University Scientific Research Project Committee, with project number 2015-TIP-034.

Compliance with ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Conflict of interest

The authors declare that they have no conflict of interest.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Hellenic Endocrine Society 2018

Authors and Affiliations

  • Banu Sarer Yurekli
    • 1
    Email author
  • Gokcen Unal Kocabas
    • 2
  • Murat Aksit
    • 3
  • Nilufer Ozdemir Kutbay
    • 1
  • Aslı Suner
    • 4
  • Ismail Yurekli
    • 5
  • Habib Cakir
    • 5
  • Giray Bozkaya
    • 3
  • Sevki Cetinkalp
    • 1
  1. 1.Department of EndocrinologyEge University Faculty of MedicineIzmirTurkey
  2. 2.Department of EndocrinologyBozyaka Education and Research HospitalIzmirTurkey
  3. 3.Department of BiochemistryBozyaka Education and Research HospitalIzmirTurkey
  4. 4.Department of Biostatistics and Medical InformaticsEge University Faculty of MedicineIzmirTurkey
  5. 5.Department of Cardiovascular SurgeryIzmir Ataturk Education and Research HospitalIzmirTurkey

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