Tip 1 ve Tip 2 Diyabetli Kadınlarda Yeni Ortaya Çıkan Biyokimyasal Belirteçler Olarak Niasin Eksikliği ve Hormonal Dengesizlik

Year 2025, Volume: 8 Issue: 1, 33 - 39, 30.06.2025

Hajer Ifsaikha Bahjat Alaiesh , Sevki Adem

https://doi.org/10.46239/ejbcs.1684314

Abstract

Diabetes mellitus, özellikle Tip 2 Diyabet (T2DM), genç yetişkinler arasında giderek daha yaygın hale gelmekte olup metabolik sendrom ve endokrin disfonksiyonla ilişkilidir. Lipid ve enerji metabolizması için hayati öneme sahip bir besin öğesi olan niasin (B3 vitamini), diyabetik komplikasyonların tanısında potansiyel bir biyobelirteç olarak kullanılabilir. Bu çalışma, Tip 1 (T1DM) ve Tip 2 diyabetli kadınlar ile diyabetik olmayan kontrol grupları arasında niasin düzeylerini, steroid hormon profillerini ve hematolojik belirteçleri karşılaştırmıştır. Çalışmaya yaşları ≥20 olan toplam 180 kadın dahil edilmiş ve katılımcılar eşit şekilde T1DM, T2DM ve kontrol gruplarına ayrılmıştır. Kan örnekleri alınarak niasin, östradiol (E2), folikül uyarıcı hormon (FSH), luteinize edici hormon (LH), kırmızı kan hücreleri (RBC), hemoglobin (Hb) ve glikozile hemoglobin (HbA1C) düzeyleri ölçülmüştür. İstatistiksel analizler ortalama karşılaştırması ve Pearson korelasyon testi ile gerçekleştirilmiştir. Her iki diyabet grubunda da kontrol grubuna kıyasla anlamlı şekilde daha düşük niasin düzeyleri (T1DM: 2,50 µg/L; T2DM: 2,61 µg/L; kontrol: 3,75 µg/L) gözlemlenmiştir. Diyabetli kadınlarda artmış E2 ve azalmış FSH ile LH düzeyleri saptanmış, bu durum endokrin bozulmayı işaret etmiştir. Ayrıca, RBC ve Hb düzeyleri de diyabetli gruplarda daha düşük (T1DM: 10,85 g/dL; T2DM: 11,70 g/dL; kontrol: 14,32 g/dL) bulunmuş, HbA1C düzeylerinde ise artış (T1DM: %6,76; T2DM: %5,83; kontrol: %5,25) saptanmıştır. Diyabetik durumla RBC, Hb, FSH, LH ve niasin için anlamlı negatif korelasyonlar; E2 ve HbA1C için ise pozitif korelasyonlar belirlenmiştir. Bu sonuçlar, kadınlarda diyabetin, niasin eksikliği, hematopoez bozukluğu ve hormonal düzensizlik gibi sistemik biyokimyasal anormalliklerle ilişkili olduğunu göstermektedir. Bulgular, kadın diyabet hastalarının tedavisinde metabolik, beslenme ve hormonal faktörleri birlikte dikkate alan bütüncül yaklaşımların önemini vurgulamaktadır.

Keywords

Diyabetes Mellitus , Niasin , Steroid Hormonlar , Kadınlar , Hemoglobin , HbA1C

Niacin deficiency and hormonal imbalance as emerging biochemical markers in women with type 1 and type 2 diabetes mellitus

Abstract

Diabetes mellitus, particularly Type 2 (T2DM), is increasingly common among young adults and is associated with metabolic syndrome and endocrine dysfunction. Niacin (vitamin B3), essential for lipid and energy metabolism, may serve as a diagnostic marker for diabetic complications. This study compared niacin levels, steroid hormone profiles, and hematological markers in women with Type 1 (T1DM) and Type 2 diabetes versus non-diabetic controls. A total of 180 women aged ≥20 were evenly divided into T1DM, T2DM, and control groups. Blood samples were collected to measure niacin, estradiol (E2), follicle-stimulating hormone (FSH), luteinizing hormone (LH), red blood cells (RBC), hemoglobin (Hb), and glycated hemoglobin (HbA1C). Statistical analysis included mean comparison and Pearson correlation. Both diabetic groups exhibited significantly lower niacin levels (T1DM: 2.50 µg/L; T2DM: 2.61 µg/L) compared to controls (3.75 µg/L). Elevated E2 and reduced FSH and LH levels were observed in diabetic women, suggesting endocrine disruption. Additionally, RBC and Hb levels were lower (T1DM: 10.85 g/dL; T2DM: 11.70 g/dL) compared to controls (14.32 g/dL), while HbA1C was higher (T1DM: 6.76%; T2DM: 5.83%; controls: 5.25%). Significant negative correlations were found for RBC, Hb, FSH, LH, and niacin, while positive correlations were found for E2 and HbA1C with diabetic status. These results indicate that diabetes in women is associated with systemic biochemical anomalies, including niacin deficiency, impaired hematopoiesis, and hormonal dysregulation. The findings emphasize the importance of holistic treatment approaches considering metabolic, nutritional, and hormonal factors in female diabetes patients.

Keywords

Diabetes Mellitus , Niacin , Steroid Hormones , Women , Hemoglobin , HbA1C

References

• Alamri BN, Bahabri A, Aldereihim AA, Alabduljabbar M, Alsubaie MM, Alnaqeb D, et al. 2019. Hyperglycemia effect on red blood cells indices. Eur Rev Med Pharmacol Sci. 23(5):2139–2150.
• Alemany M. 2021. Estrogens and the regulation of glucose metabolism. World J Diabetes. 12(10):1622–1654.
• Asghar S, Asghar S, Shahid S, Fatima M, Bukhari H, Siddiqui SN. 2023. Metabolic syndrome in type 2 diabetes mellitus patients: prevalence, risk factors, and associated microvascular complications. Cureus. 5(5):1–9.
• Belete R, Ataro Z, Abdu A, Sheleme M. 2021. Global prevalence of metabolic syndrome among patients with type 1 diabetes mellitus: a systematic review and meta-analysis. Diabetol Metab Syndr. 13(1):1–13.
• Bertone-Johnson ER, Virtanen JK, Niskanen L, Nurmi T, Ronkainen K, Voutilainen S, et al. 2017. Association of follicle-stimulating hormone levels and risk of type 2 diabetes in older postmenopausal women. Menopause. 24(7):796–802.
• Boden WE, Probstfield JL, Anderson T. 2011. Niacin in patients with low HDL cholesterol levels receiving intensive statin therapy. N Engl J Med. 365(24):2255–2267.
• Cho NH, Shaw JE, Karuranga S, Huang Y, da Rocha Fernandes JD, Ohlrogge AW, et al. 2018. IDF Diabetes Atlas: Global estimates of diabetes prevalence for 2017 and projections for 2045. Diabetes Res Clin Pract. 138:271–281.
• D’Andrea E, Hey SP, Ramirez CL, Kesselheim AS. 2019. Assessment of the role of niacin in managing cardiovascular disease outcomes. JAMA Netw Open. 2(4):1–14.
• Duggal JK, Singh M, Attri N, Singh PP, Ahmed N, Pahwa S, et al. 2010. Effect of niacin therapy on cardiovascular outcomes in patients with coronary artery disease. J Cardiovasc Pharmacol Ther. 15(2):158–166.
• Ebrahim H, Fiseha T, Ebrahim Y, Bisetegn H. 2022. Comparison of hematological parameters between type 2 diabetes mellitus patients and healthy controls at Dessie comprehensive specialized hospital, Northeast Ethiopia: Comparative cross-sectional study. PLoS One. 17(7):1–15.
• Ford ES. 2005. Risks for all-cause mortality, cardiovascular disease, and diabetes associated with the metabolic syndrome: a summary of the evidence. Diabetes Care. 28(7):1769–1778.
• Fruchart JC, Sacks FM, Hermans MP, Assmann G, Brown VW, Ceska R, et al. 2010. Residual Risk Reduction Initiative: a call to reduce residual vascular risk in patients with dyslipidemia. Cor Vasa. 52(4):212–228.
• Gui MH, Ling Y, Liu L, Jiang JJ, Li XY, Gao X. 2017. Effect of metabolic syndrome score, metabolic syndrome, and its individual components on the prevalence and severity of angiographic coronary artery disease. Chin Med J (Engl). 130(6):669–677.
• Harding JL, Pavkov ME, Magliano DJ, Shaw JE, Gregg EW. 2019. Global trends in diabetes complications: a review of current evidence. Diabetologia. 62(1):3–16.
• Jiang Y, Zhang Z, Zhu Y, Chai Y, Xie H. 2023. Dose-response association between dietary folate and niacin intakes with diabetes among Chinese adults: a cross-sectional study. J Health Popul Nutr. 42(1):1–7.
• Magliano DJ, Sacre JW, Harding JL, Gregg EW, Zimmet PZ, Shaw JE. 2020. Young-onset type 2 diabetes mellitus: implications for morbidity and mortality. Nat Rev Endocrinol. 16(6):321–331.
• Malik S, Kashyap ML. 2003. Niacin, lipids, and heart disease. Curr Cardiol Rep. 5(6):470–476.
• Maric C, Forsblom C, Thorn L, Waden J, Groop PH. 2010. Association between testosterone, estradiol and sex hormone-binding globulin levels in men with type 1 diabetes with nephropathy. Steroids. 75(11):772–778.
• Natah TM, Wtwt MA-A, Al-Saadi HK, Al-Saadi AH, Farhood HF. 2013. Study the levels of adiponectin, FSH, LH and sex hormones in type 2 diabetes (NIDDM). J Biol Agric Healthc. 2(3):172–181.
• Şener G, Kahvecioğlu ED, Can B, Gümüş A, Yeşil BS, Evran B. 2023. The effect of age and gender on HbA1c levels in adults without diabetes mellitus. J Med Biochem. 42(4):714–721.
• Stanaway JD, Afshin A, Gakidou E, Lim SS, Abate D, Abate KH, et al. 2018. Global, regional, and national comparative risk assessment of 84 behavioral, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 392(10159):1923–1994.
• Viner R, White B, Christie D. 2017. Type 2 diabetes in adolescents: a severe phenotype posing major clinical challenges and public health burden. Lancet. 389(10085):2252–2260.
• Xiang D, Zhang Q, Wang YT. 2020. Effectiveness of niacin supplementation for patients with type 2 diabetes. Medicine (Baltimore). 99(29):1–10.