Background and objectives Nesfatin-1 as a potent anorexigenic peptide is secreted by pancreatic β cells. Conflicting data are available about its level among diabetic patients. Our study aimed to assess nesfatin-1 levels in newly diagnosed drug-naïve diabetic and pre-diabetic patients and its association with cardio-metabolic risk and insulin resistance (IR). This case-control study included drug-naive patients with DMT2 (group 1, n = 30) and pre-diabetes (group 2, n = 30) in addition to healthy subjects (group 3, n = 28). Anthropometric and routine biochemical assessments were performed. Serum nesfatin-1and plasma insulin levels were assessed by ELISA methods. Homeostatic model for assessment of IR (HOMA-IR) was calculated. Results Serum nesfatin-1 was significantly lower in diabetic and pre-diabetic compared to healthy subjects (3.89 ± 1.1 ng/dl and 7.47 ± 1.22 ng/dl versus 15.39 ± 3.53 respectively, p < 0.001). Also diabetic patients had statistically significant lower nesfatin-1 levels than pre-diabetic patients (p < 0.001) Roc curve analysis identified cut-off values of ≤ 9 ng/dl and ≤ 5.5 ng/dl with an AUC of 0.94 and 0.97, sensitivity of 96.7 and 100%, and specificity of 93.3% and 96.7% for diagnosis of pre-diabetes and diabetes respectively. Using bivariate analysis, nesfatin-1 was negatively correlated with glycemic parameters (fasting and 2 h postprandial blood sugar, HBA1c), IR parameters (fasting insulin and HOMA-IR) and atherogenic lipid profile (triglyceride, cholesterol, and LDL-c); and positively correlated to HDL-c in both diabetic and pre-diabetic but not in healthy. Conclusion Nesfatin-1 is an excellent predictor for pre-diabetes and DMT2. It is associated with favorable glucose and lipid metabolism probably via insulin signaling pathway.

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Introduction: Diabetes mellitus type 2 (formerly non insulin-dependent diabetes mellitus (NIDDM) is a metabolic disorder that is characterized by hyperglycemia in the context of insulin resistance and relative lack of insulin. Aims of the Work: The aim of the present study is assessment of plasma level of nesfatin-1 and its association with various metabolic parameters in newly diagnosed type 2 diabetic patients. Subjects and Methods: This study included 90 Patients were selected from those coming to Minia University hospital diabetes and outpatient clinics known to have newly diagnosed Diabetes Mellitus, diagnosed according to 2017 American Diabetes association (ADA) criteria. Results: This study was conducted on 90 persons our selected from our diabetic outpatient clinic and outpatient clinic of internal medicine .All subjected were divided into three groups. Discussion: Diabetes mellitus is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. (ADA 2013). Conclusion and recommendations:The novelty of our study is that we showed, for the first time, significantly lower nesfatin-1 levels in diabetic patients (Type 2 DM) but less lower in prediabetic patients (IGT). Nesfatin-1 is a newly identified polypeptide probably involved, in the regulation of food intake. It is important to clarify the relationships between nesfatin-1 and insulin resistance with regard to diabetes. To elucidate its physiological role further studies are required.