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Original article

Vol. 149 No. 4344 (2019)

Neuregulin-4 is associated with plasma glucose and increased risk of type 2 diabetes mellitus

  • Mehmet Z. Kocak
  • Gulali Aktas
  • Edip Erkus
  • Ozgur M. Yis
  • Tuba T. Duman
  • Burcin M. Atak
  • Haluk Savli
Cite this as:
Swiss Med Wkly. 2019;149:w20139



Neuregulin-4 is a cytokine with many functions and is primarily produced by fat tissue.


The aim of the study was to observe the relationship between serum neuregulin-4 levels and diabetes regulation in type 2 diabetes mellitus (T2DM), and to compare neuregulin-4 levels of diabetic subjects with those in healthy controls.


Patients with T2DM were included to the study. Healthy subjects were enrolled as controls. Subjects with T2DM with glycated haemoglobin (HbA1c) <7% were classed as well controlled and those with HbA1c ≥7% were classed as poorly controlled. Neuregulin-4 levels of the study and control groups were compared.


The neuregulin-4 levels of the poorly controlled T2DM, well-controlled T2DM and control groups were significantly different (p = 0.005). Neuregulin-4 was significantly correlated with fasting plasma glucose (r = 0.247, p = 0.002) but not with HbA1c. In a regression analysis model, 0.1 point elevation in neuregulin-4 levels increased the rate of existence of T2DM 4.4-fold (odds ratio 4.4, 95% confidence interval 1.26–15.1; p = 0.02).


Neuregulin-4 is significantly increased in patients with T2DM compared with control subjects, which means that it could be a marker of T2DM. Since neuregulin-4 was correlated with fasting glucose, we suggest that elevated neuregulin-4 could predict poor control in T2DM for short periods when HbA1c is not useful. Moreover, one unit elevation in neuregulin-4 (0.1 ng/ml) increases the rate of existence of T2DM 4.4-fold, independently from other variables.


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