The impact of Ramadan fasting on Fetuin-A level in type 2 diabetes mellitus

Dante S Harbuwono; Brama I Sazli; Farid Kurniawan; Budiman Darmowidjojo; Sukamto Koesnoe; Dicky L Tahapary

doi:10.1016/j.heliyon.2021.e06773

The impact of Ramadan fasting on Fetuin-A level in type 2 diabetes mellitus

Heliyon. 2021 May 15;7(5):e06773. doi: 10.1016/j.heliyon.2021.e06773. eCollection 2021 May.

Authors

Dante S Harbuwono^{1

2}, Brama I Sazli^{1

2}, Farid Kurniawan^{1

2}, Budiman Darmowidjojo^{1

2}, Sukamto Koesnoe³, Dicky L Tahapary^{1

2}

Affiliations

¹ Division of Endocrinology, Department of Internal Medicine, Dr. Cipto Mangunkusumo National Referral Hospital, Faculty of Medicine Universitas Indonesia, Jl. Diponegoro No.71, Central Jakarta, 10430, Indonesia.
² Metabolic, Cardiovascular and Aging Cluster, The Indonesian Medical Education and Research Institute, Faculty of Medicine Universitas Indonesia, Jl. Diponegoro No.71, Central Jakarta, 10430, Jakarta, Indonesia.
³ Division of Allergy and Immunology, Department of Internal Medicine, Dr. Cipto Mangunkusumo National Referral Hospital, Faculty of Medicine Universitas Indonesia, Jl. Diponegoro No.71, Central Jakarta, 10430, Indonesia.

Abstract

Background/aims: Ramadan fasting creates changes in lifestyle, causing biochemical alterations that affect glucose metabolism and insulin sensitivity. This study aims to assess the impact of Ramadan fasting on glycemic control and Fetuin-A, a glycoprotein that affects insulin resistance, in patients with type 2 diabetes mellitus (T2DM).

Materials and methods: This was a prospective study done among 37 patients with T2DM from Internal Medicine Polyclinic in a hospital in Jakarta, Indonesia. Anthropometric data as well as Hemoglobin A1c (HbA1c), Fasting Blood Glucose (FBG), and Fetuin-A levels of the subjects were measured in three time points: before, during, and after Ramadan fasting. A bivariate analysis was done to see the effect of Ramadan fasting on those parameters.

Results: Ramadan fasting reduced Fetuin-A levels [median (minimum-maximum), 5.35 (2.91-7.81) vs. 3.22 (2.35-5.60) mg/dl; p = 0.039] four weeks after the end of Ramadan compared to pre-Ramadan. After two weeks of Ramadan fasting, we found a significant reduction in body weight, BMI, FBG, and HbA1c levels which rebounded to baseline level after Ramadan.

Conclusion: Ramadan fasting was associated with a significant decrease in Fetuin-A level post Ramadan.

Keywords: Diabetes mellitus; Fetuin-A; Glycoprotein; Insulin resistance; Ramadan fasting.