Association of Asprosin Levels with Metabolic Syndrome Severity and Insulin Resistance: A Case-Control Study

Abstract

Background: Asprosin, a novel adipokine primarily secreted by white adipose tissue during fasting. Circulating asprosin promotes hepatic glucose release and has been reported to be elevated in obesity, type 2 diabetes mellitus, and metabolic syndrome (MetS), correlating with markers of insulin resistance such as HOMA-IR. Objectives: This case-control study evaluated the association between serum asprosin levels, metabolic syndrome severity, and insulin resistance Materials and Methods: A total of 300 Iraqi adult’s participants were enrolled, including 150 subjects with MetS and 150 age, sex-matched controls without MetS. Serum asprosin, insulin, IL-6, and hs-CRP concentrations were measured using enzyme-linked immunosorbent assay (ELISA). Metabolic syndrome was diagnosed according to established criteria. Insulin resistance was assessed using the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR). Anthropometric indices, blood pressure, fasting glucose, and lipid profile were measured. Logistic regression and correlation analyses were performed to evaluate the associations between asprosin, MetS components, and insulin resistance. Results: Participants with MetS exhibited significantly elevated asprosin concentrations compared to those without MetS (P < 0.001). Logistic regression analysis demonstrated that asprosin independently predicted elevated fasting blood glucose (P < 0.001), increased triglyceride levels (P < 0.01), and reduced HDL cholesterol (P < 0.001). Asprosin remained a significant predictor of MetS after adjusting for age, diabetes status, total cholesterol, and BMI (OR: 3.62; P < 0.001 for women; OR: 3.58; P < 0.001 for men). However, this association lost statistical significance after adjustment for HOMA-IR (P = 0.068 for women; P = 0.08 for men). Positive correlations were observed between asprosin and obesity, dyslipidemia, hyperglycemia, insulin resistance, and inflammatory biomarkers.  Conclusion: The findings indicate that serum asprosin is significantly associated with metabolic syndrome and its components independent of obesity. This relationship appears to be largely mediated by insulin resistance, suggesting that asprosin may serve as a valuable biomarker for metabolic dysfunction and a potential therapeutic target.