diaendoСахарный диабетDiabetes mellitus2072-03512072-0378Endocrinology research centre10.14341/DM13165diaendo-13165Research ArticleОригинальные исследованияOriginal StudiesСывороточный висфатин у пациентов с сахарным диабетом 2 типа и диабетической ретинопатиейSerum visfatin in patients with type two diabetic retinopathyhttps://orcid.org/0000-0003-2813-3879SalmanI. N.SalmanI. N.

Багдад

Isam Noori Salman - Assistant Professor; Scopus Author ID: 57195920582.

Baghdad

esamnoori61@gmail.comhttps://orcid.org/0000-0003-3549-1578MohammedN. U. G.MohammedN. U. G.

Багдад

Noor Ulhuda G. Mohammed - lecturer, PhD in Biochemistry; Scopus Author ID: 57221703672.

Baghdad

noorulhuda.g@csw.uobaghdad.edu.iqhttps://orcid.org/0009-0004-8252-9967AttaS. E.AttaS. E.

Багдад

Safaa Ehssan Atta – MD; Scopus Author ID: 7101843976.

Baghdad, Palastine Street, 10064

safaaehssan@uomustansiriyah.edu.iqhttps://orcid.org/0000-0002-8895-7901AbedB. A.AbedB. A.

Багдад

Baydaa Ahmed Abed - Assistant Professor, PhD in Biochemistry; Scopus Author ID: 57202648526.

Baghdad

baydaaahmed@yahoo.comhttps://orcid.org/0009-0001-1965-8668SalimR.SalimR.

Багдад

Rafal Salim - assistant lecturer.

Baghdad

rafal.s@csw.uobaghdad.edu.iqУниверситет Аль-Мустансирия/Национальный центр диабетаИракMustansiriyah University/National Diabetes CenterIraqУниверситет Багдада/Колледж наук для женщинИракUniversity of Baghdad/College of Science for Women/department of ChemistryIraq202420112024275480486Copyright © Salman I.N., Mohammed N.G., Atta S.E., Abed B.A., Salim R., 20242024Salman I.N., Mohammed N.G., Atta S.E., Abed B.A., Salim R.Salman I.N., Mohammed N.G., Atta S.E., Abed B.A., Salim R.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.dia-endojournals.ru/jour/article/view/13165ОБОСНОВАНИЕ

ОБОСНОВАНИЕ. Основной причиной слепоты у пациентов с сахарным диабетом (СД) является диабетическая ретинопатия (ДР) — наиболее распространенное микрососудистое осложнение СД — и нарушение зрения. Висфатин — это адипоцитокин, который способствует активности инсулина при гестационном диабете и беременности.

ЦЕЛЬ

ЦЕЛЬ. Целью данного исследования было оценить уровни висфатина в сыворотке крови у пациентов с СД 2 типа (СД2), пролиферативной ДР, непролиферативной ДР и у здоровых лиц.

МАТЕРИАЛЫ И МЕТОДЫ

МАТЕРИАЛЫ И МЕТОДЫ. В исследовании приняли участие 120 пациентов с историей СД2 более 5 лет и 30 здоровых участников. Группа пациентов была разделена на три подгруппы: СД2, с пролиферативной и с непролиферативной ДР. Уровни висфатина измерялись с использованием коммерчески доступного набора для иммуноферментного анализа. Были оценены уровни триглицеридов (ТГ), общего холестерина (ОХ), холестерина липопротеинов низкой плотности (ЛПНП), холестерина липопротеинов высокой плотности (ЛПВП) и гликированного гемоглобина (HbA1c).

РЕЗУЛЬТАТЫ

РЕЗУЛЬТАТЫ. У пациентов с пролиферативной ДР и пациентов с плохим гликемическим контролем наблюдалось значительное повышение уровней висфатина по сравнению с группой здоровых контролей и пациентами с СД2 без ДР. Уровни ОХ, ТГ и ЛПНП в группе ДР были заметно выше и значительно превышали показатели в группе здоровых контролей.

ЗАКЛЮЧЕНИЕ

ЗАКЛЮЧЕНИЕ. Уровни висфатина связаны как с тяжестью, так и с наличием ДР, и более высоки у пациентов с плохим гликемическим контролем. Повышенный уровень липидов ассоциирован с риском ДР.

BACKGROUND

BACKGROUND: The primary cause of blindness in diabetics is diabetic retinopathy (DR), the most common microvascular complication of diabetes, and visual impairment. Visfatin is an adipocytokine that aids in insulin activity during gestational diabetes and pregnancy.

AIM

AIM: This study aimed to estimate serum visfatin levels in DR, proliferative (PDR), non-proliferative (NPDR), and healthy subjects (HS).

MATERIALS AND METHODS

MATERIALS AND METHODS: A 120-patient case-control study with a history of T2DM for more than 5 years as well as 30 healthy subjects enrolled in the study. Patients group divided into three sub-groups, DM, PDR, and NPDR. Visfatin levels were measured using a commercially available enzyme-linked immunosorbent assay kit. Triglyceride (TG), serum cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) levels and glycated haemoglobin (HbA1c) were assessed.

RESULTS

RESULTS: The PDR patients and patients with poor glycemic control showed significantly increased visfatin levels compared with the HS group and T2DM patients without DR. The TC, TG, and DR group’s LDL-C levels were noticeably higher and significantly greater in PDR than in the group of HS.

CONCLUSION

CONCLUSION: Visfatin levels have been linked to both the severity and existence of DR. and more in patients with poor glycemic control. Elevated lipids were associated with DR risk.

диабетическая ретинопатиялипидный профильсахарный диабет 2 типагликемический контроль­висфатинdiabetic retinopathylipid profiletype 2 diabetes mellitusglycemic controlvisfatinWe express our gratitude to all the patients who participated in this study and thereby made this work possible. This work was supported by the National Diabetes center/ Mustaniriyah University and Ibn Al Haytham Ophthalmology HospitalReferencesHoffmann JG, Xie W, Chopra AR. Energy regulation mechanism and therapeutic potential of asprosin. Diabetes. 2020;69(4):559-566. https://doi.org/10.2337/dbi19-0009Simo R, Simo-Servat O, Bogdanov P, Hernandez C. Diabetic retinopathy: role of neurodegeneration and therapeutic perspectives. Asia-Pacific J Ophthalmol 2022;11(2):160–7.Pratt H. Deep Learning for Diabetic Retinopathy Diagnosis & Analysis. The University of Liverpool (United Kingdom); 2019.Farhan LO, Abed BA, Dawood A. Comparison Study between Adipsin Levels in Sera of Iraqi Patients with Diabetes and Neuropathy. Baghdad Sci J 2023;20(3):726.Abed BA, Hamid GS. Evaluation of Lipocalin-2 and Vaspin Levels in In Iraqi Women with Type 2 Diabetes Mellitus. Iraqi Journal of Science. 2022:4650-4658. https://doi.org/10.24996/ijs.2022.63.11.3Pratt H. Deep Learning for Diabetic Retinopathy Diagnosis & Analysis. The University of Liverpool (United Kingdom); 2019.Bajwa EK, Yu C-L, Gong MN, Thompson BT, Christiani DC. Pre-B-cell colony-enhancing factor gene polymorphisms and risk of acute respiratory distress syndrome. Critical care medicine. 2007;35(5):1290-1295. https://doi.org/10.1097/01.ccm.0000260243.22758.4fAbed BA, Hamid GS. Evaluation of Lipocalin-2 and Vaspin Levels in In Iraqi Women with Type 2 Diabetes Mellitus. Iraqi J Sci [Internet] 2022;4650–8. Available from: https://ijs.uobaghdad.edu.iq/index.php/eijs/article/view/6294Szywacz W, Mielcarska S, Szczerba A, Macionga A, Szweda-Gandor N, Grzeszczak W. Influence of visfatin’s gene variations on late diabetic complications. Medical Research Journal. 2021;6(1):28-32. doi: http://dx.doi.org/10.5603/MRJ.a2021.0004Bajwa EK, Yu CL, Gong MN, Thompson BT, Christiani DC. Pre-B-cell colony-enhancing factor gene polymorphisms and risk of acute respiratory distress syndrome. Crit Care Med 2007;35(5):1290–5.Farhan LO, Salman IN. A review on the role of novel adipokine Isthmin-1 and Subfatin in human type 2 diabetes mellitus. University of Thi-Qar Journal of Science. 2023;10(2):181-186. https://doi.org/10.32792/utq/utjsci/v10i2.1129Szywacz W, Mielcarska S, Szczerba A, Macionga A, Szweda-Gandor N, Grzeszczak W. Influence of visfatin’s gene variations on late diabetic complications. Med Res J 2021;6(1):28–32.Shao Y-N. Research progress of visfatin in diabetic retinopathy. International Eye Science. 2020:485-488. https://dx.doi.org/10.3980/j.issn.1672-5123.2020.3.17Lefta NA, Abed AY, Abed BA. Estimation of asprosin levels in female Iraqi patients with type 2 diabetes and hypothyroidism. J Med Chem Sci 2023;6(2):433–9.Blüher M. Importance of adipokines in glucose homeostasis. Diabetes Management. 2013;3(5):389. doi: http://dx.doi.org/10.2217/dmt.13.35Shao YN. Research progress of visfatin in diabetic retinopathy. Int Eye Sci 2020;485–8.Saadi MT, Mohammed NUG, Abed BA, Farhan LO, Salman IN. Validity of galactin-3 in acromegaly: comparison with traditional markers. Irish Journal of Medical Science. 2024;193(4):1837-1841. https://doi.org/10.1007/s11845-024-03674-wBlüher M. Importance of adipokines in glucose homeostasis. Diabetes Manag 2013;3(5):389.Rao H, Jalali JA, Johnston TP, Koulen P. Emerging roles of dyslipidemia and hyperglycemia in diabetic retinopathy: molecular mechanisms and clinical perspectives. Frontiers in Endocrinology. 2021;12:620045. https://doi.org/10.3389%2Ffendo.2021.620045Saadi MT, Mohammed NUG, Abed BA, Farhan LO, Salman IN. Validity of galactin-3 in acromegaly: comparison with traditional markers. Irish J Med Sci (1971 -) [Internet] 2024;1–5. Available from: https://link.springer.com/10.1007/s11845-024-03674-wAldebasi YH, Mohieldein AH, Almansour YS, Almutairi BL. Dyslipidemia and lipid peroxidation of Saudi type 2 diabetics with proliferative retinopathy. Saudi Med J. 2013;34(6):616-622.Gnaneswaran S, Vinodhini VM, Kuberan D, Rajesh K, Swamy Raj S V, Kumar JS. Dyslipidemia and diabetic retinopathy in a rural population. Int J Res Pharm Biomed Sci 2013;4(3):829–32.Kim S-R, Bae S-K, Choi K-S, et al. Visfatin promotes angiogenesis by activation of extracellular signal-regulated kinase 1/2. Biochemical And Biophysical Research Communications. 2007;357(1):150-156. https://doi.org/10.1016/j.bbrc.2007.03.105Yousef H A, Abdelmarouf H M, Yousef S A, Barakat L A. Dyslipidemia and lipid peroxidation of Saudi type 2 diabetics with proliferative retinopathy. 2013;De Palma M, Biziato D, Petrova TV. Microenvironmental regulation of tumour angiogenesis. Nature Reviews Cancer. 2017;17(8):457-474. https://doi.org/10.1038/nrc.2017.51Kim SR, Bae SK, Choi KS, Park SY, Jun HO, Lee JY, et al. Visfatin promotes angiogenesis by activation of extracellular signal-regulated kinase 1/2. Biochem Biophys Res Commun 2007;357(1):150–6.Mohammed NUG, Khaleel FM, Gorial FI. The role of serum chitinase-3-like 1 protein (YKL-40) level and its correlation with proinflammatory cytokine in patients with rheumatoid arthritis. Baghdad Science Journal. 2022;19(5):1014-1014. https://doi.org/10.21123/bsj.2022.6293De Palma M, Biziato D, Petrova T V. Microenvironmental regulation of tumour angiogenesis. Nat Rev Cancer 2017;17(8):457–74.Wu M-H, Tsai C-H, Huang Y-L, Fong Y-C, Tang C-H. Visfatin promotes IL-6 and TNF-α production in human synovial fibroblasts by repressing miR-199a-5p through ERK, p38 and JNK signaling pathways. International Journal of Molecular Sciences. 2018;19(1):190. https://doi.org/10.3390/ijms19010190Mohammed NUG, Khaleel FM, Gorial FI. The Role of Serum Chitinase-3-Like 1 Protein (YKL-40) Level and its Correlation with Proinflammatory Cytokine in Patients with Rheumatoid Arthritis. Baghdad Sci J [Internet] 2022;19(5):1014. Available from: https://bsj.uobaghdad.edu.iq/index.php/BSJ/article/view/6293Mehde AA, Yusof F, Mezal SA, Farhan LO, Mehdi WA. Study the effect of increased levels of lead on sera alpha amylase activity, and some biochemical parameters from a large private electrical generators workers. Advances in Environmental Biology. 2015;9(8):163-168.Wu MH, Tsai CH, Huang YL, Fong YC, Tang CH. Visfatin promotes IL-6 and TNF-α production in human synovial fibroblasts by repressing miR-199a-5p through ERK, p38 and JNK signaling pathways. Int J Mol Sci 2018;19(1):190.The Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Research Group. Retinopathy and nephropathy in patients with type 1 diabetes four years after a trial of intensive therapy. New England Journal of Medicine. 2000;342(6):381-389. https://doi.org/10.1056%2FNEJM200002103420603Mehde AA, Yusof F, Mezal SA, Farhan LO, Mehdi WA. Study the effect of increased levels of lead on sera alpha amylase activity, and some biochemical parameters from a large private electrical generators workers. Adv Environ Biol [Internet] 2015;9(8):163–8. Available from: http://irep.iium.edu.my/id/eprint/44459Shichiri M, Kishikawa H, Ohkubo Y, Wake N. Long-term results of the Kumamoto Study on optimal diabetes control in type 2 diabetic patients. Diabetes care. 2000;23:B21.Group DC and CT of DI and CR. Retinopathy and nephropathy in patients with type 1 diabetes four years after a trial of intensive therapy. N Engl J Med 2000;342(6):381–9.Wang Y, Yuan Y, Jiang H. Serum and vitreous levels of visfatin in patients with diabetic retinopathy. Medical science monitor: international medical journal of experimental and clinical research. 2014;20:2729. https://doi.org/10.12659%2FMSM.891292Shichiri M, Kishikawa H, Ohkubo Y, Wake N. Long-term results of the Kumamoto Study on optimal diabetes control in type 2 diabetic patients. Diabetes Care 2000;23:B21.Saddi-Rosa P, Oliveira CS, Giuffrida FM, Reis AF. Visfatin, glucose metabolism and vascular disease: a review of evidence. Diabetology & Metabolic Syndrome. 2010;2:1-6. https://doi.org/10.1186%2F1758-5996-2-21Chew EY, Ambrosius WT, Davis MD. ACCORD Eye Study Group Effects of medical therapies on retinopathy progression in type 2 diabetes. N Engl J Med 2010;363(3):233–44.Abdalla MMI. Role of visfatin in obesity-induced insulin resistance. World Journal Of Clinical Cases. 2022;10(30):10840. https://doi.org/10.12998%2Fwjcc.v10.i30.10840Saddi-Rosa P, Oliveira CS V, Giuffrida F, Reis AF. Visfatin, glucose metabolism and vascular disease: a review of evidence. Diabetol Metab Syndr 2010;2(1):1–6.Romacho T, Valencia I, Ramos-González M, et al. Visfatin/eNampt induces endothelial dysfunction in vivo: A role for Toll-Like Receptor 4 and NLRP3 inflammasome. Scientific Reports. 2020;10(1):5386. https://doi.org/10.1038/s41598-020-62190-wAbdalla MMI. Role of visfatin in obesity-induced insulin resistance. World J Clin Cases 2022;10(30):10840.Pradeepa R, Anitha B, Mohan V, Ganesan A, Rema M. Risk factors for diabetic retinopathy in a South Indian type 2 diabetic population—the Chennai Urban Rural Epidemiology Study (CURES) Eye Study 4. Diabetic Medicine. 2008;25(5):536-542. https://doi.org/10.1111/j.1464-5491.2008.02423.xRomacho T, Valencia I, Ramos-González M, Vallejo S, López-Esteban M, Lorenzo O, et al. Visfatin/eNampt induces endothelial dysfunction in vivo: A role for Toll-Like Receptor 4 and NLRP3 inflammasome. Sci Rep 2020;10(1):5386.Sherwani SI, Khan HA, Ekhzaimy A, Masood A, Sakharkar MK. Significance of HbA1c Test in Diagnosis and Prognosis of Diabetic Patients. Biomark Insights. 2016;11:95-104. https://doi.org/10.4137/bmi.s38440Pradeepa R, Anitha B, Mohan V, Ganesan A, Rema M. Risk factors for diabetic retinopathy in a South Indian type 2 diabetic population—the Chennai Urban Rural Epidemiology Study (CURES) Eye Study 4. Diabet Med 2008;25(5):536–42.Farhan LO, Taha EM, Farhan AM. A Case control study to determine Macrophage migration inhibitor, and N-telopeptides of type I bone collagen Levels in the sera of osteoporosis patients. Baghdad Science Journal. 2022;19(4):0848-0848. https://doi.org/10.21123/bsj.2022.19.4.0848Sherwani SI, Khan HA, Ekhzaimy A, Masood A, Sakharkar MK. Significance of HbA1c test in diagnosis and prognosis of diabetic patients. Biomark Insights 2016;11:BMI-S38440.Hetta HF, Ez-Eldeen ME, Mohamed GA, et al. Visfatin serum levels in obese type 2 diabetic patients: relation to proinflammatory cytokines and insulin resistance. Egypt J Immunol. 2018;25(2):141-151.Farhan LO, Taha EM, Farhan AM. A Case control study to determine Macrophage migration inhibitor, and N-telopeptides of type I bone collagen Levels in the sera of osteoporosis patients. Baghdad Sci J 2022;848.Gurlevik U, Erol YO, Yasar E. Serum and vitreous resistin levels in patıents with proliferative diabetic retinopathy. Diabetes Research And Clinical Practice. 2019;155:107803. https://doi.org/10.1016/j.diabres.2019.107803Hetta HF, Ez-Eldeen ME, Mohamed GA, Gaber MA, ElBadre HM, Ahmed EA, et al. Visfatin serum levels in obese type 2 diabetic patients: relation to proinflammatory cytokines and insulin resistance. Egypt J Immunol 2018;25(2):141–51.Tolonen N, Hietala K, Forsblom C, et al. Associations and interactions between lipid profiles, retinopathy and nephropathy in patients with type 1 diabetes: the FinnDiane Study. J Intern Med. 2013;274(5):469-479. https://doi.org/10.1111/joim.12111Wang Y, Yuan Y, Jiang H. Serum and vitreous levels of visfatin in patients with diabetic retinopathy. Med Sci Monit Int Med J Exp Clin Res 2014;20:2729.Chatziralli I, Sergentanis TN, Crosby-Nwaobi R, et al. Model for risk-based screening of diabetic retinopathy in people with newly-diagnosed type 2 diabetes mellitus. Investigative Ophthalmology & Visual Science. 2017;58(6):BIO99-BIO105. https://doi.org/10.1167/iovs.17-21713Gurlevik U, Erol YO, Yasar E. Serum and vitreous resistin levels in patıents with proliferative diabetic retinopathy. diabetes Res Clin Pract 2019;155:107803.Nakayama A, Morita H, Sato T, et al. Small dense low-density lipoprotein cholesterol is a potential marker for predicting laser treatment for retinopathy in diabetic patients. Journal Of Atherosclerosis And Thrombosis. 2022;29(5):678-691. https://doi.org/10.5551/jat.62889Tolonen N, Hietala K, Forsblom C, Harjutsalo V, Mäkinen V, Kytö J, et al. Associations and interactions between lipid profiles, retinopathy and nephropathy in patients with type 1 diabetes: the F inn D iane S tudy. J Intern Med 2013;274(5):469–79.Kowluru RA, Kowluru A, Mishra M, Kumar B. Oxidative stress and epigenetic modifications in the pathogenesis of diabetic retinopathy. Prog Retin Eye Res. 2015;48:40-61. https://doi.org/10.1016/j.preteyeres.2015.05.001Chatziralli I, Sergentanis TN, Crosby-Nwaobi R, Winkley K, Eleftheriadis H, Ismail K, et al. Model for risk-based screening of diabetic retinopathy in people with newly-diagnosed type 2 diabetes mellitus. Invest Ophthalmol Vis Sci 2017;58(6):BIO99–105.Simo R, Sundstrom JM, Antonetti DA. Ocular anti-VEGF therapy for diabetic retinopathy: the role of VEGF in the pathogenesis of diabetic retinopathy. Diabetes Care. 2014;37(4):893-899. https://doi.org/10.2337/dc13-2002Nakayama A, Morita H, Sato T, Kawahara T, Takeda N, Kato S, et al. Small dense low-density lipoprotein cholesterol is a potential marker for predicting laser treatment for retinopathy in diabetic patients. J Atheroscler Thromb 2022;29(5):678–91.Kinuthia UM, Wolf A, Langmann T. Microglia and inflammatory responses in diabetic retinopathy. Frontiers In Immunology. 2020;11:564077. https://doi.org/10.3389/fimmu.2020.564077Kowluru RA, Kowluru A, Mishra M, Kumar B. Oxidative stress and epigenetic modifications in the pathogenesis of diabetic retinopathy. Prog Retin Eye Res 2015;48:40–61.Semeraro F, Morescalchi F, Cancarini A, Russo A, Rezzola S, Costagliola C. Diabetic retinopathy, a vascular and inflammatory disease: therapeutic implications. Diabetes & Metabolism. 2019;45(6):517-527. https://doi.org/10.1016/j.diabet.2019.04.002Simo R, Sundstrom JM, Antonetti DA. Ocular anti-VEGF therapy for diabetic retinopathy: the role of VEGF in the pathogenesis of diabetic retinopathy. Diabetes Care 2014;37(4):893–9.Rezzola S, Corsini M, Chiodelli P, et al. Inflammation and N-formyl peptide receptors mediate the angiogenic activity of human vitreous humour in proliferative diabetic retinopathy. Diabetologia. 2017;60:719-728. https://doi.org/10.1007/s00125-016-4204-0Kinuthia UM, Wolf A, Langmann T. Microglia and inflammatory responses in diabetic retinopathy. Front Immunol 2020;11:564077.Li X, Zhang M, Zhou H. The morphological features and mitochondrial oxidative stress mechanism of the retinal neurons apoptosis in early diabetic rats. J Diabetes Res. 2014;2014:678123. https://doi.org/10.1155/2014/678123Semeraro F, Morescalchi F, Cancarini A, Russo A, Rezzola S, Costagliola C. Diabetic retinopathy, a vascular and inflammatory disease: Therapeutic implications. Diabetes Metab 2019;45(6):517–27.Mohammed NUG, Gorial FI, Khaleel FM, et al. Role of Human β-Defensin-3 in Rheumatoid Arthritis: An Observational Single-Center Study. Al-Rafidain Journal of Medical Sciences. 2023;5(1S):S71-75. https://doi.org/10.54133/ajms.v5i1S.289Rezzola S, Corsini M, Chiodelli P, Cancarini A, Nawaz IM, Coltrini D, et al. Inflammation and N-formyl peptide receptors mediate the angiogenic activity of human vitreous humour in proliferative diabetic retinopathy. Diabetologia 2017;60:719–28.Mårtensson CU, Doan KN, Becker T. Effects of lipids on mitochondrial functions. Biochim Biophys Acta Mol Cell Biol Lipids. 2017;1862(1):102-113. https://doi.org/10.1016/j.bbalip.2016.06.015Li X, Zhang M, Zhou H. The morphological features and mitochondrial oxidative stress mechanism of the retinal neurons apoptosis in early diabetic rats. J Diabetes Res 2014;2014.Mohammed NUG, Gorial FI, Khaleel FM, Abed BA, Mutar SA, Farhan LO, et al. Role of Human β-Defensin-3 in Rheumatoid Arthritis: An Observational Single-Center Study. Al-Rafidain J Med Sci ( ISSN 2789-3219 ) [Internet] 2023;5(1S):S71-75. Available from: https://alhadhar.co/ajms/index.php/ALRAFIDAIN/article/view/289Mohammed NUG, Gorial FI, Khaleel FM, Abed BA, Mutar SA, Farhan LO, et al. Role of Human β-Defensin-3 in Rheumatoid Arthritis: An Observational Single-Center Study. Al-Rafidain J Med Sci ( ISSN 2789-3219 ) [Internet] 2023;5(1S):S71-75. Available from: https://alhadhar.co/ajms/index.php/ALRAFIDAIN/article/view/289Mårtensson CU, Doan KN, Becker T. Effects of lipids on mitochondrial functions. Biochim Biophys Acta (BBA)-Molecular Cell Biol Lipids 2017;1862(1):102–13.Mårtensson CU, Doan KN, Becker T. Effects of lipids on mitochondrial functions. Biochim Biophys Acta (BBA)-Molecular Cell Biol Lipids 2017;1862(1):102–13.

The authors declare that there are no conflicts of interest present.