Fibronectin as a Nexus of Inflammation and Dysmetabolism in Type 2 Diabetes

Abstract

Fibronectin (FN) is a major component of the extracellular matrix and is known to participate in essential biological activities such as wound healing, cell adhesion, and vascular remodeling. Several studies have suggested that FN might be involved in the metabolic disturbances and vascular complication commonly seen in type 2 diabetes mellitus (T2DM).

The purpose of this research was to investigate FN concentrations in Iraqi T2DM patients, examine their links to insulin resistance, and oxidative stress.

We conducted a study at Baghdad Medical City Hospital between January and June 2025. A total of 150 participants were enrolled and divided equally into three groups: patients with T2DM and complications, patients with T2DM but without complications, and healthy controls. For all participants, plasma FN, HOMA‑IR, malondialdehyde (MDA), C‑reactive protein (CRP), HbA1c, fasting glucose, and total cholesterol were assessed using validated ELISA kits together with routine biochemical techniques.

Our findings revealed that FN concentrations were substantially higher in patients with T2DM who had complications (662.6 ± 6.1 mg/dL) compared with those without complications (533.4 ± 6.2 mg/dL) and the control group (311.5 ± 6.2 mg/dL) (p < 0.001). Moreover, FN showed strong positive correlations with HOMA‑IR (r = 0.84), CRP (r = 0.88), and MDA (r = 0.85), all of which were statistically significant (p < 0.01).

These observations highlight that FN is closely related to insulin resistance, oxidative stress, and inflammatory status in patients with T2DM. Its strong association with diabetic complications supports its potential value as a complementary biomarker to HbA1c. Our study adds new data from a Middle Eastern population, where few studies have examined FN in diabetes.