The Role of Leptin to Adiponectin Ratio in Prediction of Insulin Resistance and Type 2 Diabetes Mellitus

Abstract

ABSTRACT
Background: Adipose tissues which secret hormones such as adiponectin and leptin are
now regarded as a functional part of the endocrine system. Many of these adipokines has
a physiological role in metabolism. The uncontrolled secretions of several adipokines were
leading to metabolic disorders including obesity, atherosclerosis and insulin resistance
and type 2 diabetes mellitus.
Objectives: To ascertain the relationship between adiponectin and leptin with the
development of type 2 diabetes mellitus and to assess the role of obesity and insulin
resistance in these relations.
Methods: This study included thirty non-diabetic obese subjects and thirty non-obese type
2 DM patients, in addition to twenty-eight age and sex matched healthy individuals. Serum
adiponectin and leptin were measured using ELISA technique.
Results: Serum levels of adiponectin for non-diabetic obese subjects were significantly
lower (15.7±2.7 μg/ml) than their levels in non-obese diabetic and control subjects
(23.9±3.8, 26.7± 3.1 μg /ml), (P<0.001, 0.005), respectively, while such difference was
lacked when comparing their levels between the non-obese diabetic and control subjects.
Serum leptin concentrations and LAR values were significantly higher in the sixty subjects
(non-diabetic obese and non-obese diabetic), (149± 21, 85± 25 ng/ml) (9.5 ± 1.1, 3.9±
0.9), when comparing their values with that of control group (20 ± 8 ng/ml)(0.7± 0.2)
(P<0.005, 0.001), respectively, while their levels were higher in non-diabetic obese in
comparison to that of non-obese diabetic (<P0.01, 0.05). There were a significant positive
correlation between serum adiponectin levels and HDL-C levels in non-diabetic obese
group (r=0.032, p<0.05) and negatively with HOMA – IR (r = 0.39, P <0.01). Serum leptin
levels and LAR values were significantly positively correlated BMI (r= 0.35, P <0.01), with
serum insulin levels (r= 0.28, p<0.001), TG and VLDL- c (r=0.25, P<0.01) in non-diabetic
obese subjects.
Conclusion: The changes of adiponectin and leptin levels attributed to the excess
adipose tissue mass rather than the presence of the state of diabetes. Leptin / Adiponectn
ratio may be a useful atherogenic index in obese type 2 diabetes mellitus
Keywords: Adiponectin, Leptin, Leptin/adiponectin ratio, Type 2 diabetes mellitus,
Insulin resistance.