Association of serum leptin and insulin levels among type 2 diabetes mellitus patients: A case–control study

Secretion of insulin is compromised in type 2 diabetes (T2DM) individuals and inadequate to accommodate for insulin resistance (IR) in peripheral tissue. Hyperleptinemia reflects leptin resistance, which is a key factor in the production of IR in T2DM patients, making leptin a potential biomarker for evaluating IR levels. The objective of the study was to assess the association of serum leptin and insulin levels among T2DM patients. This case-control research was carried out on T2DM patients. A total of 73 patients diagnosed with T2DM (the case group) and 40 healthy participants (control; group 3) were enrolled according to the American Diabetes Association (ADA) criteria. In the case group, T2DM patients were enrolled with metabolic syndrome (group 1, n = 38) or without metabolic syndrome (group 2, n = 35) according to the WHO criteria. Metabolic profiles of T2DM patients with or without metabolic syndrome were evaluated, and compare these two groups with healthy controls. The subjects of all groups were age- and gender-matched. Body mass index (BMI, P < .01), fasting (P = .0133) and postprandial (P < .01) blood sugar levels, % glycated hemoglobin (HbA1c, P < .01), and lipid profile (P < .01) were found significantly different and higher in group 1 as compared to groups 2 and 3. Serum leptin and insulin levels were found higher and significant in patients with metabolic syndrome (P < .01 for both). The values of serum leptin levels were 10.01 ± 2.7 ng/mL, 6.9 ± 2.4 ng/mL, and 4.11 ± 1.8 ng/mL, and those of serum insulin 120 ± 40.7 µIU/mL, 20.43 ± 5.2 µIU/mL, and 11.4 ± 2.5 µIU/mL in groups 1, 2, and 3, respectively. There was a positive linear correlation between BMI, blood sugar, HbA1c, serum cholesterol (TC), and triglycerides (TG) with serum insulin and leptin levels in the case group. An extremely significant correlation (R = 0.74, P < .001) was found in BMI and serum leptin level in the case group. Serum leptin and insulin levels have a positive association, with serum leptin being a significant predictor of IR syndrome (Evidence Level: 5; Technical Efficacy: Stage 3).

[1]  C. Dayanand,et al.  Insulin resistance and decreased spexin in Indian Patients with Type 2 Diabetes Mellitus , 2021, Bioinformation.

[2]  T. Gojobori,et al.  Leptin and Obesity: Role and Clinical Implication , 2021, Frontiers in Endocrinology.

[3]  Ratan Kumar,et al.  Association of Leptin With Obesity and Insulin Resistance , 2020, Cureus.

[4]  G. Aktas,et al.  Is Neuregulin‐4 a predictive marker of microvascular complications in type 2 diabetes mellitus? , 2020, European journal of clinical investigation.

[5]  Adnan Khan,et al.  Correlation between serum leptin level and Body mass index (BMI) in patients with type 2 diabetes Mellitus. , 2020, JPMA. The Journal of the Pakistan Medical Association.

[6]  2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes—2020 , 2019, Diabetes Care.

[7]  F. Casanueva,et al.  Leptin, Obesity, and Leptin Resistance: Where Are We 25 Years Later? , 2019, Nutrients.

[8]  G. Aktas,et al.  Neuregulin-4 is associated with plasma glucose and increased risk of type 2 diabetes mellitus. , 2019, Swiss medical weekly.

[9]  N. Wong,et al.  Epidemiology of Diabetes Mellitus and Cardiovascular Disease , 2019, Current Cardiology Reports.

[10]  S. Koh,et al.  Contribution of obesity as an effect regulator to an association between serum leptin and incident metabolic syndrome. , 2018, Clinica chimica acta; international journal of clinical chemistry.

[11]  P. Titchenell,et al.  Resolving the Paradox of Hepatic Insulin Resistance , 2018, Cellular and molecular gastroenterology and hepatology.

[12]  M. Akishita,et al.  Plasma Leptin Concentration and Sympathetic Nervous Activity in Older Adults With Physical Dysfunction , 2018, Journal of the Endocrine Society.

[13]  S. A. Sadananthan,et al.  Regulation of glucose metabolism in nondiabetic, metabolically obese normal-weight Asians. , 2018, American journal of physiology. Endocrinology and metabolism.

[14]  K. Ravichandran,et al.  Evaluation of Leptin as a Marker of Insulin Resistance in Type 2 Diabetes Mellitus , 2017, International journal of applied & basic medical research.

[15]  S Lovestone,et al.  Insulin signalling in Alzheimer′s disease and diabetes: from epidemiology to molecular links , 2016, Journal of internal medicine.

[16]  J. Shapiro,et al.  Systematic Review of Metabolic Syndrome Biomarkers: A Panel for Early Detection, Management, and Risk Stratification in the West Virginian Population , 2016, International journal of medical sciences.

[17]  A. Zeidan,et al.  Differential Role of Leptin and Adiponectin in Cardiovascular System , 2015, International journal of endocrinology.

[18]  M. Sit,et al.  Evaluation of the urinary kidney injury molecule-1 levels in patients with diabetic nephropathy. , 2014, Clinical and investigative medicine. Medecine clinique et experimentale.

[19]  Yoshimasa Tanaka,et al.  Risk Factors Contributing to Type 2 Diabetes and Recent Advances in the Treatment and Prevention , 2014, International journal of medical sciences.

[20]  A. Alçelik,et al.  Serum omentin-1 levels in diabetic and nondiabetic patients with chronic kidney disease. , 2014, Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association.

[21]  M. Tosun,et al.  Association between omentin levels and insulin resistance in pregnancy. , 2014, Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association.

[22]  A. Asakawa,et al.  The role of leptin in the control of insulin-glucose axis , 2013, Front. Neurosci..

[23]  A. A. da Silva,et al.  Role of leptin and central nervous system melanocortins in obesity hypertension , 2013, Current opinion in nephrology and hypertension.

[24]  A. Kengne,et al.  Metabolic syndrome in type 2 diabetes: comparative prevalence according to two sets of diagnostic criteria in sub-Saharan Africans , 2012, Diabetology & Metabolic Syndrome.

[25]  P. Zimmet,et al.  The worldwide epidemiology of type 2 diabetes mellitus—present and future perspectives , 2012, Nature Reviews Endocrinology.

[26]  S. Lee,et al.  Association between metabolic syndrome and serum leptin levels in postmenopausal women , 2012, Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology.

[27]  J. Gómez-Reino,et al.  Adipokines: biofactors from white adipose tissue. A complex hub among inflammation, metabolism, and immunity. , 2011, BioFactors.

[28]  P. O S I T I O N S T A T E M E N T,et al.  Diagnosis and Classification of Diabetes Mellitus , 2011, Diabetes Care.

[29]  Adil Omar,et al.  Relationship of Leptin Hormones with Body Mass Index and Waist Circumference in Saudi Female Population of the Makkah Community , 2010 .

[30]  Paul L. Huang A comprehensive definition for metabolic syndrome , 2009, Disease Models & Mechanisms.

[31]  P. Macfarlane,et al.  Leptin Predicts Diabetes but Not Cardiovascular Disease , 2009, Diabetes Care.

[32]  R. Leibel,et al.  20 YEARS OF LEPTIN Role of leptin in energy homeostasis in humans , 2014 .

[33]  Debojyoti Bhattacharjee,et al.  Association of obesity and leptin with insulin resistance in type 2 diabetes mellitus in Indian population. , 2013, Indian journal of physiology and pharmacology.

[34]  M. Martins,et al.  [Relationship between leptin and body mass and metabolic syndrome in an adult population]. , 2012, Revista portuguesa de cardiologia : orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology.