Metabolic changes in obese patients with and without diabetic mellitus

الملخص EN

Increasing body weight is a risk factor for development of insulin resistance and type 2 diabetes mellitus (T2DM).

The exact relationship between leptin (a hormonal product of adipocytes), insulin and adiposity in patients with T2DM are sometimes controversial.

In this study we investigated diabetics obese (n=30), non-obese (n=31) and subjects with simple obesity (n=34) looking for a specific metabolic profile associated with T2DM and obesity.

Compared to controls (n=15), serum C-peptide was higher while insulin was lower in diabetics but higher in non-diabetics obese, implying a state of insulin resistance.

Hyperleptinemia was observed in diabetics and obese subjects, implying a state of leptin resistance.

Serum cortisol was higher in non-diabetics obese.

Triglyceridemia and hyperuricemia were observed in diabetics and non-diabetics obese respectively.

Significant correlations between leptin and insulin were reported in obese (r=-0.465, p<0.035) and obese diabetics (r=-0.383, p<0.046) and diabetics non-obese (r=0.589, p<0.008).

With simple obesity, positive correlations were reported between leptin, cortisol (r=0.357, p<0.045) and uric acid (r=0.547, p<0.001).

The association of insulin and leptin resistances, dyslipidemia, hyperuricemia and hypercortisolemia with obesity supports the notion that the regulatory defect of blood glucose and obesity is associated with long-term metabolic and vascular complications.