Association of Adiponectin-Leptin Ratio and HOMA-IR in Obese Patients with and without Type 2 Diabetes Mellitus: A Cross-sectional Study

Abstract

Introduction: Obesity is one of the leading causes of morbidity and mortality due to associated risk factors, including Type 2 Diabetes Mellitus (T2DM). Obese and diabetic patients have lower amounts of adiponectin. Leptin, a hormone released by adipocytes that controls hunger, is crucial in the emergence of obesity. Furthermore, it has been claimed that the Adiponectin/ Leptin Ratio (ALR) correlates with Insulin Resistance (IR) better than adiponectin or leptin alone. Aim: To evaluate adiponectin, leptin, and Homeostasis Model Assessment-Insulin Resistance (HOMA-IR) in obese subjects with and without T2DM and compare the variations, if any, from the normal subjects. Materials and Methods: This hospital-based, cross-sectional study was carried out at Sri Guru Ram Das (SGRD) University of Health Sciences, Amritsar, and Punjab Institute of Medical Sciences (PIMS), Jalandhar from January 2020 to December 2022. A total of 125 subjects of either gender aged above 18 years, visiting the medicine Outpatient Department (OPD) of PIMS, Jalandhar, were included in the study. Among them, 25 healthy volunteers served as controls. Serum levels of Adiponectin, Leptin, and Insulin were estimated using the Enzyme-Linked Immunosorbent Assay (ELISA) method. The data obtained were statistically analysed using one-way Analysis of Variance (ANOVA) test (with Bonferroni post-hoc). Results: A total of 125 participants were analysed in the present study, with 50 being obese with T2DM (mean age: 50.22±8.6 years), 50 being obese without T2DM (mean age: 46.9±9.8 years), and 25 being non obese non diabetic individuals (controls) (mean age: 42.8±9.09 years). A higher number of females 78 (62.4%) reported to the OPD compared to males 47 (37.6%). Although no statistical significance was found, there was a considerable decrease in adiponectin levels in obese and obese with T2DM subjects. Moreover, the leptin levels and HOMA-IR were increased in obese and obese with T2DM subjects compared to the control subjects. Conclusion: ALR may be used as a clinical marker for assessing the morbidity due to obesity and in T2DM subjects. Moreover, lifestyle modifications can be targeted to prevent IR.

Keywords

• adipose tissue
• glycated haemoglobin
• homeostatic model assessment of insulin resistance
• insulin levels