Serum leptin and its relationship with metabolic variables in Arabs with type 2 diabetes mellitus

Abstract

Background and Objectives: Most studies on serum leptin in type 2 diabetes mellitus have focused on white populations. We studied serum leptin concentrations and parameters related to glycemic control and the association between leptin levels and anthropometric and metabolic factors in Arab patients with type 2 diabe--tes and in Arab control subjects. Subjects and Methods: Ninety-two patients (65 females and 27 males) with type 2 diabetes and 69 matched normal control subjects (48 females and 21 males) were included. Anthropometric measures (including body mass index [BMI] and waist:hip ratio) were assessed in all subjects. After an overnight fast, blood was collected for serum leptin assay. Other metabolic parameters including glucose, insulin, C-peptide, intact proinsulin, insulin resistance index (HOMA-IR), insulin-like growth factor 1 (IGF-1), lipids and hemoglobin A1c (HbA 1c ) were determined. Results: Fasting serum leptin levels, IGF-1 and high-density lipoprotein (HDL) cholesterol were similar in patients with type 2 diabetes and control subjects. When obese subjects (BMI 230 kg/m 2 ) were analyzed separately, serum levels of leptin were significantly lower in patients compared to controls. In contrast, patients had higher fasting glucose, insulin, C-peptide, intact proinsulin, insulin resistance, total cholesterol, triglycerides, HbA 1c , and a larger waist circumference and waist-to-hip ratio than controls. Serum leptin correlated positively with BMI, negatively with waist-to-hip ratio, and demonstrated no relationship to other parameters. Conclusion: Patients with type 2 diabetes in an Arab ethnic population showed evidence of an unfavorable metabolic profile despite having leptin levels similar to controls. Obesity influences serum leptin levels more significantly in type 2 diabetes, in which leptin levels tends to be low.