Effects of Improving Glycemic Control with Insulin on Leptin, Adiponectin, Ghrelin and Neuropeptidey Levels in Patients with Type 2 Diabetes Mellitus: a Pilot Study
Niki Katsiki1, 2, Dimitri P Mikhailidis2, *, Anna Gotzamani-Psarrakou3, Triantafillos P Didangelos1, John G Yovos4, Dimitrios T Karamitsos1
1 First Propedeutic Department of Internal Medicine, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
2 Department of Clinical Biochemistry, Royal Free Campus, University College London Medical School, University College London (UCL), London, UK
3 2nd Laboratory of Nuclear Medicine, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
4 Department of Endocrinology and Metabolism, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
Insulin therapy is associated with weight gain in patients with type 2 diabetes mellitus (T2DM). Several peptides are implicated in appetite control. We evaluated the effects of insulin-induced improved glycaemic control on leptin, adiponectin, ghrelin, neuropeptide Y (NPY) levels and patient characteristics.
Consecutive T2DM patients (n = 90) were divided into 2 groups: Group A: 45 insulin-naïve uncontrolled (glycosylated haemoglobin A1c; HbA1c >7%) patients on oral hypoglycaemic agents (OHAs) who converted to insulin monotherapy. Group B: 45 well-controlled (HbA1c <7%) patients on OHAs. Both groups were monitored at baseline, 3 and 6 months. Males and females were analyzed separately because some hormone levels differ between genders.
In both genders, insulin therapy (Group A) was associated with significant (p = 0.003 to <0.001) increases in weight, body mass index and leptin levels and significant decreases in glucose, HbA1c and NPY levels. In male insulin-treated patients a significant increase in adiponectin levels (p = 0.008) was observed. There were significant correlations (p = 0.016 to <0.001) between leptin levels, waist circumference and body fat in all patient groups, except group B males.
Changes in leptin, adiponectin and NPY levels may occur after insulin-induced improved glycaemic control. These changes may be influenced by gender, weight, body fat and HbA1c.
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* Address correspondence to this author at the Dept. of Clinical Biochemistry (Vascular Disease Prevention Clinics), Royal Free Hospital Campus, University College London Medical School, University College London (UCL), Pond Street, London NW3 2QG, UK; Tel: 0044 (0) 20 7830 2258; Fax: 0044 (0) 20 7830 2235; E-mails: MIKHAILIDIS@aol.com, firstname.lastname@example.org