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Alfaqih MA, Aljanabi M, Ababneh E, Khanfar M, Alqudah M, Sater M. Leptin and the rs2167270 Polymorphism Are Associated with Glycemic Control in Type Two Diabetes Mellitus Patients on Metformin Therapy. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:997. [PMID: 37241229 PMCID: PMC10221967 DOI: 10.3390/medicina59050997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 05/04/2023] [Accepted: 05/06/2023] [Indexed: 05/28/2023]
Abstract
Background and Objectives: Type two diabetes mellitus (T2DM) is a chronic disease with debilitating complications and high mortality. Evidence indicates that good glycemic control delays disease progression and is hence a target of disease management protocols. Nonetheless, some patients cannot maintain glycemic control. This study aimed to investigate the association between serum leptin levels and several SNPs of the LEP gene with the lack of glycemic control in T2DM patients on metformin therapy. Materials and Methods: In a hospital-based case-control study, 170 patients with poor glycemic control and 170 patients with good glycemic control were recruited. Serum leptin was measured. Patients were genotyped for three SNPs in the LEP gene (rs7799039, rs2167270, and rs791620). Results: Serum leptin was significantly lower in T2DM patients with poor glycemic control (p < 0.05). In multivariate analysis, serum leptin levels significantly lowered the risk of having poor glycemic control (OR = 0.985; CI: 0.976-0.994; p = 0.002); moreover, the GA genotype of rs2167270 was protective against poor glycemic control compared to the GG genotype (OR = 0.417; CI: 0.245-0.712; p = 0.001). Conclusions: Higher serum leptin and the GA genotype of the rs2167270 SNP of the LEP gene were associated with good glycemic control in T2DM patients on metformin therapy. Further studies with a larger sample size from multiple institutions are required to validate the findings.
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Affiliation(s)
- Mahmoud A. Alfaqih
- Department of Biochemistry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama 15503, Bahrain;
- Department of Physiology and Biochemistry, Faculty of Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan; (M.A.); (E.A.); (M.K.)
| | - Mukhallad Aljanabi
- Department of Physiology and Biochemistry, Faculty of Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan; (M.A.); (E.A.); (M.K.)
| | - Ebaa Ababneh
- Department of Physiology and Biochemistry, Faculty of Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan; (M.A.); (E.A.); (M.K.)
| | - Mariam Khanfar
- Department of Physiology and Biochemistry, Faculty of Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan; (M.A.); (E.A.); (M.K.)
| | - Mohammad Alqudah
- Department of Physiology, Faculty of Medicine, College of Medicine and Medical Sciences, Manama 15503, Bahrain;
| | - Mai Sater
- Department of Biochemistry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama 15503, Bahrain;
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Wei X, Bai Y, Wang Z, Zheng X, Jin Z, Liu X. Association between dipeptidyl peptidase-4 inhibitors use and leptin in type 2 diabetes mellitus. Diabetol Metab Syndr 2021; 13:88. [PMID: 34446063 PMCID: PMC8390252 DOI: 10.1186/s13098-021-00703-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 08/02/2021] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Dipeptidyl peptidase-4 inhibitors (DPP-4i) provide a unique antihyperglycemic effect by regulating incretin peptides in type 2 diabetes mellitus (T2DM) patients who are inadequately controlled with insulin therapy. The aim of this study was to investigate the impact of DPP-4i on leptin concentrations in subjects with T2DM. METHODS Randomized controlled trials (RCTs) with comparators were systematically searched through PubMed, Embase, and the Cochrane Library. Quantitative analysis was performed with a fixed or random-effects model according to heterogeneity. Publication bias was evaluated by using the standard methods for sensitivity analysis. RESULTS Ten trials with 698 patients with T2DM were included. Pooled analysis demonstrated that DPP-4i did not significantly change leptin concentrations (1.31 ng/mL, 95 % CI - 0.48 to 3.10). DPP-4i exerted effects on modulating leptin levels compared to active comparators (0.21 ng/mL, 95 % CI - 1.37 to 1.78). Meta-analysis was powerful and stable after sensitivity analysis. CONCLUSIONS DPP-4i did not modulate leptin concentrations in T2DM and exerted no stronger effects than traditional antidiabetic agents.
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Affiliation(s)
- Xin Wei
- Department of Cardiology and Macrovascular Disease, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yu Bai
- Department of Otolaryngology, Beijing Haidian Hospital, Beijing, China
| | - Zhuo Wang
- Department of Gastroenterology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xiaohong Zheng
- Department of Neuro-Oncology, Cancer Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Zening Jin
- Department of Cardiology and Macrovascular Disease, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
| | - Xin Liu
- Department of Pharmacy, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
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Metabolic Syndrome and Abnormal Peri-Organ or Intra-Organ Fat (APIFat) Deposition in Chronic Obstructive Pulmonary Disease: An Overview. Metabolites 2020; 10:metabo10110465. [PMID: 33203192 PMCID: PMC7696438 DOI: 10.3390/metabo10110465] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 11/04/2020] [Accepted: 11/13/2020] [Indexed: 12/11/2022] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is a common disorder with an increasing prevalence, characterised by persistent respiratory symptoms and airflow limitation. Systemic inflammation is involved in the pathogenesis of COPD and can also predispose to metabolic disorders (e.g., metabolic syndrome (MetS) and non-alcoholic fatty liver disease (NAFLD)). Such comorbidities can negatively affect COPD outcomes, cardiovascular risk, and quality of life. Apart from NAFLD, abnormal peri-organ or intra-organ fat (APIFat) could be considered as markers for cardiometabolic diseases and even for COPD. The present narrative review considers the associations of COPD with MetS, NAFLD, and other APIFat, including epicardial, perirenal, peripancreatic, and intramuscular adipose tissue. Further research is needed to define these relationships and identify any potential clinical implications.
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Li YX, Fang DH, Liu TX. Laparoscopic sleeve gastrectomy combined with single-anastomosis duodenal-jejunal bypass in the treatment of type 2 diabetes mellitus of patients with body mass index higher than 27.5 kg/m2 but lower than 32.5 kg/m2. Medicine (Baltimore) 2018; 97:e11537. [PMID: 30075520 PMCID: PMC6081088 DOI: 10.1097/md.0000000000011537] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 06/20/2018] [Indexed: 12/25/2022] Open
Abstract
This study aimed to introduce this surgical technique laparoscopic sleeve gastrectomy combined with single-anastomosis duodenal-jejunal bypass (LDJB-LSG), and to confirm this new surgical technique was safe in the treatment of type 2 diabetes mellitus (T2DM) of patients with body mass index (BMI) higher than 27.5 kg/m but lower than 32.5 kg/m.A total of 34 T2DM patients with (BMI) higher than 27.5 kg/m but lower than 32.5 kg/m were admitted to our department between January 2014 and October 2016, of whom 25 received laparoscopic gastric bypass surgery (LRYGB) and 9 received LDJB-LSG. The efficacy and safety were compared between the 2 groups.None in both groups died and had severe postoperative complications. All the surgeries were performed by laparoscopy, and none received switching to open surgery. Patients received regular follow-up after surgery and none were lost to follow-up.Our study indicates LDJB-LSG is similar to LRYGB in the improvements of the body weight, blood glucose, insulin resistance, islet β cell function, blood lipid profile and serum uric acid, and thus LDJB-LSG is applicable in T2DM patients with 27.5 kg/m ≤ BMI ≤ 32.5 kg/m and risk for gastric cancer. However, long-term therapeutic effects need to be evaluated by studies with multicenter, large sample size, and long-term follow-ups.
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Katsiki N, Mikhailidis DP, Banach M. Leptin, cardiovascular diseases and type 2 diabetes mellitus. Acta Pharmacol Sin 2018; 39:1176-1188. [PMID: 29877321 PMCID: PMC6289384 DOI: 10.1038/aps.2018.40] [Citation(s) in RCA: 148] [Impact Index Per Article: 24.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2018] [Accepted: 05/02/2018] [Indexed: 02/07/2023] Open
Abstract
Leptin, an adipokine that is implicated in the control of food intake via appetite suppression, may also stimulate oxidative stress, inflammation, thrombosis, arterial stiffness, angiogenesis and atherogenesis. These leptin-induced effects may predispose to the development of cardiovascular diseases. In the present review we discuss the evidence linking leptin levels with the presence, severity and/or prognosis of both coronary artery disease and non-cardiac vascular diseases such as stroke, carotid artery disease, peripheral artery disease (PAD) and abdominal aortic aneurysms (AAA) as well as with chronic kidney disease (CKD) and type 2 diabetes mellitus (T2DM). Leptin levels have been positively associated with the presence, severity, extent and lesion complexity of coronary atherosclerosis as well as with the presence, severity and poor clinical outcomes of both ischemic and hemorrhagic strokes. But conflicting results also exist. Furthermore, leptin was reported to independently predict common carotid intima-media thickness and carotid plaque instability. A link between hyperleptinemia and PAD has been reported, whereas limited data were available on the potential association between leptin and AAA. Elevated leptin concentrations have also been related to CKD incidence and progression as well as with insulin resistance, T2DM, micro- and macrovascular diabetic complications. Statins and antidiabetic drugs (including sitagliptin, metformin, pioglitazone, liraglutide and empagliflozin) may affect leptin levels. Further research is needed to establish the potential use (if any) of leptin as a therapeutic target in these diseases.
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Affiliation(s)
- Niki Katsiki
- Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippocration Hospital, Thessaloniki, Greece
| | - Dimitri P Mikhailidis
- Department of Clinical Biochemistry, Royal Free Hospital Campus, University College London Medical School, University College London (UCL), London, UK.
| | - Maciej Banach
- Department of Hypertension, Medical University of Lodz, Lodz, Poland
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Zhang Q, Zhao X, Chen M, Fang Z, Chen Y, Wang Y. Weight gain and changes in plasma adiponectin and leptin concentrations after 12-month insulin intensive therapy for Chinese male patients with newly diagnosed type 2 diabetes. Obes Res Clin Pract 2016; 10:553-563. [DOI: 10.1016/j.orcp.2015.09.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2014] [Revised: 08/17/2015] [Accepted: 09/08/2015] [Indexed: 12/15/2022]
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Anagnostis P, Katsiki N, Athyros VG, Karagiannis A. Adiponectin and Aldosterone in Left Ventricular Hypertrophy: An Intriguing Interplay. Angiology 2014; 69:745-748. [PMID: 24687414 DOI: 10.1177/0003319714527785] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Affiliation(s)
- Panagiotis Anagnostis
- 1 Division of Endocrinology, Police Medical Centre, Thessaloniki, Greece.,2 Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece
| | - Niki Katsiki
- 2 Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece
| | - Vasilios G Athyros
- 2 Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece
| | - Asterios Karagiannis
- 2 Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece
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Obradovic M, Bjelogrlic P, Rizzo M, Katsiki N, Haidara M, Stewart AJ, Jovanovic A, Isenovic ER. Effects of obesity and estradiol on Na+/K+-ATPase and their relevance to cardiovascular diseases. J Endocrinol 2013; 218:R13-23. [PMID: 23785175 DOI: 10.1530/joe-13-0144] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Obesity is associated with aberrant sodium/potassium-ATPase (Na(+)/K(+)-ATPase) activity, apparently linked to hyperglycemic hyperinsulinemia, which may repress or inactivate the enzyme. The reduction of Na(+)/K(+)-ATPase activity in cardiac tissue induces myocyte death and cardiac dysfunction, leading to the development of myocardial dilation in animal models; this has also been documented in patients with heart failure (HF). During several pathological situations (cardiac insufficiency and HF) and in experimental models (obesity), the heart becomes more sensitive to the effect of cardiac glycosides, due to a decrease in Na(+)/K(+)-ATPase levels. The primary female sex steroid estradiol has long been recognized to be important in a wide variety of physiological processes. Numerous studies, including ours, have shown that estradiol is one of the major factors controlling the activity and expression of Na(+)/K(+)-ATPase in the cardiovascular (CV) system. However, the effects of estradiol on Na(+)/K(+)-ATPase in both normal and pathological conditions, such as obesity, remain unclear. Increasing our understanding of the molecular mechanisms by which estradiol mediates its effects on Na(+)/K(+)-ATPase function may help to develop new strategies for the treatment of CV diseases. Herein, we discuss the latest data from animal and clinical studies that have examined how pathophysiological conditions such as obesity and the action of estradiol regulate Na(+)/K(+)-ATPase activity.
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Affiliation(s)
- Milan Obradovic
- Laboratory of Radiobiology and Molecular Genetics, Institute Vinca, University of Belgrade, PO Box 522, 11000 Belgrade, Serbia
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Barrett HL, Dekker Nitert M, Jones L, O'Rourke P, Lust K, Gatford KL, De Blasio MJ, Coat S, Owens JA, Hague WM, McIntyre HD, Callaway L, Rowan J. Determinants of maternal triglycerides in women with gestational diabetes mellitus in the Metformin in Gestational Diabetes (MiG) study. Diabetes Care 2013; 36:1941-6. [PMID: 23393209 PMCID: PMC3687298 DOI: 10.2337/dc12-2132] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Factors associated with increasing maternal triglyceride concentrations in late pregnancy include gestational age, obesity, preeclampsia, and altered glucose metabolism. In a subgroup of women in the Metformin in Gestational Diabetes (MiG) trial, maternal plasma triglycerides increased more between enrollment (30 weeks) and 36 weeks in those treated with metformin compared with insulin. The aim of this study was to explain this finding by examining factors potentially related to triglycerides in these women. RESEARCH DESIGN AND METHODS Of the 733 women randomized to metformin or insulin in the MiG trial, 432 (219 metformin and 213 insulin) had fasting plasma triglycerides measured at enrollment and at 36 weeks. Factors associated with maternal triglycerides were assessed using general linear modeling. RESULTS Mean plasma triglyceride concentrations were 2.43 (95% CI 2.35-2.51) mmol/L at enrollment. Triglycerides were higher at 36 weeks in women randomized to metformin (2.94 [2.80-3.08] mmol/L; +23.13% [18.72-27.53%]) than insulin (2.65 [2.54-2.77] mmol/L, P = 0.002; +14.36% [10.91-17.82%], P = 0.002). At 36 weeks, triglycerides were associated with HbA1c (P = 0.03), ethnicity (P = 0.001), and treatment allocation (P = 0.005). In insulin-treated women, 36-week triglycerides were associated with 36-week HbA1c (P = 0.02), and in metformin-treated women, they were related to ethnicity. CONCLUSIONS At 36 weeks, maternal triglycerides were related to glucose control in women treated with insulin and ethnicity in women treated with metformin. Whether there are ethnicity-related dietary changes or differences in metformin response that alter the relationship between glucose control and triglycerides requires further study.
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Affiliation(s)
- Helen L Barrett
- UQ Centre for Clinical Research, The University of Queensland, Herston, Queensland, Australia.
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Stępień M, Stępień A, Banach M, Wlazeł RN, Paradowski M, Rizzo M, Toth PP, Rysz J. New Obesity Indices and Adipokines in Normotensive Patients and Patients With Hypertension. Angiology 2013; 65:333-42. [DOI: 10.1177/0003319713485807] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
We compared the obesity parameters and selected adipokines—leptin, adiponectin, and resistin—in obese patients with hypertension and normotensive patients. A total of 67 nondiabetic obese outpatients were divided into 2 groups: A–hypertensive and B–normotensive. Serum levels of leptin, adiponectin, resistin, and insulin were measured. Weight, height, waist circumference, and hip circumference were measured to calculate waist-to-hip ratio (WHR), weight-to-height ratio, visceral adiposity index, and body adiposity index (BAI). Among patients with hypertension, significant positive correlations were observed between leptin and body mass index and BAI ( r = .31 and r = .63, respectively). In normotensive patients, leptin positively correlated with BAI ( r = .73, P < .01) and negatively with WHR ( r = −.55, P < .0001); adiponectin negatively correlated with WHR ( r = .38, P < .01) and BAI ( r = .52; P < .0001), and resistin negatively correlated with WHR ( r = −.36, P < .05). In conclusion, visceral obesity and leptin are associated with hypertension in obese patients.
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Affiliation(s)
- Mariusz Stępień
- Department of Nephrology, Hypertension and Family Medicine, WAM University Hospital in Lodz, Medical University of Lodz, Lodz, Poland
| | - Anna Stępień
- Department of Nephrology, Hypertension and Family Medicine, WAM University Hospital in Lodz, Medical University of Lodz, Lodz, Poland
| | - Maciej Banach
- Department of Hypertension, WAM University Hospital in Lodz, Medical University of Lodz, Lodz, Poland
| | - Rafał N. Wlazeł
- Department of Laboratory Diagnostics and Clinical Biochemistry, Medical University of Lodz, Lodz, Poland
| | - Marek Paradowski
- Department of Hypertension, WAM University Hospital in Lodz, Medical University of Lodz, Lodz, Poland
| | - Manfredi Rizzo
- BioMedical Department of Internal Medicine and Medical Specialties, University of Palermo, Italy
- Euro-Mediterranean Institute of Science and Technology, Italy
| | - Peter P. Toth
- CGH Medical Center, Sterling, IL, USA
- University of Illinois College of Medicine, Peoria, IL, USA
| | - Jacek Rysz
- Department of Nephrology, Hypertension and Family Medicine, WAM University Hospital in Lodz, Medical University of Lodz, Lodz, Poland
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Paspala I, Katsiki N, Kapoukranidou D, Mikhailidis DP, Tsiligiroglou-Fachantidou A. The role of psychobiological and neuroendocrine mechanisms in appetite regulation and obesity. Open Cardiovasc Med J 2012; 6:147-55. [PMID: 23346258 PMCID: PMC3549543 DOI: 10.2174/1874192401206010147] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2012] [Accepted: 09/01/2012] [Indexed: 12/19/2022] Open
Abstract
Obesity is a multifactorial disease. Among its causes are physical inactivity and overeating. In addition, other factors may play an important role in the development of overweight/obesity. For example, certain hormones including leptin, insulin and ghrelin, may influence appetite and consequently body weight. Obesity frequently co-exists with metabolic disorders including dyslipidemia, hypertension and insulin resistance, thus constituting the metabolic syndrome which is characterized by increased cardiovascular risk. Lack of comprehensive knowledge on obesity-related issues makes both prevention and treatment difficult. This review considers the psychobiological and neuroendocrine mechanisms of appetite and food intake. Whether these factors, in terms of obesity prevention and treatment, will prove to be relevant in clinical practice (including reducing the cardiovas-cular risk associated with obesity) remains to be established.
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Affiliation(s)
- Ioanna Paspala
- Laboratory of Hygiene & Sports Nutrition, Department of Physical Education and Sport Science, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Stepien M, Stepien A, Wlazel RN, Paradowski M, Rizzo M, Banach M, Rysz J. Predictors of insulin resistance in patients with obesity: a pilot study. Angiology 2012; 65:22-30. [PMID: 23267236 DOI: 10.1177/0003319712468291] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
We compared adipokines and inflammatory markers in obese insulin-sensitive (group A, n = 16) and insulin-resistant (group B, n = 48) patients divided according to homeostasis model assessment of insulin resistance (HOMA-IR). Serum levels of adiponectin, leptin, resistin, high-sensitivity C-reactive protein, interleukin 6, and tumor necrosis factor α were measured. Weight, height, waist (WC) and hip circumferences, waist to hip ratio , weight to height ratio, visceral adiposity index (VAI), and body adiposity index (BAI) were measured. The WC and VAI were significantly higher in group B (113.9 ± 11.1 vs 105.3 ± 9.8 cm; P < .01 and 2.3 ± 1.1 vs 1.6 ± 0.9; P < .05, respectively), while serum adiponectin levels were higher in group A (24.5 ± 14.6 vs 15.1 ± 9.6 ng/mL; P < .005). The BAI strongly correlated with adiponectin and leptin in group B (r = .479; P < .001 and r = .705; P < .001). Insulin resistance is associated with visceral adiposity described by VAI and WC. The BAI may be a useful index in obese patients, especially with insulin resistance.
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Affiliation(s)
- Mariusz Stepien
- 1Department of Nephrology, Hypertension and Family Medicine, WAM University Hospital in Lodz, Lodz, Poland
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