Abstract
Ghrelin and leptin are hunger hormones related to type 2 diabetes mellitus (T2DM), and the pathogenesis of T2DM is the abnormality in insulin secretion and insulin resistance (IR). The aim of this study is to evaluate ghrelin and leptin concentrations in blood and to specify the relationship of these hormones as dependent variables with some biochemical and clinical measurements in T2DM patients. In this study, forty one T2DM and forty three non-diabetes mellitus (non-DM) subjects, aged between 40-60 years and with normal weight, were enrolled. Fasting serum ghrelin and leptin were estimated by enzyme-linked immunosorbent assay (ELISA). In our results ghrelin was significantly increased, and leptin was significantly decreased, in T2DM patients compared with non-DM subjects. Ghrelin was positively correlated with the fasting blood glucose (FBG) and IR, but inversely related to the insulin sensitivity (IS). Leptin was negatively correlated with mean arterial pressure (MAP), FBG, glycated hemoglobin (HbA1c), IR, low-density lipoprotein cholesterol, nitric oxide (NO), and alanine aminotransferase (ALT), as well as showed a linear correlation with IS and a strong dependence on sex. The area under the curve (AUC) value shows ghrelin and leptin as biomarkers for T2DM. In conclusion ghrelin and leptin hormones have predictive ability to predict T2DM, as they are significantly associated with IR, IS, free radicals, and lipid profile.
Highlights
Type 2 diabetes mellitus is a chronic disease due to deficiency in insulin secretion and insulin actions 1
The increment of ghrelin may be related to hyperglycemia and IR in our population with type 2 diabetes mellitus (T2DM), as ghrelin induces insulin resistance 26 or may be related to body mass index (BMI) as our subject were within normal BMI, a previous study reported the peripheral ghrelin is inversely correlated with BMI and they had lower ghrelin level in
Another possible reason for significantly higher ghrelin concentration is the antidiabetes medication, metformin, which causes an elevation in plasma ghrelin level and this explanation approved by Nabel M, as they found serum ghrelin level in control diabetic patients was lower than that of control healthy group while it was higher in diabetic patients' using metformin daily 29
Summary
Type 2 diabetes mellitus is a chronic disease due to deficiency in insulin secretion and insulin actions 1. Many studies are presented to explain the association of hunger hormones (ghrelin and leptin) with IR 2-5. Ghrelin is an orexigenic hormone, first isolated from the stomach of humans and rats in 1999 6. Studies have focused on the relationship between ghrelin and diabetes complications, especially hypertension, atherosclerosis, and obesity 7. Patients with T2DM has a lower ghrelin level than healthy subjects 4. Ghrelin has a role in glucose metabolism, and involved in insulin secretion and IS 8, 9
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