TY - JOUR
T1 - The ratio of leptin to adiponectin can be used as an index of insulin resistance
AU - Oda, Naohisa
AU - Imamura, Shigeo
AU - Fujita, Takashi
AU - Uchida, Yuka
AU - Inagaki, Kazumichi
AU - Kakizawa, Hiroaki
AU - Hayakawa, Nobuki
AU - Suzuki, Atsushi
AU - Takeda, Jun
AU - Horikawa, Yukio
AU - Itoh, Mitsuyasu
N1 - Funding Information:
This study was in part supported by a grant-in-aid for the 21st Century Center of Excellence Program of Fujita Health University from the Ministry of Education, Culture, Sports, Science, and Technology of Japan. We thank N Takekawa for her secretarial assistance.
PY - 2008/2
Y1 - 2008/2
N2 - The level of leptin increases with obesity, whereas that of adiponectin decreases with obesity. It is reported that the ratio of leptin to adiponectin (L/A) is associated with insulin resistance. It is difficult to evaluate insulin resistance in diabetic patients who have a dysfunction of insulin secretion. The aim of this study was to examine whether the L/A ratio is a useful marker for insulin resistance in diabetic patients. We examined L/A in the serum of a total of 139 Japanese patients with type 2 diabetes mellitus (66 women and 73 men) and 7 healthy individuals recruited in our hospital. Changes in the levels of leptin and adiponectin were observed using the oral glucose tolerance test and a hyper- and euglycemic clamp test. Twenty-one patients with type 2 diabetes mellitus were observed for more than 6 months after treatment with pioglitazone, and 31 patients with type 2 diabetes mellitus were observed for more than 6 months after the treatment with metformin. The mean value of L/A in 139 Japanese patients with type 2 diabetes mellitus was 1.22 ± 1.41 (1.68 ± 1.76 in women, 0.81 ± 0.80 in men; P = .0002). In the clamp tests, L/A correlated with glucose infusion rate (GIR) (r2 = 0.26, P = .0034). The correlation of L/A and GIR indicated a stronger correlation than either leptin (r2 = 0.144, P = .03) or adiponectin alone (r2 = 0.023, P = .41), or the homeostasis model assessment of insulin resistance (r2 = 0.103, P = .08). The average hemoglobin A1c (HbA1c) improved from 10.2% ± 1.2% to 9.2% ± 1.6% (P = .0037) in 6 months after treatment with pioglitazone. Our results indicate pioglitazone to be effective for HbA1c improvement in subjects with high L/A and low L/A. The average HbA1c improved from 9.2% ± 0.9% to 8.0% ± 1.2% (P = .0002) in 6 months after treatment with metformin. Our results indicate metformin to be effective for HbA1c improvement in subjects with a low L/A. In conclusion, we demonstrate that L/A is different between male and female subjects. The correlation of L/A and GIR by the euglycemic hyperinsulinemic clamp test suggests that L/A is a useful indicator for the choice of drug to treat diabetes mellitus.
AB - The level of leptin increases with obesity, whereas that of adiponectin decreases with obesity. It is reported that the ratio of leptin to adiponectin (L/A) is associated with insulin resistance. It is difficult to evaluate insulin resistance in diabetic patients who have a dysfunction of insulin secretion. The aim of this study was to examine whether the L/A ratio is a useful marker for insulin resistance in diabetic patients. We examined L/A in the serum of a total of 139 Japanese patients with type 2 diabetes mellitus (66 women and 73 men) and 7 healthy individuals recruited in our hospital. Changes in the levels of leptin and adiponectin were observed using the oral glucose tolerance test and a hyper- and euglycemic clamp test. Twenty-one patients with type 2 diabetes mellitus were observed for more than 6 months after treatment with pioglitazone, and 31 patients with type 2 diabetes mellitus were observed for more than 6 months after the treatment with metformin. The mean value of L/A in 139 Japanese patients with type 2 diabetes mellitus was 1.22 ± 1.41 (1.68 ± 1.76 in women, 0.81 ± 0.80 in men; P = .0002). In the clamp tests, L/A correlated with glucose infusion rate (GIR) (r2 = 0.26, P = .0034). The correlation of L/A and GIR indicated a stronger correlation than either leptin (r2 = 0.144, P = .03) or adiponectin alone (r2 = 0.023, P = .41), or the homeostasis model assessment of insulin resistance (r2 = 0.103, P = .08). The average hemoglobin A1c (HbA1c) improved from 10.2% ± 1.2% to 9.2% ± 1.6% (P = .0037) in 6 months after treatment with pioglitazone. Our results indicate pioglitazone to be effective for HbA1c improvement in subjects with high L/A and low L/A. The average HbA1c improved from 9.2% ± 0.9% to 8.0% ± 1.2% (P = .0002) in 6 months after treatment with metformin. Our results indicate metformin to be effective for HbA1c improvement in subjects with a low L/A. In conclusion, we demonstrate that L/A is different between male and female subjects. The correlation of L/A and GIR by the euglycemic hyperinsulinemic clamp test suggests that L/A is a useful indicator for the choice of drug to treat diabetes mellitus.
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U2 - 10.1016/j.metabol.2007.09.011
DO - 10.1016/j.metabol.2007.09.011
M3 - Article
C2 - 18191059
AN - SCOPUS:38049075329
SN - 0026-0495
VL - 57
SP - 268
EP - 273
JO - Metabolism: Clinical and Experimental
JF - Metabolism: Clinical and Experimental
IS - 2
ER -
