内分泌学とメタボリックシンドローム
オープンアクセス

概要

Role of Ghrelin, Leptin and Insulin Resistance in Development of Metabolic Syndrome in Obese Patients

Waleed S. Mohamed, Mohammed A. Hassanien and Khalid EL Sayed Abokhosheim

Objective: Obesity and its complications including metabolic syndrome (MetS) have been increased in children and adolescents recently. Leptin is known to play an important role in the pathogenesis of obesity. The objective of this study was to evaluate the relationship between Leptin, Ghrelin and Insulin resistance in the development of metabolic syndrome in obese persons.

Methods: this study was carried out on fifty obese persons. All patients have BMI ≥ 30 Kg/m2. Twenty of them have metabolic syndrome. Body Mass Index (BMI), Waist Circumference (WC), and blood pressure were measured. Fasting Plasma Glucose (FBG), two hours Post Prandial Blood Glucose (PPBG), Glycated hamoglobin A1C (HbA1c), triglyceride (TG), Total Cholesterol (TC), high and low density lipoprotein cholesterol (HDL-C and LDL-C), serum Leptin, Ghrelin and Insulin were done. HOMA-IR and HOMA- β were calculated.

Results: SBP, DBP, FBS, PPBG, HbA1c, HOMA-IR and HOMA-β were significantly increased in obese and MetS groups compared to control group. There was a significant increase in insulin and Leptin, serum TG, TC and LDL-C with a significant decrease in HDL cholesterol and Ghrelin in obese and MetS groups. A significant negative correlation between plasma Ghrelin and BMI, WC, SBP, DBP, and FBS, PPBG, serum TG, TC, LDL-C, HbA1c, and HOMA-B was observed while leptin showed a significant positive correlation with them and a negative correlation with HOMA-IR. Plasma Ghrelin was positively correlated with HDL-C while Leptin was positively correlated with it in obese and MetS groups. There was a significant negative correlation between plasma Ghrelin, Insulin and leptin with significant positive correlation between plasma insulin and leptin in obese and MS groups.

Conclusion: There are hormonal changes associated with clusters of metabolic abnormalities and elevation of blood pressure that may have a role in the development of MetS in obese persons and are major CHD risk factors. Insulin has stimulatory trophic effect on leptin secretion, but the effect of leptin on insulin is controversial as leptin may modulate insulin action and participates in the development of insulin resistance. As regard Ghrelin secretion, there are many suppressive factors: insulin, Leptin and glucose. Our study produces a preliminary result, thus further studies with large number of patients are required.