Leptin Levels in Type 2 Diabetes: Associations with Measures of   Insulin Resistance and Insulin Secretion

M. Wauters; R. V. Considine; J. S. Yudkin; F. Peiffer; I. De Leeuw; L. F. Van Gaal

doi:10.1055/s-2003-39054

Hormone and Metabolic Research, Inhaltsverzeichnis

Horm Metab Res 2003; 35(2): 92-96
DOI: 10.1055/s-2003-39054

Original Clinical

Leptin Levels in Type 2 Diabetes: Associations with Measures of Insulin Resistance and Insulin Secretion

M. Wauters ¹ , R. V. Considine ² , J. S. Yudkin ³ , F. Peiffer ¹ , I. De Leeuw ¹ , L. F. Van Gaal ¹

¹ Department of Diabetology, Metabolism and Clinical Nutrition, University Hospital Antwerp, Antwerp, Belgium
² Division of Endocrinology and Metabolism, School of Medicine, Indiana University, Indianapolis, Indiana, USA
³ Department of Medicine, University College London Medical School, Whittington Hospital, London, UK

Abstract

Interactions between leptin and insulin have been shown previously, in vitro and in vivo. In this study, we evaluate the associations of leptin levels with insulin secretion and insulin sensitivity in type 2 diabetes. Fasting leptin levels, HbA_1c, glucose, insulin, C-peptide, intact and des-31,32-proinsulin were measured in 100 non-insulin-treated type 2 diabetic patients. Glucose, insulin and C-peptide were measured 2 hours after an oral glucose load. Insulin resistance and β-cell function were calculated using HOMA. Leptin levels were found to be associated with all measures of β-cell secretion: with fasting and 2 hours insulin and C-peptide, with intact and des-31,32-proinsulin concentrations, and with β-cell secretion estimated with HOMA. This association was independent of age and body fat in women, but in men, associations with insulin and C-peptide weakened after controlling for fat mass, whereas those with intact and des-31,32-proinsulin disappeared. Fasting insulin and C-peptide levels were also significant in multiple regression analyses, besides gender and fat mass. Insulin resistance, as assessed by HOMA, was strongly correlated with leptin, also after correction for age and fat mass in both genders. We conclude that, besides fat mass and gender - the main determinants for leptin levels in type 2 diabetic subjects as in healthy subjects - insulin secretion and the degree of insulin resistance also seem to contribute significantly to leptin levels.

Key words

Leptin - Type 2 Diabetes - Insulin Resistance - Proinsulin - β-Cell Function

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References

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Prof. Dr. L. F. Van Gaal

University Hospital Antwerp · Dept. of Diabetology

Wilrijkstraat 10 · 2650 Edegem · Belgium

Telefon: +32 (3) 821 32 66

Fax: +32 (3) 825 49 80

eMail: luc.van.gaal@uza.be