DIABETES OR OBESITY; MAJOR EFFECTOR OF ALTERED LEVELS OF GHRELIN AND LEPTIN

Background: Ghrelin and leptin are the key hormones involved in the energy homeostasis and plays a relevant role in regulating hunger and satiety stimuli afferent to the brain. Abnormalities in the levels of ghrelin and leptin are often associated with the obesity and type 2 diabetes complications. However, there are no studies clarifying whether ghrelin and leptin levels have stronger association with obesity or Type 2 diabetes (T2DM). Aims:To evaluate and compare the independent effect of major dening factors of obesity and diabetes on ghrelin and leptin concentrations. Materials And Methods: Anthropometric measures such as height, weight, waist (WC) and hip circumference (HC), Body mass index (BMI), Basal metabolic rate (BMR), fat percentage, lean body mass, were taken. Assessed daily physical activity and energy intake. Biochemical parameters such as fasting glucose, postprandial glucose, HBA1c, ghrelin, leptin and insulin levels were measured. Statistical Analysis: One-way analysis of variance (ANOVA), Chi-square (χ2) test Pearson's correlation coefcients, Multiple stepwise linear regression model analysis were performed. Result: The diabetic subjects irrespective of obesity showed signicantly higher waist to hip ratio, HOMAIR levels of fasting blood glucose, postprandial glucose and signicantly lower levels of Ghrelin than non-diabetics. Similarly, obese subjects irrespective of diabetes have signicantly higher BMR and higher levels of Leptin than non-diabetics. Asignicantly higher BMI, fat mass percentage and lower lean body mass percentage were observed in obese subjects irrespective of diabetes than non-obese subjects. Among non-obese, diabetics have higher BMI, Fat mass percentage and lower lean body mass percentage. The levels of insulin were signicantly higher in diabetic obese subjects. HOMAIR (P≤0.0001) and Postprandial glucose (P≤0.05) showed negative independent effect and QUICKI (P≤0.0001) showed positive independent effect on the levels of ghrelin. BMI (P≤0.05) showed a positive effect and lean body mass percentage (P≤0.0001) showed an inverse effect on levels of leptin. Conclusion: It is evident from the study that low levels of ghrelin are predominantly associated with diabetes parameters when compared to parameters of obesity and on the contrary increased leptin levels have much stronger association with measures of obesity than diabetes. Evidence of altered leptin and ghrelin levels in these disorders infers vice versa, their respective roles in obesity and lean diabetes.

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Association of Predicted Lean Body Mass and Fat Mass With Incident Diabetic Nephropathy in Participants With Type 2 Diabetes Mellitus: A Post Hoc Analysis of ACCORD Trial

Frontiers in Endocrinology ◽

10.3389/fendo.2021.719666 ◽

2021 ◽

Vol 12 ◽

Author(s):

Daniel Nyarko Hukportie ◽

Fu-Rong Li ◽

Rui Zhou ◽

Meng-Chen Zou ◽

Xiao-Xiang Wu ◽

...

Keyword(s):

Type 2 Diabetes ◽

Diabetic Nephropathy ◽

Lean Body Mass ◽

Body Mass ◽

Fat Mass ◽

Accord Study ◽

Increased Risk ◽

Specific Association ◽

Post Hoc

BackgroundLean body mass (LBM) and fat mass (FM) have been shown to have different associations with several chronic diseases but little is known about the sex-specific association of LBM and FM with diabetic nephropathy (DN) risk among participants with diabetes.MethodsParticipants from the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study was used in a post hoc analysis to examine the association of predicted LBM index (LBMI) and FM index (FMI) with incident DN risk (defined as a composite outcome of three types of predefined DN). Because of sex differences in body composition, analyses were conducted separately using sex-specific quartiles of predicted LBMI and FMI.ResultsOf the 9,022 participants with type 2 diabetes (5,575 men and 3,447 women) included in this study, 5,374 individuals developed DN (3,396 in men and 1,978 in women). Higher quartiles of LBMI were associated with a reduced risk of DN while higher quartiles of FMI were associated with an increased higher risk of DN among men but not women. Compared with the lowest quartile, the fully adjusted hazard ratios (HRs) and 95% confidence intervals (CIs)for the highest quartile of predicted LBMI and FMI were respectively 0.83 (95% CI 1.71 – 0.96) and 1.23 (95% CI 1.06-1.43) among men; and 0.92 (95% CI 0.63 – 1.33) and 1.14 (95% CI 0.79 – 1.63) among women.ConclusionsAmong participants with diabetes, predicted LBMI was inversely associated with risk of DN while predicted FMI was positively associated with an increased risk of incident DN among men but not women. Trial registration: ClinicalTrials.gov., no. NCT00000620.

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Association of predicted lean body mass and fat mass with cardiovascular events in patients with type 2 diabetes mellitus

Canadian Medical Association Journal ◽

10.1503/cmaj.190124 ◽

2019 ◽

Vol 191 (38) ◽

pp. E1042-E1048 ◽

Cited By ~ 4

Author(s):

Zhenhua Xing ◽

Liang Tang ◽

Jian Chen ◽

Junyu Pei ◽

Pengfei Chen ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Lean Body Mass ◽

Body Mass ◽

Fat Mass ◽

Cardiovascular Events

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Association of Bariatric Surgery With Cancer Incidence in Patients With Obesity and Diabetes: Long-term Results From the Swedish Obese Subjects Study

10.2337/figshare.16903630 ◽

2021 ◽

Author(s):

Kajsa Sjöholm ◽

Lena MS Carlsson ◽

Per-Arne Svensson ◽

Johanna C. Andersson-Assarsson ◽

Felipe Kristensson ◽

...

Keyword(s):

Type 2 Diabetes ◽

Bariatric Surgery ◽

Cancer Risk ◽

Cancer Incidence ◽

Diabetes Remission ◽

Obesity And Diabetes ◽

Obese Subjects

OBJECTIVE Obesity and type 2 diabetes are associated with serious, adverse health effects, including cancer. Although bariatric surgery has been shown to reduce cancer risk in patients with obesity, the effect of bariatric surgery on cancer risk in patients with obesity and diabetes is less studied. We therefore examined the long-term incidence of cancer after bariatric surgery and usual care in patients with obesity and diabetes in the matched prospective Swedish Obese Subjects (SOS) study. RESEARCH DESIGN AND METHODS The SOS study examines long-term outcomes following bariatric surgery or usual care. The current analysis includes 701 patients with obesity and type 2 diabetes at baseline, 393 of which underwent bariatric surgery, and 308 who received conventional obesity treatment. Information on cancer events was obtained from the Swedish National Cancer Register. Median follow-up time was 21.3 years (interquartile range 17.6-24.8 years, maximum 30.7 years). RESULTS During follow-up, the incidence rate for first-time cancer was 9.1 per 1000-person-years (95% CI, 7.2-11.5) in patients with obesity and diabetes treated with bariatric surgery and 14.1 per 1000-person-years (95% CI, 11.2-17.7) in patients treated with usual obesity care (HRadj=0.63; 95% CI 0.44-0.89, p=0.008). Moreover, surgery was associated with reduced cancer incidence in women (HRadj=0.58; 0.38-0.90, p=0.016), although the sex-treatment interaction was non-significant (p=0.630). In addition, diabetes remission at the 10-year follow-up was associated with reduced cancer incidence (HRadj=0.40; 95% CI 0.22-0.74, p=0.003). CONCLUSIONS These results suggest that bariatric surgery prevents cancer in patients with obesity and diabetes, and that durable diabetes remission is associated with reduced cancer risk.

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Association of Bariatric Surgery With Cancer Incidence in Patients With Obesity and Diabetes: Long-term Results From the Swedish Obese Subjects Study

10.2337/figshare.16903630.v1 ◽

2021 ◽

Author(s):

Kajsa Sjöholm ◽

Lena MS Carlsson ◽

Per-Arne Svensson ◽

Johanna C. Andersson-Assarsson ◽

Felipe Kristensson ◽

...

Keyword(s):

Type 2 Diabetes ◽

Bariatric Surgery ◽

Cancer Risk ◽

Cancer Incidence ◽

Diabetes Remission ◽

Obesity And Diabetes ◽

Obese Subjects

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The effect of combination therapy of insulin glargine, metformin, and sitagliptin on insulin secretion, insulin resistance, and metabolic parameters in obese subjects with type 2 diabetes

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh1610497z ◽

2016 ◽

Vol 144 (9-10) ◽

pp. 497-502

Author(s):

Teodora Beljic-Zivkovic ◽

Milica Marjanovic-Petkovic ◽

Miljanka Vuksanovic ◽

Ivan Soldatovic ◽

Dobrila Kanlic ◽

...

Keyword(s):

Insulin Resistance ◽

Type 2 Diabetes ◽

Body Mass Index ◽

Waist Circumference ◽

Insulin Glargine ◽

Body Mass ◽

Fasting Glucose ◽

C Peptide ◽

Obese Subjects

Introduction. A combination of drugs is required for treatment of obese subjects with diabetes, due to multiple pathogenic mechanisms implicated in the development of both diabetes and obesity. Objective. Assessment of the effect of sitagliptin added to insulin glargine and metformin, in obese subjects with type 2 diabetes. Methods. A total of 23 obese subjects on metformin and insulin glargine participated in the study. Titration of insulin glargine during a one-month period preceded the addition of 100 mg of sitagliptin daily. Body mass index, waist circumference, fasting, and prandial glucose were measured monthly, lipids and hemoglobin A1c (HbA1c) every three months, insulin, c-peptide and glucagon at the start and after six months of treatment. Homeostatic models for insulin secretion (HOMA B) and insulin resistance (HOMA IR) were calculated. Results. Participants were 58.65 ?} 7.62 years of age with a body mass index of 35.06 ?} 5.15 kg/m2, waist circumference of 115.04 ?} 15.5 cm, and the duration of diabetes of 4.11 ?} 2.57 years. With the titration of insulin glargine, target fasting glucose levels were not achieved. Waist circumference and body mass index decreased during three months of sitagliptin treatment, thereafter remaining stable. HbA1c decreased significantly after three and six months of therapy. C-peptide increased significantly, while glucagon level fell. HOMA indexes were unchanged. Conclusion. Sitagliptin can improve diabetes control and induce modest weight loss in obese subjects poorly controlled on insulin glargine and metformin. Titration of insulin glargine to optimal fasting glucose values is a prerequisite of success of this combination therapy.

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Abstract P209: Which Comes First, Type 2 Diabetes (T2DM) or Hypertension?

Circulation ◽

10.1161/circ.129.suppl_1.p209 ◽

2014 ◽

Vol 129 (suppl_1) ◽

Author(s):

Kazuko Masuo ◽

Gavin W Lambert

Keyword(s):

Type 2 Diabetes ◽

Weight Gain ◽

Fat Mass ◽

Study Groups ◽

High Plasma ◽

Sympathetic Overactivity ◽

Entry Period ◽

Obese Subjects ◽

Total Body

Objectives: It is well demonstrated that there is a higher prevalence of hypertension (HT) in patients with type 2 diabetes (T2DM) than non-DM individuals as well as higher prevalence of DM in HT than normotensives (NT). However, it has not been clarified which of DM or HT leads to other, and what mechanisms may play a major role. Methods: In the present study, we compared neurohormonal parameters in the following 4 groups in weight loss (WL) program with a mild calorie restriction and exercise over 12 weeks; 53 obese NT without DM, 44 NT with T2DM, 68 HT without DM, and 43 HT with T2DM. HT and T2DM were all diagnosed in the last 3 months and none had medications. At entry period, the 4 groups were strictly matched in BMI and in BP. They were measured BMI, total body fat-mass, waist/hip ratio (W/H), BP, PR, HbA 1c , fasting glucose, insulin (HOMA-IR), norepinephrine (NE) and leptin (LEP) at entry, 4 and 12 weeks. Results: At entry, fat-mass was greater in subjects with T2DM than non-DM in both NT and HT and HT had slightly greater fat-mass than NT, although BMI were strictly matched in the 4 study groups. HbA 1c in T2DM was greater than non-DM, and slightly greater in HT than NT. Fasting insulin was greater in HT and T2DM than NT or non-DM, and HOMA-IR was slightly greater in HT than NT and significantly greater in T2DM than non-DM. LEP was similar between NT and HT, but it was greater in T2DM than non-DM. (HbA 1c , HT with T2DM>NT with T2DM>>HT without DM>NT without DM; Insulin, HT with T2DM>NT with T2DM>>HT without DM>NT without DM; NE, HT with T2DM>>HT without DM≥NT with T2DM>>NT without DM; LEP, HT with T2DM≈NT with T2DM>>HT without DM>NT without DM). WL over 12 wks in HT and T2DM were smaller than those in NT or non-DM. At 12 weeks, in HT groups regardless of T2DM, percent (%) decreases in plasma NE and BP, and reductions in HbA 1c were smaller than those in NT groups, although reductions in fat-mass and leptin were similar. In T2DM groups regardless of BP levels at entry, reductions in BMI, BP, HbA 1c , HOMA-IR and NE were smaller than those in non-DM group. In the 4 groups, reductions in plasma NE was observed at first followed by reductions in HOMA-IR, HbA 1c, BMI and BP over 12 weeks. Conclusions: These findings demonstrate that insulin resistance (IR) may play an important role on the onset of T2DM and high plasma NE appears to cause HT. HT had resistance to normalized high plasma NE and %reductions in NE, and T2DM had resistance to normalize IR and sympathetic overactivity. We previously reported that high plasma NE could predict future weight gain and BP elevation, and high NE preceded IR in non-obese subjects. Taken together, sympathetic overactivity observed in high NE may cause obesity and HT, and then IR seems to start with weight gain leading T2DM, suggesting that HT may lead to T2DM with this mechanisms.

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Reduced Lean Body Mass and Cardiometabolic Diseases in Adult Males with Overweight and Obesity: A Pilot Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph15122754 ◽

2018 ◽

Vol 15 (12) ◽

pp. 2754 ◽

Cited By ~ 11

Author(s):

Shirine Khazem ◽

Leila Itani ◽

Dima Kreidieh ◽

Dana El Masri ◽

Hana Tannir ◽

...

Keyword(s):

Type 2 Diabetes ◽

Cardiovascular Diseases ◽

Lean Body Mass ◽

Body Mass ◽

Overweight And Obesity ◽

Treatment Seeking ◽

Adult Males ◽

Body Composition Assessment ◽

Cardiometabolic Diseases

Little is known about the reduction in lean body mass (LBM) and its health consequences in overweight and in obesity, especially in males. Therefore, we aimed to assess the prevalence of low LBM in treatment-seeking adult males with overweight and obesity and the association with cardiometabolic diseases, i.e., type 2 diabetes, cardiovascular diseases and dyslipidemia. A body composition assessment was conducted by a bio-impedance analyzer (InBody 170) among a total of 110 males, of whom 72 were overweight and obese and were referred to the Outpatient Clinic in the Department of Nutrition and Dietetics at Beirut Arab University (BAU) in Lebanon, and 38 were normal-weight participants of similar ages. The participants with overweight and obesity were then categorized as being with or without low LBM. Of the sample of 72 participants, 50 (69.4%) met the criteria for reduced LBM and displayed a significantly higher prevalence of cardiometabolic diseases (i.e., type 2 diabetes, cardiovascular diseases and dyslipidemia) than those with normal LBM (36.0% vs. 9.1%; p = 0.019). Logistic regression analysis showed that low LBM increases the odds of having cardiometabolic diseases by nearly 550% (odds ratio (OR) = 5.46, 95% confidence interval (CI) = 1.31–26.39, p < 0.05) after adjusting for total fat and central adiposity. Treatment-seeking adult males with overweight and obesity displayed a great prevalence of reduced LBM, which seems to be strongly associated with cardiovascular and metabolic diseases.

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Body Composition Outcomes of a Qigong Intervention Among Community-Dwelling Aging Adults

Western Journal of Nursing Research ◽

10.1177/0193945916654907 ◽

2016 ◽

Vol 38 (12) ◽

pp. 1574-1594 ◽

Cited By ~ 6

Author(s):

Mei-Ying Chang ◽

Hsiao-Yu Chen

Keyword(s):

Body Composition ◽

Lean Body Mass ◽

Body Mass ◽

Fat Mass ◽

Community Dwelling ◽

The Body ◽

Control Group ◽

Mass Percentage ◽

Aging Adults ◽

Experimental Group

Aging causes various changes in body composition, which are critical implications for health and physical functioning in aging adults. The aim of this study was to explore the body composition outcomes of a qigong intervention among community-dwelling aging adults. This was a quasi-experimental study in which 90 participants were recruited. Forty-eight participants (experimental group) attended a 30-min qigong program 3 times per week for 12 weeks, whereas 42 participants (control group) continued performing their usual daily activities. The experimental group achieved a greater reduction in the fat mass percentage at the posttest, and exhibited increased fat-free mass, lean body mass percentage, and lean body mass to fat mass ratio compared with the controls. No difference between the two groups in body mass index, fat mass, and lean body mass was observed. These results indicated that the qigong intervention showed beneficial outcomes of body composition among community-dwelling aging adults.

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Effects of Exenatide on both fat mass loss and cardiometabolic risk in obese subjects with type 2 diabetes mellitus

Clinical Practice ◽

10.4172/clinical-practice.1000134 ◽

2017 ◽

Vol 14 (7) ◽

Author(s):

Carmela Colica ◽

Sara Parrettini ◽

Giuseppe Merra ◽

Lorenzo Romano ◽

Laura Di Renzo ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Mass Loss ◽

Fat Mass ◽

Cardiometabolic Risk ◽

Obese Subjects ◽

Fat Mass Loss

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Dietary protein and exercise for preservation of lean mass and perspectives on type 2 diabetes prevention

Experimental Biology and Medicine ◽

10.1177/1535370219861910 ◽

2019 ◽

Vol 244 (12) ◽

pp. 992-1004

Author(s):

Maysa Vieira de Sousa ◽

Diana Bento da Silva Soares ◽

Elaine Reis Caraça ◽

Ronaldo Cardoso

Keyword(s):

Physical Activity ◽

Type 2 Diabetes ◽

Lean Body Mass ◽

Muscle Mass ◽

Body Mass ◽

Dietary Protein ◽

The Elderly ◽

Sarcopenic Obesity ◽

Nutritional Interventions

Sedentary lifestyle and aging favor the increasing prevalence of obesity and type 2 diabetes and their comorbidities. The loss of lean body mass reduces muscle strength, resulting in impaired functional capacity and leading to increased risks of chronic diseases with advancing age. Besides aging, conditions such as inappetence, social isolation, and inadequate dietary intake cause the loss of lean body mass and increased abdominal fatty mass, resulting in sarcopenic obesity and predisposition to type 2 diabetes. Compared to younger people, this condition is more common in the elderly owing to natural changes in body composition associated with aging. Lifestyle changes such as increased physical activity and improved dietary behaviors are effective for preventing the occurrence of comorbidities. Regarding muscle nutrition, besides caloric adequacy, meeting the requirements for the consumption of dietary amino acids and proteins is important for treating sarcopenia and sarcopenic obesity because muscle tissue mainly consists of proteins and is, therefore, the largest reservoir of amino acids in the body. Thus, this review discusses the effects of dietary protein on the preservation of lean body mass, improvements in the functional capacity of muscle tissue, and prevention of chronic diseases such as type 2 diabetes. In addition, we address the effects of regular physical training associated with dietary protein strategies on lean body mass, body fat loss, and muscle strength in the elderly at a risk for type 2 diabetes development. Impact statement Diabetes mellitus is a worldwide health problem associated with obesity and sedentary lifestyle, which predisposes affected individuals to mortality and morbidity. Additionally, aging and unhealthy lifestyle behaviors increase inflammation and insulin resistance, contributing to the reduction of cytokines related to muscle nutrition and the suppression of lipogenesis, resulting in the development of sarcopenic obesity. One strategy for the prevention of T2D is the avoidance of secondary aging by participating in healthy action programs, including exercise and nutritional interventions. This minireview of several studies demonstrates the impact of physical activity and nutritional interventions on gaining or preserving muscle mass and on the functional aspects of muscles with aging. It provides information on the effect of protein, leucine, β-hydroxy-β-methylbutyrate (HMB), and creatine supplementation on muscle mass, strength, and volume gain and on the prevention of the progressive decrease in muscle mass with aging in combination with maintaining regular physical activity.

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