Study of the Relation of Visfatin to Obesity and Type II Diabetes Mellitus in Adult Male Subjects
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- Category: Vol. 82, March 2014
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Study of the Relation of Visfatin to Obesity and Type II Diabetes Mellitus in Adult Male Subjects, HASSAN M. EISSA, MOHAMMED E. SALEH, KHALED E. ELHADIDY, GHADA M. ABDEL-AZIZ and AHMAD A. TAMAM
Abstract
Objective: The association of obesity with type II diabetes mellitus has been known for long time. Visceral fat derived adipokine named visfatin, was discovered in 2005, has insulin-mimetic effects. The main determinants of both the production and the physiologic role of visfatin are still unclear. The aim of this study is to determine the relation of serum visfatin levels in obesity and type 2 diabetes to anthropometric mea-sures (weight, height, and waist circumference), visceral adipose tissue mass, subcutaneous adipose tissue mass, arterial blood pressure, glucose metabolism, atherogenic lipid profile, and to the inflammatory marker high sensitivity C reactive protein (Hs-CRP).
Patients and Methods: Subjects were chosen from the outpatient clinic of internal medicine department, Faculty of medicine in Bani Suef University hospital. The study included 48 non-diabetic male subjects and 48 male patients recently diagnosed with type II diabetes mellitus (type II DM), these subjects included 24 lean non-diabetic [body mass index (BMI) <25], 24 obese non-diabetic, (BMI >30), 24 lean diabetic and 24 obese diabetic subjects. All subjects underwent history taking, physical examination. Anthropometric mea-surements (weight, height, and waist circumference) and blood pressure measurement were performed. Body mass index was determined. Visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) were measured using computed tomog-raphy scans and venous blood samples were withdrawn for the determination of levels of fasting plasma glucose (FPG), 2h postprandial plasma glucose (2hpG), fasting plasma insulin level, Insulin resistance was calculated using the homeostasis assessment model of insulin resistance (HOMA-IR), glycated hemoglobin (HbA1c) % which is well accepted as the bio-chemical parameter for assessing long-term glycaemic control in diabetic patients, serum lipid profile [total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), triglycerides (TG), and low density lipoprotein-cholesterol (LDL-C) con-centration], serum visfatin concentrations and serum high sensitivity C-reactive protein (Hs-CRP) were measured.
Results: The mean value of serum visfatin level is signif-icantly (p<0.05) increased in obese non-diabetic compared to lean non-diabetic subjects and in obese diabetic compared to lean diabetic patients. Serum visfatin level is also significantly increased (p<0.05) in lean and obese diabetic patients compared to lean and obese non-diabetic subjects respectively. Serum visfatin is insignificantly (p>0.05) correlated with age in any of the studied group. Serum visfatin is significantly (p<0.05) correlated to BMI, WC, VAT In obese non-diabetic (n=24), obese diabetic (n=24), obese (non-diabetic and diabetic, n=48), non-diabetic (lean and obese, n=48), diabetic (lean and obese, n=48), and combined group (n=96) whereas significantly correlated to SAT in obese diabetic (n=24) and diabetic (lean and obese, n=48). Serum visfatin is insignificantly (p>0.05) correlated to arterial blood pressure in any of the studied groups. In lean (non-diabetic and diabetic, n= 48), obese (non-diabetic and diabetic, n=48), and combined (n=96) groups, serum visfatin is significantly (p<0.05) correlated to FBG, 2- hPG, fasting plasma insulin, HOMA-IR, HbA1c % whereas significantly (p<0.05) correlated with fasting plasma insulin and HOMA-IR in non-diabetic (lean and obese, n=48) and diabetic (lean and obese, n=48) subjects. Serum visfatin is significantly (p<0.05) correlated of TC, LDL-C, TG and significantly (p<0.05) but negatively correlated with HDL-C in lean (non-diabetic and diabetic, n=48), obese (non-diabetic and diabetic, n=48), non-diabetic (lean and obese, n=48), diabetic (lean and obese, n=48), and combined group (n=96). Moreover, serum visfatin is significantly (p<0.05) correlated to Hs-CRP in obese non-diabetic, lean diabetic, obese diabetic, lean, obese, non-diabetic, diabetic, and com-bined groups.
Conclusions: Serum visfatin levels are elevated in obese and diabetic subjects. Hyperinsulinemia as a consequence of insulin resistance may leads to elevated visfatin levels. Visfatin levels are related with adiposity and blood glucose levels. Elevated visfatin production in obesity seems to be a compen-satory, although unfortunately insufficient response in obesity-induced insulin resistance. However, the role and contribution of the circulating visfatin levels to glucose and lipid metabolism in obese and diabetic subjects remain to be explored. Visfatin levels are correlated with Hs-CRP in obese and diabetic subjects, which may suggest that a chronic inflammatory state is associated with hyperglycemia and diabetes through obesity or increased insulin resistance.