Adiponectin in type 2 diabetes: relation to insulin sensitivity

Adiponectin, which is a novel-specific protein with putative antiatherogenic and anti-inflammatory effect, was found to be decreased in individuals with obesity, type 2 diabetes and cardiovascular disease, conditions commonly associated with insulin resistance and hyperinsulinemia. Insulin resistance appears to play a pivotal role in the pathogenesis of type 2 diabetes and other chronic diseases including hypertension, cardiovascular disease and hyperlipidemia. Alteration in adiponectin level is suggested to be a primary metabolic abnormality leading to insulin resistance. The main aim of this work was to evaluate the plasma level of adiponectin and its relation to insulin resistance. We studied 20 type 2 diabetic patients and 20 healthy controls. All patients and controls were subjected to history taking, clinical examination and laboratory studies including oral glucose tolerance curve with estimation of serum glucose and insulin, plasma adiponectin, lipid profile, serum uric acid and microalbuminuria. insulin sensitivity index [SI] was calculated. We found that plasma adiponectin, total serum cholesterol, triglycerides, LDL-C, uric acid and microalbumiuria were significantly higher in the diabetic group than in the healthy control subjects [P < 0.05]. Plasma adiponectin was significantly lower in diabetic patients than in normal subjects. it was positively correlated with the degree of insulin sensitivity and negatively correlated with body mass index, total cholesterol, triglycerides and uric acid. We concluded that adiponectin may play a role in insulin sensitivity in type 2 diabetes

Erythropoitin level in diabetics with and without autonomic neuropathy: relation to anaemia and metabolic control

Anaemia is a frequently noted complication of diabetes. There are several causes for anaemia in diabetes, however, in some diabetic anaemic patients the cause of their anaemia was not clearly explained despite differential hematological studies. This study aimed to measure the level of erythropoietin [EPO] in diabetic anaemic patients with and without autonomic neuropathy, and to compare this level with non-diabetic anaemic patients as control. We therefore studied the clinical and biochemical characteristics of 40 diabetic patients with anaemia of uncertain cause and patients were subdivided into two groups: those complicated with autonomic neuropathy [Group I, n=20], and those without autonomic neuropathy [Group II, n=20]. In addition, we enrolled 20 non-diabetic patients with similar degree of anaemia [Group Ill, n=20] in order to compare the serum EPO responsiveness to anaemia. The haemoglobin levels of diabetic patients correlated with creatinine clearance [r=0.34, p=0.009], but showed no relation to age, sex, duration of diabetes, or glycosylated haemoglobin percentage. The serum EPO concentrations of Group I patients [11.41 +/- 2.58 mIU/ml] were significantly lower than those of Group II[29.92 +/- 6.27 mIU/ml], and Group Ill [38.66 +/- 12.90 mIU/mI]. We concluded that the relatively low serum EPO levels of Group I patients could be the cause of their anaemia, and that the autonomic neuropathy complicating this group of diabetic anaemia patients could be the cause of this blunted EPO responsiveness to anaemia

Tumor Necrosis factor - alpha, leptin and insulin resistance [peripheral sensitivity] in type 2 diabetes

Aim: Insulin resistance appears to play a pivotal role in the pathogenesis of type 2 diabetes and other chronic diseases including hypertension, cardiovascular disease and hyperlipidemia. Alterations in tumour necrosis factor-alpha [TNF-alpha] and leptin are suggested to be primary metabolic abnormalities leading to insulin resistance. The main aim of this work was to evaluate the serum level of TNF-alpha and leptin in type 2 diabetes mellitus and to correlate these levels with the degree of insulin resistance. Subjects and We studied 40 type 2 diabetic patients and 20 healthy controls. All patients and controls were subjected to history taking, clinical examination and laboratory studies including oral glucose tolerance curve with estimation of serum glucose and insulin, plasma TNF-alpha, serum leptin, lipid profile, serum uric acid and micro-albuminuria. Insulin sensitivity index [SI] was calculated. We found that serum TNF-alpha, serum leptin, total cholesterol, triglycerides, LDL-C, uric acid and micro-albumin were significantly higher in the diabetic group than in the healthy control subjects [P<0.05]. TNF-alpha and leptin were negatively correlated with the degree of insulin sensitivity. Conclusions: We concluded that both TNF-alpha and leptin may play an important role in insulin resistance syndrome in type 2 diabetes