The relationship of adiponectin, leptin and ghrelin to insulin resistance and cardiovascular risk factors in human obesity / 대한내과학회지

ABSTRACT

BACKGROUND: Adiponectin, letin and ghrelin are considered to take part in the regulation of energy metabolism. We investigated the relationship between these adipokines and body mass index (BMI), regional adiposity, insulin resistance and cardiovascular risk factors in human. METHODS: Eighty six (Male Female = 36 50, Age = 21-71 year old, BMI 18 - 39.5 kg/m2) subjects without known medical problems participated in this study. Subjects were grouped based on BMI or visceral fat area (VFA) and gender. We measured lipid concentration, fasting glucose, fasting insulin, insulin resistance (HOMA-IR) and high sensitivity CRP (hsCRP). Body fat distribution was determined by computed tomography. Fasting serum adiponectin, leptin, and ghrelin were measured by ELISA. RESULTS: The group of BMI over 25 kg/m2 showed significant difference in waist circumference (WC), total fat area (TFA), subcutaneous fat area (SFA), VFA, Triglyceride (TG), hsCRP and leptin. Visceral fat dominant (VFD) group (VFA>or=100 cm2 or VFA/SFA>or=0.4) showed significant difference in age, BMI, WC, TFA, SFA, free fatty acid, HOMA-IR, hsCRP, adiponectin, leptin and ghrelin. Leptin was positively correlated with BMI, waist hip ratio (WHR), TFA, VFA, SFA, low-density lipoprotein cholesterol (LDL-C), HOMA-IR and fasting insulin. Adiponectin was negatively correlated with BMI, WHR, TFA, VFA, HOMA-IR and positively correlated with High-density lipoprotein cholesterol (HDL-C). Ghrelin level was negatively correlated with WHR, VFA, fasting glucose, HOMA-IR and positively correlated with HDL-C. And leptin was negatively correlated with ghrelin. As regional adiposity, SFA was positively correlated with leptin, and VFA was negatively correlated with adiponectin and ghrelin and positively correlated with leptin. CONCLUSIONS: This study demonstrated that VFA had more significant association with lipid metabolism and adipokine secretion than BMI and leptin levels were inversely correlated with ghrelin level.