ABSTRACT
BACKGROUND: A polymorphism (1359 G/A) of the cannabinoid receptor 1 (CNR1) gene was reported as a common polymorphism (rs1049353) with potential implications in weight loss. We decide to investigate the role of this polymorphism on metabolic changes and weight loss secondary to treatment with liraglutide. METHODS: A population of 86 patients with diabetes mellitus type 2 and obesity, unable to achieve glycemic control (hemoglobine glycate A1c >7%) with metformin alone or associated to sulfonylurea, who require initiation of liraglutide treatment in progressive dose to 1.8 mg/d subcutaneously, was analyzed. RESULTS: Fifty-one patients (59.3%) had the genotype G1359G, and 35 patients (40.7%) had G1359A (28 patients, 32.6%) or A1359A (7 patients, 8.1%) (A allele carriers). In patients with both genotypes, basal glucose, HbA1c, body mass index, weight, fat mass, waist circumference, and systolic blood pressures decreased. In patients with G1359G genotype, total cholesterol and low-density lipoprotein cholesterol decreased, and in patients with A allele, homeostasis model assessment for insulin resistance decreased, too. CONCLUSIONS: There is an association of the A allele with an improvement of insulin resistance secondary to weight loss after liraglutide treatment in obese patients with diabetes mellitus type 2. Noncarriers of A allele showed an improvement in cholesterol levels after weight loss.
Subject(s)
Diabetes Mellitus, Type 2/genetics , Genetic Variation/genetics , Glucagon-Like Peptide 1/analogs & derivatives , Obesity/genetics , Receptor, Cannabinoid, CB1/genetics , Weight Loss/genetics , Adult , Aged , Cardiovascular Diseases/epidemiology , Cardiovascular Diseases/genetics , Diabetes Mellitus, Type 2/drug therapy , Diabetes Mellitus, Type 2/epidemiology , Female , Glucagon-Like Peptide 1/therapeutic use , Humans , Hypoglycemic Agents/therapeutic use , Insulin Resistance/genetics , Liraglutide , Male , Middle Aged , Obesity/drug therapy , Obesity/epidemiology , Prospective Studies , Risk Factors , Treatment OutcomeABSTRACT
BACKGROUND: Primary hyperparathyroidism (PHPT) is associated with high cardiovascular morbidity. The aim of the present study was to explore the relationship of leptin and adiponectin levels with cardiovascular risk factors and anthropometric parameters in patients with PHTP with and without metabolic syndrome (MS). METHODS: A total of 62 patients with PHPT were enrolled. Weight, blood pressure, basal glucose, insulin, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, insulin, HOMA-R, intact parathormone, vitamin D, calcium, leptin, and adiponectin levels were measured in fasting condition. RESULTS: Prevalence of MS with ATP III definition was 32.3% (20 patients; 15 females (75%) and 5 males (25%)) and 67.7% patients without MS (n = 42 patients; 35 females (83.3%) and 7 males (16.7%)). In the analysis with leptin as dependent variable, the weight and HOMA-R levels remained in the model (F = 9.2; P < 0.05), with an increase of 1.31 (CI 95%: 0.24-2.31) ng/ml with each one unit of HOMA-R and an increase of 0.4 (CI 95%: 0.01-0.84) ng/ml with each 1 kg of weight. In a second model with adiponectin as dependent variable, the HOMA-R and HDL-cholesterol levels remained in the model (F = 7.37; P < 0.05), with a decrease of -0.62 (CI 95%: 0.01-1.1) ng/ml with each one point of HOMA-R and an increase of 0.18 (CI 95%: 0.04-0.38) ng/ml with each 1 mg/dl of HDL-cholesterol. In the multivariate, PTH I was not associated with other variables. CONCLUSION: There was a high prevalence of MS-32.3% of patients with PHPT presented an MS. Serum levels of leptin and adiponectin are not related with PTH I, vitamin D, and calcium levels in patients with PHPT.
