Leptin Status and some Biochemical Parameters among Type 2 Diabetic Females in the Gaza Governorate, Gaza Strip

Abstract

Background: Diabetes mellitus is a multifactorial disease characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. Its prevalent rate in Gaza Strip is alarming. Although the role of leptin hormone in obesity is well established, its status in diabetes is still unclear and controversial. Understanding such role may help in future control and therapy of diabetes. Objective: To assess leptin status and some biochemical parameters among type 2 diabetic females in Gaza Governorate, Gaza Strip. Materials and Methods: In this cross sectional study, data were obtained from questionnaire interview, and biochemical analysis of blood and urine of 81 type 2 diabetic patients and 74 healthy individuals. Results: The average age of the controls was 48.0±5.8 years whereas that of diabetic patients was 52.2±6.1 years. There was a significant decrease in the mean of blood glucose level with increasing the patient educational level. (FANOVA=2.82, P=0.027). Diabetes was found to be associated with family history (c2=3.2, P=0.05). Also, there was a high significant association between diabetes and diet (c2=95.93, P=0.000). The main self-reported complications among patients were retinopathy, neuropathy and cardiovascular diseases. In general, the longer the duration of diabetes, the higher the percentage of self reported complications among patients (p<0.05). Body mass index (BMI) was positively associated with diabetes ((c2=6.11, P=0.047). Serum glucose was significantly higher in diabetics compared to controls (mean=197.6+81.6mg/dl vs 89.9+14.2mg/dl, % difference=119.8, p=0.000). Serum urea and creatinine were not changed (mean=24.0±7.9mg/dl vs 24.9±7.8mg/dl and 0.73±0.23mg/dl vs 0.70±0.16mg/dl, % differences=3.6 and 4.3, p=0.492 and 0.257, respectively). Cholesterol, triglycerides(TAG) and low density lipoprotein(LDL-C) cholesterol were significantly higher in diabetics (204.3±52.6mg/dl, 187.7±103.2mg/dl and 105.9±35.2mg/dl) than controls (180.5±36.1mg/dl, 118.3±72.7mg/dl and 91.9±31.5mg/dl) with % differences of 13.2, 58.7 and 15.2%, p=0.002, 0.000 and 0.011, respectively. In contrast, high density lipoprotein cholesterol (HDL-C) was significantly lower in diabetics (43.1±13.1mg/dl vs. 47.9±16.6mg/dl, % difference=10.0 and p=0.045). Serum leptin levels were significantly lower in diabetic patients compared to controls (12.3±8.7ng/ml vs. 16.8±14.4ng/ml, % difference=26.8 and p=0.018). Leptin was negatively correlated with blood glucose and triglyceride levels (r= -0.170, p = 0.030 and r= -0.174, p = 0.032) whereas it correlates positively with HDL-C level (r= -0.200, p = 0.013). Individuals who were not restricted to diet had higher leptin levels than those who did (t=1.66, p=0.07). The larger the BMI, the higher the level of leptin (F= 4.45, p = 0.013). Diabetic patients showed higher albumin levels in their urine compared to controls (41.1±62.6µg/dl vs. 24.7±23.5µg/dl,5, %difference=66.4 and p=0.045. serum creatinine level was normal (75.1±40.3mg/dl vs. 80.0±49.8mg/dl, %difference=6.1 and p=0.547). However, when albumin/creatinine ratio was calculated and averaged, significant increase was detected (0.72±1.11µg/mg vs. 0.37±0.41µg/mg, % difference=94.6 and p=0.017). Microalbuminuria among controls and patients were 7 (9.5%) and 20 (24.7%) with c2=3.59, P=0.045. Conclusions: Diabetes is associated with family history, diet and obesity. Lower leptin levels were found in diabetics. Leptin was negatively correlated with blood glucose and triglyceride and positively with BMI and HDL-C. Diabetic patients showed higher albumin levels in their urine. Serum creatinine level was normal in blood and urine. Albumin/creatinine ratio increased in patients, as well as. Microalbuminuria.