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|Title||Ghrelin, Leptin and Insulin in Type 2 Diabetic Patients in Gaza Strip|
Background: Recent studies on ghrelin in type 2 diabetes mellitus and its interactions with insulin or leptin is limited and controversial. However, it was shown that ghrelin and leptin recorded low and high levels, respectively with increasing insulin resistance. Clarifying and understanding of such tri-hormonal interplay in type 2 diabetes could be helpful in the intervention and control strategies of the disease. Objective: to assess ghrelin, leptin and insulin in type 2 diabetic patients in Gaza Strip. Materials and Methods: This case-control study comprised 80 diabetic patients selected from different Gaza Strip hospitals and diabetic clinics and 80 healthy controls. Controls and cases were matched for age and sex. Questionnaire interviews were applied. Serum ghrelin, leptin, insulin, glucose, cholesterol, triglycerides, high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), urea and creatinine were determined. Data were analyzed using SPSS version 18.0. Results: The mean ages of controls and cases were 49.8±6.5 and 51.7±7.0 years, respectively. Family history was found to be associated with diabetes. The number of diabetic patients who ate 3 and ≥ 4 meals/day were about twice higher than controls. Although half of patients had diabetes since less than 5 years, the majority of them had blood glucose test once/month, reflecting inadequate blood glucose monitoring. The most common self-reported complications among diabetic patients were retinopathy, neuropathy and cardiovascular disease. The prevalence of such complications were positively associated with the duration of diabetes. Body mass index of cases was significantly higher than that of controls. Serum glucose and insulin levels were significantly higher in diabetic patients than controls (187.4±74.1 and 28.8±23.9 vs. 98.3±17.0 and 18.8±13.5, % difference=62.4 and 42.0, P=0.000 and P=0.025). Serum leptin showed no significant increase in diabetic patients compared to controls (7.1±2.7 vs. 5.9±2.2 ng/ml, % difference=18.5 and P= 0.081) whereas ghrelin was significantly lower in patients (1189±580 vs.1531±822 pg/ml, % difference=25.1 and P=0.038). The mean level of triglyceride was significantly higher in patients compared to controls (212.5±78.9 vs. 143.2±50.4 % difference=39.0 and P=0.000). In addition, urea showed no significant increase in patients (33.5±11.0 vs. 28.3±13.3, % difference=16.8 and P=0.059). The Pearson correlation test showed positive significant correlation of BMI with triglycerides (r=0.228, P=0.044). Insulin showed positive correlations with glucose, triglycerides and leptin (r=0.286, r=0.224 and r=0.187, respectively). However, this positive correlation was significant for glucose and triglycerides (P=0.011, P=0.049, respectively). On the other hand, ghrelin showed negative not significant correlation with insulin (r=-0.213 and P=0.057). Conclusion: serum insulin and leptin levels were increased in diabetic patients compared to controls whereas ghrelin was decreased in patients. Insulin was positively correlated with leptin and negatively correlated with ghrelin confirming the tri-hormonal interplay in diabetes.
|Publisher||الجامعة الإسلامية - غزة|
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