| Summary: | 碩士 === 高雄醫學大學 === 公共衛生學研究所碩士班 === 95 === Background: Obesity is a well known risk factor of insulin resistance and type II diabetes. Adipocyte-derived proteins had been discovered recently and might contribute to the pathomechanism between obesity and insulin resistance. This study investigated the association between adipocyte-derived proteins (leptin and adiponectin), insulin resistance and impaired glucose tolerance in non-diabetic women.
Methods: One hundred ninety women were recruited from the Obesity Clinic at Kaohsiung Medical University Hospital, Taiwan, between February 2003 and February 2004. Eligible subjects were those who did not have diabetes or not taking medications that would affect glucose, blood pressure, or lipid metabolism. All participants completed a simple questionnaire on their medication history and lifestyle characteristics. Fasting glucose, total cholesterol, HDL-cholesterol, TG, leptin, adiponectin, and fasting insulin level were collected after an overnight fast. Two-hour glucose level after OGTT was obtained. HOMA-IR was calculated as the index of insulin resistance. BMI, waist-to-hip ratio and percent body fat were measured for analyzing the relationship between obesity, insulin resistance and adipocytokines.
Results: In the multiple regression analysis, it showed that leptin and adiponectin were independently associated with HOMA-IR and fasting insulin concentration but in divergent direction after controlling for potential confounding factors; leptin was positively associated with HOMA-IR (b=0.03，p=0.036) and fasting insulin concentration (b=0.16, p=0.009), while adiponectin was negatively associated with HOMA-IR (b=-0.09, p=0.001) and fasting insulin concentration (b=-0.36, p=0.001). Adiponectin was associated with risk of impaired glucose tolerance (OR (95%C.I) =0.78(0.67-0.92)), but leptin was not associated with impaired glucose tolerance after controlling for potential confounding factors (OR (95%C.I) =1.01(0.95-1.08)).
Conclusions: Leptin and adiponectin were both associated with insulin resistance and hyperinsulinemia independent of obesity, suggesting that leptin and adiponectin may be involved in the pathophysiologic of insulin resistance and hyperinsulinemia independent of obesity. Adiponectin was negatively associated with 2-hr glucose levels and impaired glucose levels, suggesting that low levels of adiponectin might be associated with developing impaired glucose tolerance and type 2 diabetes.
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