BackgroundThe fast pace of life, promoting fast food consumption and low physical activity, has resulted in obesity and/or diabetes as being serious social problems.The aim of the present study was to evaluate concentrations of selected adipokines (leptin, adiponectin, resistin, and visfatin) and to assess the leptin/adiponectin ratio in plasma of type 2 diabetes (T2D) patients in relation to degree of obesity.Material/MethodsThe study comprised 92 T2D subjects divided into 4 groups according to BMI value – I (normal body weight), II (overweight), III (obesity), and IV (severe obesity) – and 20 healthy volunteers (control group). Each group was divided into male and female subgroups. Plasma concentrations of adipokines were determined by enzyme-linked immunosorbent assay.ResultsIn women, leptin concentration was significantly higher in group IV, whereas in men it was higher in groups III and IV than in the control group and groups I and II. Irrespective of sex, a significant decrease in adiponectin level was observed in group III vs. control. There was no significant difference in resistin levels. In women visfatin was markedly enhanced in group III, whereas in men in groups II, III and IV vs. control. Leptin/adiponectin ratio was increased in groups III and IV vs. control in women, whereas in men vs. both control and group I.ConclusionsThe obese type 2 diabetic patients presented a disturbed adipokine profile, which seems to be an important link between obesity and T2D. The future studies concerning the question if regulating of adipokines’ concentrations could be a promising approach for managing metabolic disorders seem to be well-grounded.

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A b s t r a c tIntroduction: Many epidemiological studies show a correlation between the risk of cancer and type 2 diabetes mellitus in various populations. Material and methods: The material was obtained from the database of the National Health Fund. This publication presents a comparison of the incidence of new malignancies in rural and urban populations of diabetic patients in Poland based on the database of the National Health Fund for the period between 1. 05.2008 and 30.09.2014. Results: Comparison of the mean incidence of selected malignancies in diabetic patients in the population analysed indicated significant differences between the incidence rate in the urban and rural populations (p < 0.001). The mean incidence of gastric cancer, colorectal cancer, kidney cancer, brain tumours and leukaemia in both sexes was significantly higher in rural areas compared to urban. The mean incidence of oesophageal cancer and pancreatic cancer in females was significantly higher among in the urban population compared to the rural areas (p < 0.001). No differences in the incidence rate of these neoplasms were observed in men (p > 0.05). Conclusions: The incidence of gastric cancer, colorectal cancer, laryngeal cancer, lung cancer, testicular cancer, kidney cancer, lung cancer, lymphocytic leukaemia and myeloid leukaemia is higher in diabetic males in rural areas than the incidence in the urban population. The incidence of the malignancies liver cancer, malignant skin melanoma, malignant skin, prostate cancer, urinary bladder cancer and multiple myeloma in male diabetic patients living in urban areas is higher than the incidence in rural areas.

Diabetes itself, by its nature, can aggravate the symptoms of depression. One of its main complications is peripheral diabetic neuropathy (PDN). Based on the literature the presence of the relationship between the PDN and depression is confirmed. The symptoms connected with instability while walking and reduction of everyday activities were the strongest predictors of the intensification of depression symptoms. The relationship between the neuropathic ulcers and depression is considered as ambiguous. Additional problems in diagnosis and evaluation is the polyetiologic character of the disease, damage to the nerve fibers of different thickness, variety of methods of the diagnosis and differences in the prevalence of diabetic neuropathy (26%-50%). The presence of the described differences may be connected with diagnostic methods and the fact of the modification of perceived symptoms such as pain by the depression itself. One of the results of difficulties in describing the relationships and diagnosis are problems, described in the literature, with the selection of patients requiring treatment of PDN.

A growing interest in the role of vitamin D in metabolic diseases led us to study the relationships between 25-hydroxyvitamin D3 (25(OH)D3) and the profiles of selected adipokines in type 2 diabetic (T2DM) patients. The study comprised 92 type 2 diabetics divided into quartiles regarding 25(OH)D3 concentration. Each group was divided into male and female subgroups. All the studied patients had their anthropometric and biochemical parameters determined. Plasma 25-hydroxyvitamin D3 concentration was determined by HPLC, while the selected adipokines (leptin, adiponectin, resistin and visfatin) by ELISA methods. The ratio of leptin to adiponectin (L/A) was calculated for all the patients. In 85.3% of diabetics a full (<20 ng/mL) or moderate (20–30 ng/mL) vitamin D deficit was found. Irrespective of sex, plasma leptin concentration decreased across increasing quartiles of 25(OH)D3 level. In women, 25(OH)D3 was negatively correlated with BMI, leptin level as well as L/A ratio, and positively with adiponectin concentration. In men, 25(OH)D3 was positively correlated with HDL and negatively with systolic blood pressure (SBP), leptin level and L/A ratio. Considering all the patients, there ocurred a significant negative correlation between 25(OH)D3 and SBP, BMI, WHR, TG, leptin and L/A ratio and positive ones between 25(OH)D3 and both adiponectin and HDL. The results of the study support the existence of the relationship among vitamin D, obesity and leptin in type 2 diabetic patients.