Is the combined use of insulin resistance indices, including adipokines, more reliable in metabolic syndrome?

Abstract

IntroductionMetabolic syndrome (MetS) is a clustering of cardiovascular risk factors associated with insulin resistance, central adiposity, hyperglycemia, hypertension, hypertriglyceridemia, and low high-density lipoprotein cholesterol (HDL-C) levels (1,2).Adipokines are secreted by adipose tissue and influence a variety of physiological processes such as food intake control, energy homeostasis, insulin sensitivity, angiogenesis, blood pressure regulation, and blood coagulation (3). They play significant roles in the pathogenesis of obesity, MetS, and chronic inflammatory and autoimmune diseases (4). Leptin is one adipokine that contributes to the regulation of body weight, modulation of insulin sensitivity, metabolism, and reproductive function (5). In addition, it affects thermogenesis, hematopoiesis, angiogenesis, and immune homeostasis (6). Another adipokine, adiponectin, produced exclusively by adipocytes of white adipose tissue, plays a significant role in the regulation of insulin sensitivity and has antiatherosclerotic and antiinflammatory properties (3). Resistin is another adipokine that may be involved in sensing the nutritional status-its mRNA level decreases during fasting and increases after food consumption. It is associated with a variety of disorders: obesity, diabetes, atherosclerosis, endothelial dysfunction, thrombosis, angiogenesis, inflammation, and smooth muscle cell dysfunction (4,7). The adipokine visfatin shows insulinlike properties, inhibits glucose release by liver cells, and promotes the storage of triglycerides in preadipocytes (8). It plays roles in immunity, metabolism, aging and Background/aim: To determine the levels of adipokines (leptin, adiponectin, resistin, and visfatin) and the indices of insulin sensitivity/ resistance, and to examine the relationship among them in patients with metabolic syndrome (MetS). Materials and methods:The study groups included 45 subjects with MetS (31 women/14 men), and 45 sex-and age-matched non-MetS healthy volunteers (31 women/14 men). The levels of adipokines were determined by enzyme-linked immunosorbent assay. Results:The levels of leptin and visfatin were significantly higher in the MetS than in the non-MetS subjects (P < 0.01). There was no difference in adiponectin levels in subjects with and without MetS (P = 0.052). Similarly, resistin did not show any statistically significant difference. A statistically significant positive correlation of leptin with insulin levels was observed, while negative correlations of visfatin levels with age, and resistin levels with the ratio of adiponectin to leptin, were found in the MetS (P < 0.05). The combination of adipokines, insulin resistance-sensitivity parameters, and MetS criteria parameters gave more significant differences than a single parameter. Conclusion:Since the parameters mentioned above might affect, interact with, and/or interfere with each other, the combinations of these parameters might give more reliable results to evaluate the insulin resistance/sensitivity in MetS patients.

Elevated Serum Levels of Cysteine and Tyrosine: Early Biomarkers in Asymptomatic Adults at Increased Risk of Developing Metabolic Syndrome

“…Similar picture was observed when assessing adipokine signaling: adiponectin was significantly lower in MetS2 group (nonpublished data) while visfatin was significantly higher [ 18 ]. Similarly to previous reports [ 26 , 27 ], we observed no difference in resistin levels between the three groups in the present study, although some studies demonstrated significantly higher serum resistin levels in MetS group compared to control group [ 28 , 29 ]. Interestingly, some parameters were statistically higher already when the groups MetS0 and MetS1 were compared.…”

Serum visfatin level in obese Egyptian children and adolescents and its relation with metabolic syndrome

“…The same was elicited by Kural et al [26], who reported that the levels of visfatin were significantly higher in MS than in non-MS individuals. Chang et al [27] also detected the same elevation of visfatin in MS cases and even suggested the use of visfatin as a diagnostic marker in MS.…”

Lansoprazole enhances the antidiabetic effect of dapagliflozin in fortified diet‐fed streptozotocin‐treated diabetic rats

“…[ 21,82 ] A previous study showed that the decreased level and negative relation of ADP/LEP with insulin suggested that the ADP/LEP ratio could be used as an insulin sensitivity index. [ 83 ] In the present study, combined treatment of DAPA and LPZ significantly increased the ADP/LEP ratio more than either drug alone, indicating a beneficial effect of this combination on the adipokine profile and resulting in better improvement of insulin sensitivity. Moreover and interestingly, the results of the present study demonstrated for the first time the role of DAPA and/or LPZ on ADP/LEP ratio as a useful estimate of IR.…”

“…[21,82] A previous study showed that the decreased level and negative relation of ADP/LEP with insulin suggested that the ADP/LEP ratio could be used as an insulin sensitivity index. [83] In the PPAR-γ plays a vital role in controlling the storage and release of fats and glucose, as well as lipid metabolism, regulating IR, blood glucose, cell growth, and differentiation, vascular inflammation reaction, as well as influencing the pathologic processes of vascular sclerosis. [84] Therefore, PPAR-γ has become the focus of investigations on antidiabetic drugs.…”