EVALUATION OF GHRELIN, INSULIN AND LEPTIN LEVELS IN OBESE TYPE 2 DIABETIC PATIENTS ON METFORMIN OR GLIMEPIRIDE THERAPY IN BASRA, IRAQ

Abstract

Background:Recent evidence has demonstrated the complex function of adipose tissue and gastric cells as an endocrine organ through release of hormones into the blood stream and involved in physiological activities of the body; of them is ghrelin. The consequences of insulin resistance manifest at many levels and in many metabolic processes, producing a cluster of homeostatic abnormalities referred to what is called metabolic syndrome.
Objectives:To evaluate and compare the possible effects of using metformin or glimepiride on serum concentrations of ghrelin, leptin and insulin resistance in obese type 2 diabetic patients in Basra, Iraq.
Methods: Forty type 2 diabetic obese patients and twenty healthy subjects were studied. The patients were divided into 2 groups (each of 20 patients); group 1 on glimepiride therapy while group 2 on metformin treatment. Blood samples were taken after at least 8 hours fasting for measurement of serum glucose, leptin, ghrelin and insulin.
Results: Ghrelin levels were significantly lower in the two patient groups with greater significant reduction in metformin group. The highest serum insulin concentration and insulin resistance levels were clearly reported in glimepiride treated group as compared to control and metformin treated group. Leptin levels show no significant differences in all studied groups.
Conclusion: Metformin treatment associated significantly with improved insulin sensitivity; insulin resistance associated significantly with decreases ghrelin concentration. Ghrelin is negatively correlated with leptin and obesity while positively correlate with insulin resistance. Our data support the role of body weight as the major determinant of circulating leptin levels.
Keywords :Diabetes mellitus, obesity, ghrelin, metformin, leptin.