Serum Adipokines In Obese Bariatric Patients - Correlations With Metabolic Parameters

IntroductionThere has been growing evidence of significantly reduced serum concentrations of adiponectin in obese individuals compared to those with normal body mass index (BMI).Hypoadiponectinemia is associated with the development of insulin resistance and type 2 diabetes mellitus, independently of BMI and metabolic syndrome. Leptin/Adiponectin ratio is considered a more precise instrument for cardio-metabolic risk evaluation in obese patients, compared to adipokines value separately.MethodsOur clinical study evaluated serum adipokines in a group of morbidly obese patients (N=106) with a mean BMI = 45.0 +/- 6.3 kg/m(2) (36.4-58.9) before bariatric surgery procedure.We assessed the relationship between serum leptin, adiponectin and leptin/adiponectin ratio values, morning blood glucose and insulin levels, lipid profile, morning cortisol and thyroid hormones profile in a group of obese bariatric patients with metabolic syndrome (N=64) versus "metabolic healthy" obese patients (N=42) according to IDF criteria.ResultsThe plasma adiponectin values varied between 8,68-33,84 mu g/dl, with a mean value of 29.0 +/- 3.2 ug/dl, with similar results in "metabolic healthy obese" patients vs subgroup with associated metabolic syndrome (29.76 vs 28.45 mu g/dl; p=0.120). Mean leptin serum level was 0.93 +/- 0.3 ng/dl and varied between 1.54-44.15 ng/dl in the studied group of obese patients and there was no statistical difference between the two obese patients' sub-groups. We found a positive correlation between Leptin levels and CT/HDL values (r=+0.492; p=0.046).Leptin/Adiponectin ratio (LAR) had higher values in obese patients with associated metabolic syndrome 0.877 vs 1.045; p=0.05, compared to the "metabolic healthy obese subgroup". In our study, the correlation between adiponectin and HOMA-IR was indirect and reduced in intensity, and by drawing the ROC curve, it is noted that the leptin/adiponectin ratio, with a probability of 65.8%, can be a good predictor in the determinism of the metabolic syndrome (AUC=0.658; 95% CI: 0.437-0.699).ConclusionLow adiponectin levels in obese patients are associated with the development of insulin resistance and type 2 diabetes, and the Leptin/Adiponectin Ratio was shown to have higher values in patients with metabolic syndrome. LAR was demonstrated in our study to be a valuable marker for metabolic syndrome in obese patients and can be useful for the evaluation of the associated cardiovascular risk in these patients.