الغريلين واللبتين وعلاقتهما مع مقاومة الأنسولين في مرضى داء ألسكري من النوع ألثاني
محتوى المقالة الرئيسي
الملخص
إن مرض السكري من النوع الثاني هو ناتج عن خلل في إفراز هرمون الأنسولين، ومقاومة الأنسولين. الهدف من الدراسة هو قياس تركيزالجريلين واللبتين في الدم وتحديد طبيعة العلاقة الموجودة بين هذه الهرمونات كمتغيرات تابعة مع بعض القياسات البيوكيميائية والسريرية في مرضى السكري من النوع الثاني. شملت الدراسة واحد و أربعين مريضآ بداء السكري من النوع الثاني و ثلاثة و أربعين شخصآ أصحاء كمجموعة ضابطة ، تتراوح أعمارهم بين 40-60 سنة و ضمن الوزن الطبيعي. وتم قياس نسبة هرمون الغريلين و اللبتين باستخدام تقنية الفحص المناعي المرتبط بالإنزيم (إلاليزا). أظهرت النتائج إن نسبة الغريلين اعلى واللبتين أقل معنويآ في مصل مرضى السكري من النوع الثاني مقارنة بالجموعة الضابطة. وتبين ان غريلين ترتبط إيجابيا مع، نسبة السكر في الدم و مقاومة الأنسولين ومن ناحية اخرى ترتبط عكسيآ بحساسية الأنسولين. أماعلاقة اللبتين مع سكر الدم، الهيموجلوبين الجلوكوزيلاتي، مقاومة الأنسولين والبروتين الدهني المنخفض الكثافة، أكسيد النيتريك وأنزيم الكبد (ألانين أماينوترانسفيريز) هي علاقة عكسية. و ترتبط اللبتين خطيآ بمعدل ضغط الدم، حساسية الأنسولين و نوع الجنس. وفقًا لاختبارات التشخيص بأستعمال منحنى الخاصية العملياتية للمستقبلية أعتبرت هرمون الغريلين واللبتين علامات حيوية لداء السكري من النوع الثاني. استنتجت هذه الدراسة أن الغريلين واللبتين يمكن إستخدامهم كأدوات تنبؤية للأصابة بمرض السكري من النوع الثاني، نظرآ لعلاقتهما المعنوية بمقاومة وحساسية الأنسولين، الشوارد الحرة و مستوى الدهون.
Received 16/3/2020
Accepted 4/11/2020
Published Online First 20/7/2021
تفاصيل المقالة
هذا العمل مرخص بموجب Creative Commons Attribution 4.0 International License.
كيفية الاقتباس
المراجع
Association AD. 2. Classification and diagnosis of diabetes: standards of medical care in diabetes—2019. American Diabetes Association; 2019. Report No.: 0149-5992 Contract No.: Supplement 1.
Jaccob AA, Sheri FH, Aljazaari QA. Evaluation of Ghrelin, Insulin and Leptin Levels in Obese Type 2 Diabetic Patients on Metformin or Glimepiride Therapy in Basra, Iraq. Iraqi J Med Sci. 2014;12(3):245-53.
Moonishaa TM, Nanda SK, Shamraj M, Sivaa R, Sivakumar P, Ravichandran K. Evaluation of Leptin as a Marker of Insulin Resistance in Type 2 Diabetes Mellitus. Int J Appl Basic Med Res. 2017;7(3):176-80. DOI: 10.4103/ijabmr.IJABMR_278_16.
Abed BA, Shkhaier SL, Abbas SA. Ghrelin Levels in Male Patients with Hyperlipoproteinemia I, II versus Type 2 Diabetes Mellitus. J Fac of Med. 2014;56(2):239-43.
Ashoor LS, Najim HD, Tahir NT. Role of leptin/adiponectin ratio in Iraqi type 2 diabetic patients treated with different antidiabetic agents. Mustansiriya Med J. 2017;16(2):54-62.
Kojima M, Hosoda H, Date Y, Nakazato M, Matsuo H, Kangawa K. Ghrelin is a growth-hormone-releasing acylated peptide from stomach. Nature. 1999;402(6762):656-60.
Farajallah A, Ahmed A, Abdullah N, Abusnana S, Andrew P. The Relationship between Type 2 Diabetes and Total Ghrelin Level in a Population Sample in the United Arab Emirates. J Pharm 2014;4(6):1-8.
Poher A-L, Tschöp MH, Müller TD. Ghrelin regulation of glucose metabolism. Peptides. 2018;100:236-42. DOI: 10.1016/j.peptides.2017.12.015.
Zhang CS, Wang LX, Wang R, Liu Y, Song LM, Yuan JH, et al. The Correlation Between Circulating Ghrelin and Insulin Resistance in Obesity: A Meta-Analysis. Front Physiol. 2018;9:1308. DOI: 10.3389/fphys.2018.01308.
Beltowski J. Leptin and atherosclerosis. Atherosclerosis. 2006;189(1):47-60.
Katsiki N, Mikhailidis DP, Banach M. Leptin, cardiovascular diseases and type 2 diabetes mellitus. Acta Pharmacol Sin. 2018;39(7):1176-88. DOI: 10.1038/aps.2018.40.
Malecha-Jedraszek A, Burska A, Matyjaszek-Matuszek B, Donica H. Serum leptin concentration in patients with type 2 diabetes. Curr Issues Pharm Med Sci. 2015;28(4):236-40. DOI: 10.1515/cipms-2015-0078.
Sheriff D. Leptin and Hypertension-A Perspective. ECEMR. 2018;3:225-9.
Rotundo L, Persaud A, Feurdean M, Ahlawat S, Kim H-s. The association of leptin with severity of non-alcoholic fatty liver disease: A population-based study. Clin Mol Hepatol. 2018;24(4):392-401.
Becerril S, Rodríguez A, Catalán V, Ramírez B, Unamuno X, Portincasa P, et al. Functional Relationship between Leptin and Nitric Oxide in Metabolism. Nutrients. 2019;11(9):2129.
Gijón-Conde T, Graciani A, Guallar-Castillón P, Aguilera MT, Rodríguez-Artalejo F, Banegas JR. Leptin reference values and cutoffs for identifying cardiometabolic abnormalities in the Spanish population. Revista Española de Cardiología (English Edition). 2015;68(8):672-9.
Najam S, Awan F, Islam M. Leptin Correlation with Obesity, Diabetes and Gender in a Population from Faisalabad, Pakistan. Arch Med. 2016;8:5.
Keys A, Fidanza F, Karvonen MJ, Kimura N, Taylor HL. Indices of relative weight and obesity. J Chronic Dis. 1972;25(6):329-43. DOI: 10.1016/0021-9681(72)90027-6.
Yu D, Zhao Z, Simmons D. Interaction between Mean Arterial Pressure and HbA1c in Prediction of Cardiovascular Disease Hospitalisation: A Population-Based Case-Control Study. J Diabetes Res. 2016;2016. DOI: 10.1155/2016/8714745.
Matthews D, Hosker J, Rudenski A, Naylor B, Treacher D, Turner R. Homeostasis model assessment: insulin resistance and β-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28(7):412-9.
Chen H, Sullivan G, Yue LQ, Katz A, Quon MJ. QUICKI is a useful index of insulin sensitivity in subjects with hypertension. American Journal of Physiology-Endocrinology and Metabolism. 2003;284:804–12.
Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. clinical chemistry. 1972;18(6):499-502.
Sun J, Zhang X, Broderick M, Fein H. Measurement of nitric oxide production in biological systems by using Griess reaction assay. Sensors. 2003;3(8):276-84.
Patait MR, Mody R. Estimation of serum malondialdehyde before and after radiotherapy in oral squamous cell carcinoma patients undergoing antioxidant therapy. Journal of Indian Academy of Oral Medicine and Radiology. 2011;23(4):563-8.
Jawed M, Saeed MS, Shahid A, Jawed S. Ghrelin Level in Type 2 Diabetes Mellitus and Obesity. Annals KEMU. 2017;23(3).
Vestergaard ET, Jessen N, Møller N, Jørgensen JOL. Acyl ghrelin induces insulin resistance independently of GH, cortisol, and free fatty acids. Sci Rep. 2017;7:42706.
Dong J, Peeters T, De Smet B, Moechars D, Delporte C, Vanden Berghe P, et al. Role of endogenous ghrelin in the hyperphagia of mice with streptozotocin-induced diabetes. Endocrinology. 2006;147(6):2634-42.
Gelling RW. Diabetic Hyperphagia—ghrelin in the Driver’s Seat. Endocrinology. 2006;147(6):2631-3.
Nabel Mohammed M, OM Tawfik N. The effect of metformin on ghrelin serum level in type 2 diabetes mellitus. Iraq J Pharm. 2013;13(1):86-94.
Abdelgadir M, Elbagir M, Eltom M, Berne C, Ahrn B. Reduced leptin concentrations in subjects with type 2 diabetes mellitus in Sudan. Metabolism. 2002;51(3):304-6. DOI: 10.1053/meta.2002.30504.
Al Sheikh MH. The determinants of leptin levels in diabetic and nondiabetic saudi males. International journal of endocrinology. 2017;2017.
Zamil GO, Ghazi H, Saleh BO. Status of serum 25-Hydroxyvitamin D and Leptin in Iraqi diabetic men: Obesity-related study. International Journal of Research in Pharmaceutical Sciences. 2019;10(1):50-5.
Frazao R, Dungan Lemko HM, da Silva RP, Ratra DV, Lee CE, Williams KW, et al. Estradiol modulates Kiss1 neuronal response to ghrelin. Am J Physiol Endocrinol Metab. 2014;306(6):E606-14. DOI: 10.1152/ajpendo.00211.2013.
Ozkanli S, Basar MM, Selimoglu S, Erol B, Ozkanli O, Nurili F, et al. The ghrelin and orexin activity in testicular tissues of patients with idiopathic non-obstructive azoospermia. The Kaohsiung Journal of Medical Sciences. 2018;34(10):564-8. DOI: https://doi.org/10.1016/j.kjms.2018.04.001.
Soriano-Guillén L, Ortega L, Navarro P, Riestra P, Gavela-Pérez T, Garcés C. Sex-related differences in the association of ghrelin levels with obesity in adolescents. Clin Chem Lab Med. 2016;54(8):1371-6. DOI: 10.1515/cclm-2015-0555.
Hellström L, Wahrenberg H, Hruska K, Reynisdottir S, Arner P. Mechanisms behind gender differences in circulating leptin levels. Journal of internal medicine. 2000;247(4):457-62.
Fungfuang W, Terada M, Komatsu N, Moon C, Saito TR. Effects of estrogen on food intake, serum leptin levels and leptin mRNA expression in adipose tissue of female rats. Laboratory animal research. 2013;29(3):168-73. DOI: 10.5625/lar.2013.29.3.168.
Malik IA, Durairajanayagam D, Singh HJ. Leptin and its actions on reproduction in males. Asian J Androl. 2019;21(3):296-9. DOI: 10.4103/aja.aja_98_18.
Vestergaard ET, Jessen N, Moller N, Jorgensen JO. Acyl Ghrelin Induces Insulin Resistance Independently of GH, Cortisol, and Free Fatty Acids. Sci Rep. 2017;7:42706. DOI: 10.1038/srep42706.
Sangiao-Alvarellos S, Cordido F. Effect of Ghrelin on Glucose-Insulin Homeostasis: Therapeutic Implications. International Journal of Peptides. 2010;2010:234709. DOI: 10.1155/2010/234709.
Mao Y, Zhang S, Yu F, Li H, Guo C, Fan X. Ghrelin attenuates liver fibrosis through regulation of TGF-β1 expression and autophagy. International journal of molecular sciences. 2015;16(9):21911-30.
Zhang S, Mao Y, Fan X. Inhibition of ghrelin o-acyltransferase attenuated lipotoxicity by inducing autophagy via AMPK-mTOR pathway. Drug Des Devel Ther. 2018;12:873-85. DOI: 10.2147/DDDT.S158985.
Mani BK, Shankar K, Zigman JM. Ghrelin’s Relationship to Blood Glucose. Endocrinology. 2019;160(5):1247-61. DOI: 10.1210/en.2019-00074.
Ramos-Lobo AM, Donato Jr J. The role of leptin in health and disease. Temperature. 2017;4(3):258-91.
Kaeidi A, Hajializadeh Z, Jahandari F, Fatemi I. Leptin attenuates oxidative stress and neuronal apoptosis in hyperglycemic condition. Fundam Clin Pharmacol. 2019;33(1):75-83. DOI: 10.1111/fcp.12411.
Indhu K, Saravanan T. Serum Leptin Levels in Type 2 Diabetes Mellitus with Chronic Complications. JDMS. 2017;16(5):22-4.
Mohiti-Ardekani J, Afkhami M, Babaei A. Relation between leptin and insulin in patients with type II diabetes mellitus. Int J Endocrinol Metab. 2005;3(3):121-5.
D'Elia L, Strazzullo P, Iacone R, Russo O, Galletti F. Leptin levels predict the development of insulin resistance in a sample of adult men–The Olivetti Heart Study. Nutrition, Metabolism and Cardiovascular Diseases. 2019;29(1):39-44.
Baban RS, Kasar KA, Al-Karawi IN. Fasting glucose to leptin ratio as a new diagnostic marker in patients with diabetes mellitus. Oman Med J. 2010;25(4):269-75.
Tanida M, Yamamoto N, Morgan DA, Kurata Y, Shibamoto T, Rahmouni K. Leptin receptor signaling in the hypothalamus regulates hepatic autonomic nerve activity via phosphatidylinositol 3-kinase and AMP-activated protein kinase. J Neurosci. 2015;35(2):474-84. DOI: 10.1523/jneurosci.1828-14.2015.
Fungfuang W, Terada M, Komatsu N, Moon C, Saito TR. Effects of estrogen on food intake, serum leptin levels and leptin mRNA expression in adipose tissue of female rats. Lab Anim Res. 2013;29(3):168-73. DOI: 10.5625/lar.2013.29.3.168.
Fujita Y, Kouda K, Ohara K, Nakamura H, Iki M. Leptin mediates the relationship between fat mass and blood pressure: The Hamamatsu School-based health study. Medicine. 2019;98(12).
Kok S, Meinders A, Overeem S, Lammers G, Roelfsema F, Frolich M, et al. Reduction of plasma leptin levels and loss of its circadian rhythmicity in hypocretin (orexin)-deficient narcoleptic humans. The Journal of Clinical Endocrinology & Metabolism. 2002;87(2):805-9.