Serum Leptin Levels in Children and Adolescents with Type 1 Diabetes Mellitus

Abstract

Abstract:Background: There is a potential interaction between leptin and insulin; insulin may alters leptin secretion/action (or vice versa), dysregulations of this system could contribute to disease states such as diabetes.Objective: To examine the effect of exogenous insulin on serum leptin in type1 diabetes patients, and determine the relation between serum leptin levels and other parameters including gender effect. Patients and methods: The study was carried out at the National Diabetes Center (NDC)/ Al-Mustansiriya university on a total (77) subjects including (57) type 1 diabetes mellitus subjects formed of (15) patients who were newly diagnosed with type1 diabetes and (42) children and adolescents previously diagnosed with type1 diabetes mellitus who were on intensive insulin therapy for two years or more. Other (20) patient serves as a healthy control. All subjects were matched with age, and sex. The BMI was calculated as weight (kg)/height in meter square (m2). Insulin dose was determined as dose/kg/day, after an overnight fasting blood was collected for laboratory evaluations consisted of measuring fasting serum glucose (FSG), glycated hemoglobin (HbA1c), and lipid profile. Estimation of Leptin was examined at least 2h after insulin injection and meal ingestion which should not affect serum leptin concentration. Results: the current study showed significant lower serum leptin level, and higher FBG in patients who were newly diagnosed with type1 diabetes before initiation of insulin therapy compared with (6-7) days of insulinization. On the other hand, the group of newly diagnosed patients had lower serum leptin levels, insulin dose, BMI, and higher FBG, HbA1c versus patients on intensive insulin therapy. Moreover, they had comparable serum leptin levels and a higher serum FBG, HbA1c compared to control group. As well as, group on intensive insulin therapy had higher serum leptin, BMI, FBG, HbA1c compared to control group. On the other hand, there is no significant difference in the levels of total cholesterol (TC), and triglycerides (TG) among the studying group, The result showed that diabetic girls have higher serum leptin levels, BMI, and TG compared to diabetic boys, and there is no significant difference in the insulin doses between them, Finally, there is a significant positive correlation between leptin levels and all of the insulin dose, BMI, duration, and TG. Also, there is a positive correlation between insulin dose and BMI, and negative correlation between insulin dose and FBG in type1 diabetic patients.Conclusion: This study suggests that insulin treatment play important roles in determining the levels of leptin in children and adolescent with type1 diabetes mellitus..Keywords: leptin, insulin, type1 diabetes