Adiponectin to Leptin ratio as marker for Insulin Resistance in Diabetic Males in relation to Glycemic Control


Background and Aims: recently it has been established that abnormal adipocytokines may contribute to insulin resistance in diabetes. The current study designed to investigate adiponectin to leptin ratio (A/L) as a reliable marker for insulin resistance in good and poor glycemic controlled type 2 diabetics. Patients and Methods: A total 120 males were recruited in the study, out of them there were sixty persons with type2 diabetes (29 of them with good glycemic control, and 31 with poor glycemic control), there were sixty persons serves as healthy controls. They were matched for age, and BMI. Fasting venous blood samples were collected for measuring fasting serum glucose (FSG), glycated hemoglobin (HbA1c), and lipid profile, insulin, adiponectin, and leptin. Blood pressure, waist circumference, and BMI were determined for all participants. Homeostasis model assessment (HOMA)-insulin resistance (IR) index, and adiponectin/leptin ratio (A/L) ratio were calculated. Results: the result showed a significant decline in adiponectin, and A/L ratio, and a significant rise in serum leptin, insulin, HOMA-IR, FSG, HbA1c, and serum triglycerides TG in diabetes group as compared to healthy control group. On the other hand, correlation analysis revealed that A/L ratio is the most likely markers that closely linked with insulin resistance parameters than HOMA, adiponectin, and leptin; even after multiple regression analyses, it was correlated more than HOMA-IR with insulin resistance parameters. When patients were divided according to their glycemic control (poor and good controlled), the result showed a lowered adiponectin, and A/L ratio; as well as, there was a significant increase in serum leptin, insulin, and HOMA-IR in poorly controlled compared to good-controlled diabetes group. On the other hand, the correlation coefficient investigated to show the relation between both (A/L ratio, and HOMA-IR) and other variables in each group of glycemic control; and observed that A/L ratio has a strong significant correlation with other parameter than HOMA-IR in both groups. Conclusions: the results suggested that the A/L ratio was more linked with insulin resistance parameters than HOMA-IR. In addition to that, A/L ratio is a good predictor for insulin resistance in good and poorly controlled diabetes mellitus. Accordingly, an A/L ratio is likely to become a new laboratory biomarker of insulin resistance.