ASSOCIATION OF ADIPOKINE LEVELS AND INSULIN RESISTANCE IN PREDIABETES: CASE–CONTROL STUDY IN A TERTIARY CARE HOSPITAL IN NORTH KERALA

Abstract Background: Increasing evidence revealed the role of adipokines in glucose and fat metabolism. The present study was designed to evaluate the adiponectin, leptin and resistin levels in prediabetes subjects and assess the relationship between these adipokines and insulin resistance. Material and Methods: A case-control study was conducted for a period of one year from January 2021 to January 2022 in the Department of Endocrinology, Aster MIMS hospital in Calicut, Kerala, India. Totally, 200 individuals those who met the inclusion criteria were enrolled for the study. Based on oral glucose tolerance test, the study subjects were grouped into healthy controls (n =100), prediabetic non obese (n=61), and prediabetic obese (n=39). Blood glucose estimation was done by glucose oxidase peroxidase method. Chemiluminescent immunoassay was used for the measurement of insulin level and homeostasis model assessment-estimated insulin resistance was used for the assessment of insulin resistance. Serum adipokines levels were determined by ELISA. Collected data was analyzed by using SPSS Software. Results: Serum adiponectin levels decreased significantly in obese prediabetes (7.21±2.15µg/ml) when compared to non-obese prediabetes (7.28±2.41µg/ml) and healthy control subjects (13.64 ±2.88µg/ml, p<0.001). Serum leptin levels increased significantly in obese prediabetes (13.59±2.59ng/ml) when compared to non-obese prediabetes (9.84±2.66 ng/ml) and healthy control subjects (12.28±2.65ng/ml, p<0.001). Serum resistin levels increased significantly in obese prediabetes (17.67±3.60ng/ml) when compared to non-obese prediabetes (17.2±3.93ng/ml) and healthy control subjects (14.46 ±4.16ng/ml, p<0.001). Adiponectin-leptin ratio decreased significantly in obese prediabetes (0.56±0.22) when compared to non-obese prediabetes (0.79±0.4) and healthy control subjects (1.15 ±0.37; p<0.001). Fasting insulin resistance statistically significant (p<0.001) in all groups. Conclusion: The present study strongly suggested that the adipokine profile is an ideal diagnostic tool to predict prediabetes and metabolic syndrome especially among those with insulin resistance. Background: Increasing evidence revealed the role of adipokines in glucose and fat metabolism. The present study was designed to evaluate the adiponectin, leptin and resistin levels in prediabetes subjects and assess the relationship between these adipokines and insulin resistance. Material and Methods: A case-control study was conducted for a period of one year from January 2021 to January 2022 in the Department of Endocrinology, Aster MIMS hospital in Calicut, Kerala, India. Totally, 200 individuals those who met the inclusion criteria were enrolled for the study. Based on oral glucose tolerance test, the study subjects were grouped into healthy controls (n =100), prediabetic non obese (n=61), and prediabetic obese (n=39). Blood glucose estimation was done by glucose oxidase peroxidase method. Chemiluminescent immunoassay was used for the measurement of insulin level and homeostasis model assessment-estimated insulin resistance was used for the assessment of insulin resistance. Serum adipokines levels were determined by ELISA. Collected data was analyzed by using SPSS Software. Results: Serum adiponectin levels decreased significantly in obese prediabetes (7.21±2.15µg/ml) when compared to non-obese prediabetes (7.28±2.41µg/ml) and healthy control subjects (13.64 ±2.88µg/ml, p<0.001). Serum leptin levels increased significantly in obese prediabetes (13.59±2.59ng/ml) when compared to non-obese prediabetes (9.84±2.66 ng/ml) and healthy control subjects (12.28±2.65ng/ml, p<0.001). Serum resistin levels increased significantly in obese prediabetes (17.67±3.60ng/ml) when compared to non-obese prediabetes (17.2±3.93ng/ml) and healthy control subjects (14.46 ±4.16ng/ml, p<0.001). Adiponectin-leptin ratio decreased significantly in obese prediabetes (0.56±0.22) when compared to non-obese prediabetes (0.79±0.4) and healthy control subjects (1.15 ±0.37; p<0.001). Fasting insulin resistance statistically significant (p<0.001) in all groups. Conclusion: The present study strongly suggested that the adipokine profile is an ideal diagnostic tool to predict prediabetes and metabolic syndrome especially among those with insulin resistance.