Endocrinol Metab.  2017 Jun;32(2):230-240. 10.3803/EnM.2017.32.2.230.

Association of Plasma Ghrelin Levels with Insulin Resistance in Type 2 Diabetes Mellitus among Saudi Subjects

• Al Qarni A
• Joatar FE
• Das N
• Awad M
• Eltayeb M
• Al-Zubair
• Ali ME
• Al Masaud
• Shire AM
• Gumaa K
• Giha HA

• KMID: 2384082
• DOI: http://doi.org/10.3803/EnM.2017.32.2.230

Abstract

BACKGROUND
Although the exact mechanism of insulin resistance (IR) has not yet been established, IR is the hallmark characteristic of type 2 diabetes mellitus (T2DM). The aim of this study was to examine the relationship between plasma ghrelin levels and IR in Saudi subjects with T2DM.
METHODS
Patients with T2DM (n=107, cases) and non-diabetic apparently healthy subjects (n=101, controls) from Saudi Arabia were included in this study. The biochemical profiles and plasma insulin levels of all subjects were analyzed, and IR was estimated using the homeostatic model assessment of insulin resistance (HOMA-IR) index. Active ghrelin levels in plasma were measured using the radioimmunoassay technique.
RESULTS
Only 46.7% (50 of 107) of the T2DM subjects had IR, including 26% (28 of 107) with severe IR (HOMA-IR ≥5), while 5.9% (six of 101) of the controls had moderate IR (3 ≤HOMA-IR <5). HOMA-IR values were not associated with age, disease duration, or gender. Importantly, T2DM itself and the co-occurrence of IR with T2DM were significantly associated with low plasma ghrelin levels. However, ghrelin levels were inversely correlated with the HOMA-IR index, body weight, and fasting plasma insulin levels, mainly in the control subjects, which was indicative of the breakdown of metabolic homeostasis in T2DM.
CONCLUSION
The prevalence of IR was relatively low, and IR may be inversely associated with plasma ghrelin levels among Saudi patients with T2DM.

Keyword

Diabetes mellitus; Insulin resistance; Ghrelin; Saudi Arabia

MeSH Terms

Body Weight
Diabetes Mellitus
Diabetes Mellitus, Type 2*
Fasting
Ghrelin*
Healthy Volunteers
Homeostasis
Humans
Insulin Resistance*
Insulin*
Plasma*
Prevalence
Radioimmunoassay
Saudi Arabia
Ghrelin
Insulin

Figure

• 

  Fig. 1 Fasting plasma levels of ghrelin (pmol/L) in subjects with type 2 diabetes mellitus (T2DM) and healthy non-diabetic controls from Saudi Arabia. Comparison between (A) all subjects with T2DM versus all control subjects, and (B) age- and sex-matched subjects with T2DM versus healthy subjects. Ghrelin levels were consistently significantly lower in patients with T2DM. The horizontal line within each box represents the median, while the lower and upper ends of the box are the 25th and 75th percentiles, the cap of the vertical line is the 95th percentile, and the closed circles are outliers.

• 

  Fig. 2 Fasting plasma levels of ghrelin (pmol/L); comparison between (A) all study subjects (type 2 diabetes mellitus [T2DM] subjects and controls) with or without insulin resistance (IR) (homeostatic model assessment of insulin resistance [HOMA-IR] ≥3 and <3, respectively), (B) T2DM subjects with or without IR, and (C) T2DM subjects with moderate IR (HOMA-IR 3 to 5) and severe IR (HOMA-IR >5). Ghrelin levels were significantly lower in subjects with IR in (A) and (B) (P<0.001 and P=0.049, respectively). The horizontal line within each box represents the median, while the lower and upper ends of the box are the 25th and 75th percentiles, the cap of the vertical line is the 95th percentile, and the closed circles are outliers.

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