Endocrine Abstracts

The aim of the present study was to determine the change of fasting serum leptin and insulin levels and insulin resistance in patients with risk factors of diabetes mellitus of type 2 (DM 2) including impaired glucose tolerance/impaired fasting glucose (IGT/IFG), obese and first-degree relatives of patients with diabetes after lifestyle modification.

Material and methods: The study included 100 patients (32 men, 68 female) 25–65 years old at risk factors of DM 2. All patients received recommendations on a balanced diet and physical activity. The average fasting plasma glucose (FPG), 2-h plasma glucose concentrations (2-h PG) following a 75-g oral glucose tolerance test, HbA1c, index HOMA-IR. Fasting serum leptin and insulin levels were detected by sensitive ELISA.

Results: During 18 months our study 56 patients carried out this recommendations (research group) and 44 patients did not (control group). Patients of the research group demonstrated mean reduction of body mass index (−2.6±0.4 kg/m²) and waist-to-hip ratio (−0.2±0.01) (P<0.01) and persons of the control group had significant increase of these parameters (P<0.05). Among subjects with IGT/IFG at baseline, glucose levels normalized in 56.0% of patients from the research group and 4.5% in control group (P<0.001). Fasting serum insulin and HOMA-IR in research group decreased from 11.9±4.3 to 9.6±4.5 μU/ml and from 3.6±1.1 to 2.7±1.4 accordingly (P<0.05). In control group the specified parameters had increased significantly (P<0.01). The main novel finding was that serum leptin median in research group was decreased from 34.7 to 26.4 ng/ml (−23.9%, P<0.001) and increased in control group from 37.9 to 44.7 ng/ml (+17.9%, P<0.01). The risk reduction of DM 2 development among patients of the research group was 48.0% compared to the control group.

Conclusion: Thereby, lifestyle modification can prevent the development of type 2 diabetes in subjects with risk factors by reduction leptin and insulin resistance.