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Adiponectin-leptin ratio : a useful estimate of insulin resistance in patients with type 2 diabetes
Zaletel, Jelka ; Pongrac Barlovič, Draženka ; Preželj, Janez
Aims: Adiponectin and leptin are adipocytokines associated with insulin resistance. The objective of this study was to evaluate the performance of theadiponectin-leptin ratio as a measure of insulin ...resistance in comparison with other surrogate measures of insulin resistance based on fasting insulin and glucose levels (HOMA, QUICKI, fasting glucose/insulin ratio) and with measure based on fasting insulin and triglyceride levels (McAuley index) in Caucasian patients with type 2 diabetes. Methods: In 70 patients included in DEMAND (delapril and manidipine for nephroprotection in diabetes) study, fasting samples of plasma insulin and adiponectin were determined by a radioimmunoassay, whereas plasma leptin was determined by an enzyme-linked immunosorbent assay. Insulin resistance estimates were derived by the established equations and compared with the direct measurement of insulin resistance obtained with the euglycemic hyperinsulinemic clamp. Insulin resistance estimates and the clamp derived sensitivity index were compared by correlation analysis. Results: The adiponectin-leptin ratio correlated best with the clamp derived sensitivity index (r=0.553, P<0.001) compared to other surrogate measures of insulin resistance. In multiple linear regression modelsincluding different surrogate measures of insulin resistance as independent predictors of the sensitivity index, the model with the adiponectin-leptin ratio accounted for the highest variability of the sensitivity index (r2=0.336, P<0.001). Conclusions: The adiponectin-leptin ratio is associated with insulin resistance, measured with the euglycemic hyperinsulinemic clamp, in Caucasians with type 2 diabetes. The association with clamp derived sensitivity index is even stronger than that of HOMA, QUICKI, fasting glucose/insulin ratio or McAuley index and is independent of BMI or glycemic control. (Abstract truncated at 2000 characters)
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