The role of adipokines in the improvement of diabetic and cardiovascular risk factors within a 52-week weight-loss programme for obesity

Changes in the Leptin to Adiponectin Ratio Are Proportional to Weight Loss After Meal Replacement in Adults With Severe Obesity

Hypocaloric diets are known to induce changes in adipokine secretion, but the influence of a low energy liquid diet (LELD) on the leptin: adiponectin ratio (LAR), a measure of insulin resistance and cardiovascular risk, has not previously been investigated in patients with severe obesity. We conducted a prospective, single-center cohort study of adults with severe obesity (defined as body mass index (BMI) ≥40 kgm−2, or ≥35 kgm−2 with co-morbidities) who completed a 24-week milk-based LELD. We measured leptin, adiponectin and LAR at the start and on completion of the programme. Of 120 patients who started, 52 (43.3 %) completed the programme. Their mean age was 50.3 ± 11.2 (range 18–74) years, 29 (55.8 %) were female and 20 (38.5 %) had type 2 diabetes mellitus (T2DM). Weight decreased from 148.2 ± 39.6 to 125.4 ± 34.8 kg and BMI decreased from 52.4 ± 11.1 to 44.3 ± 9.8 kgm−2, respectively (all p < 0.001). In patients with T2DM, HbA1c decreased from 60.0 ± 17.4 to 47.5 ± 15.5 mmol/mol (p < 0.001). Leptin decreased (from 87.2 [48.6, 132.7] to 39.1 [21.0, 76.4] ng/ml) and adiponectin increased (from 5.6 [4.5, 7.5] to 7.1 [5.5, 8.5] μg/ml), with a reduction in LAR from 15 [8.4, 22.4] to 5.7 [3.0, 9.1] ng/μg (all p < 0.001), indicating decreased insulin resistance. The percentage weight lost was associated with the percentage reduction in LAR (ß = 2.9 [1.7, 4.1], p < 0.001) and this association was stronger in patients with T2DM. Patients with severe obesity who completed a milk-based LELD had a substantial reduction in LAR, consistent with decreased insulin resistance and cardiovascular risk, proportional to weight loss.

The Correlation between Type 2 Diabetes Mellitus and Cardiovascular Disease Risk Factors in the Elderly

With the improvement of people's living conditions and changes in social lifestyles, the incidence of type 2 diabetes is gradually increasing, and the number of people with diabetes and cardiovascular disease is also increasing. Based on this, the article collects basic information on 650 elderly patients with type 2 diabetes, of which 49.39% are between 60 and 70 years old, 32.46% are between 70 and 80 years old, and 18.15% are between 80 and 90 years old. Through the analysis of related cardiovascular disease risk factors, the correlation between the elderly cardiovascular disease risk factors and type 2 diabetes is explored. The results showed that the correlations between smoking history, diastolic blood pressure, total cholesterol, low-density lipoprotein cholesterol, and the risk of type 2 diabetes in the elderly were 0.987, 0.956, 0.971, and 0.940, respectively. It can be seen that these factors are highly correlated with the risk of type 2 diabetes in the elderly, and smoking history has the strongest correlation, indicating that high levels of smoking may be a key pathogenic factor in the onset of type 2 diabetes. The correlation of other factors is lower than 0.8, indicating that other factors are additional risk factors for the disease. After that, the p value was 0.01, and the difference test was passed, which proved the accuracy of the model.