Pei‑Wei Tsenga,†, Du‑An Wua,b,†, Jia‑Sian Houc, Bang‑Gee Hsua,d*
aSchool of Medicine, Tzu Chi University, Hualien, Taiwan, bDivision of Metabolism and Endocrinology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan, cDepartment of Nursing, Buddhist Tzu Chi General Hospital, Hualien, Taiwan, dDivision of Nephrology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
†Both authors contributed equally to this work.
Open Access funded by Buddhist Compassion Relief Tzu Chi Foundation
Abstract
Objective: It is well established that patients with metabolic syndrome (MetS) demonstrate elevated levels of serum leptin. The aim of this study is to identify fasting serum leptin as an independent marker of MetS in geriatric diabetic patients. Materials and Methods: Sixty‑four patients over 65 years old with type 2 diabetic mellitus (T2DM) were assessed for MetS based on the diagnostic criteria of the International Diabetes Federation. Fasting blood samples including serum leptin concentrations were obtained from the participants. Leptin levels were determined using a commercial enzyme immunoassay. Results: Forty‑five (70.3%) of the 64 geriatric T2DM patients enrolled in this study were found to have MetS. This group of participants compared with those in the non‑MetS group had higher serum levels of leptin (P = 0.004), triglycerides (P = 0.005), fasting glucose (P = 0.049), glycated hemoglobin (P = 0.016), white blood cells (P = 0.003), C‑reactive protein (CRP, P = 0.028), insulin (P < 0.001), higher homeostatic model assessment insulin resistance values (HOMA1‑IR and HOMA2‑IR, both P < 0.001), a higher body weight (P = 0.024), body mass index (P < 0.001), body fat mass (P < 0.001), waist circumference (P < 0.001), systolic blood pressure (BP) (P < 0.001), diastolic BP (P < 0.001), percentage of women (P = 0.011), prevalence of hypertension (P = 0.042), and a lower level of serum high‑density lipoprotein cholesterol (P = 0.001). Univariate linear analysis of the clinical variables associated with the fasting serum leptin level revealed that height (P = 0.020) had a negative correlation, while body fat mass (P < 0.001) and logarithmically transformed CRP (log‑CRP, P < 0.001) had positive correlations with serum leptin levels. Multivariate forward step‑wise linear regression analysis of the variables significantly associated with fasting serum leptin levels showed that body fat mass (P < 0.001) and log‑CRP (P = 0.001) were independent predictors of these values. Conclusion: Serum leptin is positively correlated with MetS. It serves as an independent marker of MetS in elderly patients with T2DM.
Keywords: Elderly, Leptin, Metabolic syndrome, Type 2 diabetes mellitus
