Association of Adipokines with Metabolic Syndrome in North-West Rajasthan (India)

Background: Metabolic syndrome is defined by a constellation of interconnected physiological, biochemical, clinical, and metabolic factors that directly increases the risk of cardiovascular disease, type 2 diabetes mellitus, and all cause mortality. Insulin resistance, visceral adiposity, atherogenic dyslipidemia, endothelial dysfunction, genetic susceptibility, elevated blood pressure, hypercoagulable state, and chronic stress are the several factors which constitute the syndrome. Adipokines may contribute to the development of obesity and insulin resistance and may be a causal link between Metabolic syndrome, diabetes and CVD. Hence, we studied the adipokines –adiponectin and leptin in subjects with Metabolic syndrome. Insulin resistance is a central abnormality of the metabolic syndrome, or syndrome X, originally hypothesized by Reaven Insulin resistance is more strongly linked to intra abdominal fat than to fat in other depots. Aim & Objective: The aim of the current study was to analyze the correlation of leptin, adiponectin and free fatty acids with obesity-related clinical, anthropometric, markers of insulin resistance and biochemical variables in adolescents from Indian origin. Materials and Methods: We studied 200 subjects, with Metabolic syndrome, diagnosed by International Diabetes Federation (IDF) criteria and 200 healthy control subjects, age between 25-65 years. Clinical evaluation included anthropometry, Waist circumference (WC), Body Mass Index (BMI) and waist-to-hip ratio (WHR) were calculated. The blood pressure (BP) - systolic (SBP) and diastolic (DBP), was also measured. Circulating levels of fasting glucose, total cholesterol (TC), high-density lipoproteins (HDL-C), adiponectin, leptin and free fatty acids were determined. Serum leptin, adiponectin and free fatty acids were estimated by sandwich ELISA method. Results: In our study, Subjects with the MetS had lower adiponectin and higher leptin levels (P<0.0001 for both variables) compared with individuals without the MetS. Adiponectin was significantly correlated with Age(r=0.917), BMI(r=0.835), WC(r=0.861), Waist-Hip ratio(r=0.872), Fasting blood sugar(r=0.844), Total Cholesterol(r=0.838), Triglycerides(r=0.907), High-density lipoprotein (HDL) cholesterol(r=0.935), Leptin(r=0.924), Free fatty acid (r=0.848) and also highly significant (P<0.0001) for all variables. In addition and Interestingly, Adiponectin & Leptin were significantly positively associated with increased MetS components (P-trend <0.0001). As well as free fatty acid levels were significantly higher in MetS subjects and women and correlate with all variables. Conclusion: Our results demonstrate a positive relationship between Adiponectin, Leptin levels, Free fatty acid and parameters of metabolic syndrome, including BP values in normotensive subjects with overweight/obesity. Serum concentrations of Leptin are associated with central body fat distribution. Insulin resistance and Adiponectin is associated with Dyslipidemia and these all disorders may ultimately lead to metabolic syndrome. Adiponectin, Leptin levels, Free fatty acid could be used as markers of metabolic syndrome development in adolescents. Obesity and related disturbances put these adults at a higher cardiovascular risk. Hence there is an urgent need for public health measures to prevent the ongoing epidemic of diabetes and CVD. Further research is encouraged to determine the efficacy of applying these biomarkers to diagnosis and treatment in a clinical setting.