الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 155 |  |  |
| | | from | 155 | | |
Abstract
Diabetes is a global health problem affecting all age groups. It is a group of metabolic diseases characterized by chronic hyperglycemia resulting from defects in insulin secretion, insulin action, or both leading to disturbances in carbohydrate, fat, and protein metabolism. The effect of diabetes includes long-term damage, dysfunction, and failure of various organs especially the eye, kidney, heart, and blood vessels.
In most of cases, insulin resistance and type 2 diabetes are associated with obesity so that overweight and obesity are considered as the main causes of diabetes and insulin resistance.
Leptin acts on the satiety center on the hypothalamus to suppress appetite, limit food intake, and increase energy expenditure. Moreover, Neuropeptide Y (NPY), a potent stimulator of food intake, is believed to be a mediator of leptin action. The synthesis of NPY is inhibited by leptin.
A state of hyperleptinemia, possibly due to leptin resistance has been described in the majority of obese individuals.
The present work aimed to study the circulatory level of serum leptin in patients with type 2 diabetes mellitus and any possible effect of antidiabetic drugs or diabetic complications on serum level of leptin.
The study included 180 subjects who were classified into two groups;
- group I: which included 120 type 2 diabetic patients who attended the diabetes clinic at Alexandria Main University Hospital after matching the inclusion and exclusion criteria described before.
- group II: which included 60 non-diabetic age and sex-matched to group I.
The current study revealed a significant elevation in Leptin levels in patients with type 2 diabetes compared to the control group (p = < 0.001).
Regarding the correlation between the serum leptin level and BMI and WC in patients compared to controls, we demonstrated a significant positive correlation (p < 0.001).
According to the correlation between serum leptin level and microvascular complication in type 2 diabetic patients:
Regarding correlation between serum leptin levels and eGFR in patients compared to controls, we demonstrated a significant negative correlation (r = -0.484, p < 0.001).
Regarding the correlation between serum leptin levels and A-C ratio in patients compared to controls, we demonstrated a significant positive correlation (p < 0.001).
Regarding the relation between serum leptin levels and peripheral neuropathy in the patients’ group, the mean value of leptin levels was higher in patients with peripheral neuropathy (28.05 ± 8.01) compared to (18.10 ± 6.14) in patients without peripheral neuropathy (p < 0.001).
Regarding the relation between serum leptin levels and diabetic retinopathy in the patients’ group, the mean value of leptin levels was higher in patients with proliferative diabetic retinopathy (29.26 ± 7.13) compared to (26.09 ± 8.86) in patients with non-proliferative diabetic retinopathy and (18.14 ± 6.20) in patients with normal fundus examination (p < 0.001).
There were no statistically significant differences in serum leptin levels among patients using sulphonylurea, Gliptins (DPP4 inhibitors), calcium channel blockers (CCB), beta-blockers (BB), or diuretics and patients not using the aforementioned medications.
There were statistically significant lower levels of serum leptin levels among patients who used metformin, glitazones, ACEI, ARBS, or statin compared to patients not using the aforementioned medications, p-value (0.049, 0.003, 0.005, <0.001, 0.033, <0.001 respectively).
There were statistically significant higher levels of serum leptin levels among patients who used insulin therapy p-value (<0.001).