Correlation Between The Adiponectin-leptin Ratio And Parameters Of Insulin Resistance In Patients With Impaired Glucose Regulation And Nonalcoholic Fatty Liver Disease

Objective To test levels of adiponectin and leptin in patients with impaired glucose regulation(IGR) and nonalcoholic fatty liver disease(NAFLD) and investigate the relationship between the adiponectin-leptin ratio and parameters of insulin resistance(IR) in patients with IGR and NAFLD.Methods Clinical and laboratory datas were collected from thirty healthy controls, thirty-two cases of impaired fasting glucose(IFG) with NAFLD,thirty cases of IFG without NAFLD,thirty-two cases of impaired glucose tolerance(IGT) and IFG with NAFLD,thirty cases of IFG and IGT without NAFLD.Fasting plasma glucose(FPG),fasting insulin(FINS),leptin, adiponectin(APN) and lipid profile were measured.The adiponectin-leptin(A/L) ratio and the index of insulin resistance were calculated with adiponectin,leptin and according to the homeostasis model assessment method(HOMA-IR),respectively.Then the role of adiponectin and leptin and the correlation between the A/L ratio and parameters of IR were examined.Resultsâ‘ In patients with IGR,serum adiponectin level and A/L ratio were statistically significantly lower,while HOMA-IR and serum leptin level were higher in patients with NAFLD than without,and the situation became worse when glucose intolerance deteriorated.â‘¡The correlation between fasting serum insulin level(FINS),FPG,leptin or adiponectin,and body mass index(BMI),waist to hip ratio(WHR),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),or low-density lipoprotein cholesterol(LDL-C) as parameters of insulin resistance were investigated.By pearson simple linear of the correlation between FINS,FPG, leptin or adiponectin,and each parameter of insulin resistance,the best correlation coefficients were seen in leptin or adiponectin but not in FINS or FPG.In patients with IGR,the correlation coefficients between FPG,leptin or adiponectin and each parameter of IR were higher in patients with NAFLD than without.â‘¢In all patients,the correlation coefficients between each parameter of IR and A./L ratio were higher than that between each parameter of IR and HOMA-IR as a whole.In addition in patients with IGR,the correlation coefficients were higher in patients with NAFLD than without as a whole.â‘£Multiple linear regression were carried out to analyze the association between A/L ratio or HOMA-IR and WHR,TG,HDL-C,and LDL-C,excluding BMI,simultaneously.In patients with IGR,the A/L ratio was significantly correlated with WHR and TG,and HOMA-R was significantly correlated with WHR.This model explained 30.11%of the variance in the A/L ratio and 15.03%of the variance in HOMA-R.In patients with IGR and NAFLD,the A,/L ratio was significantly correlated with WHR,TG and LDL-C,and HOMA-R was significantly correlated with WHR.This model explained 37.19%of the variance in A/L ratio and 12.17%of the variance in HOMA-R.Conclusionâ‘ In patients with IGR,serum adiponectin level was statistically significantly lower,leptin level was higher than healthy controls as a whole,and the occurrance of NAFLD or deteriorated glucose intolerance only made the insulin resistance's situation worse.â‘¡In conclusion,the present study suggested that the A/L ratio might be more useful than HOMA-IR to accurately assess insulin resistance in patients with IGR.â‘¢BMI and WHR are the major factors of influencing serum APN and leptin in patients with IGR and NAFLD.