Indian journal of Medical Biochemistry

Register      Login

VOLUME 20 , ISSUE 1 ( January-June, 2016 ) > List of Articles

RESEARCH ARTICLE

Metabolic Status of Lean, Overweight, and Obese Type 2 Diabetes Mellitus Patients

Shilpa B Asegaonkar, Ishrat Kareem, Avinash Pagdhune, Anand Thorat, Mangala S Borkar

Citation Information : Asegaonkar SB, Kareem I, Pagdhune A, Thorat A, Borkar MS. Metabolic Status of Lean, Overweight, and Obese Type 2 Diabetes Mellitus Patients. Indian J Med Biochem 2016; 20 (1):6-10.

DOI: 10.5005/jp-journals-10054-0002

Published Online: 01-06-2016

Copyright Statement:  Copyright © 2016; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Aims

To compare metabolic status of lean vs overweight/ obese type 2 diabetes mellitus (T2DM) patients and correlate biochemical parameters with anthropometric measures.

Materials and methods

A total of 100 T2DM patients were categorized as lean and overweight/obese according to body mass index (BMI); 50 age- and sex-matched healthy controls were selected. Anthropometric measures of BMI, waist circumference (WC), and waist:hip (W:H) were recorded. Fasting blood samples were assayed for fasting plasma glucose (FPG), serum total cholesterol (TC), triglycerides (TG), high-density lipoprotein (HDL), and nonesterified free fatty acids (NEFA). Low-density lipoprotein (LDL) was calculated by Friedewald's formula and TG: HDL was measured as measure of insulin resistance (IR).

Results

Anthropometric measures of overall (BMI 31.65 ± 5.49, 20.34 ± 2.45 vs 22.29 ± 3.21) and visceral adiposity (WC 91.98 ± 6.8, 75.45 ± 4.34 vs 74.19 ± 3.98 and W:H 0.99 ± 0.12, 0.78 ± 0.21 vs 0.76 ± 0.32) were significantly higher in overweight/ obese (p < 0.05) compared with lean T2DM and controls. Total cholesterol, TG, LDL, and NEFA were significantly raised and HDL decreased in T2DM compared with those of controls. But much higher values were observed in overweight/obese than in lean group. Triglycerides: HDL was significantly higher in obese than in lean patients (4.66 ± 1.89 vs 7.91 ± 3.01), confirming significantly decreased insulin sensitivity among obese than non-obese diabetics. Positive correlation was observed between BMI, WC, W:H and TC, TG, LDL, NEFA, and TG:HDL, while negative correlation was observed with HDL in obese group. Lean individuals with normal BMI, WC had deranged lipids with IR.

Conclusion

Lean and obese T2DM have dyslipidemia and IR. Poor metabolic profile is associated with overall and visceral adiposity in obese and not in lean T2DM individuals.

How to cite this article

Asegaonkar SB, Kareem I, Aghade S, Pagdhune A, Thorat A, Borkar MS. Metabolic Status of Lean, Overweight, and Obese Type 2 Diabetes Mellitus Patients. Indian J Med Biochem 2016;20(1):6-10.


PDF Share
  1. Body fat distribution and insulin resistance in healthy Asian Indians and Caucasians. J Clin Endocrinol Metab 2001 Nov;86(11):53665371.
  2. Clinical profile of type 2 diabetes mellitus and body mass index- is there any correlation. Calicut Med J 2004;2(4):e3.
  3. Clinical profile of lean NIDDM in South India. Diabetes Res Clin Pract 1997 Nov;38(2):101-108.
  4. Mechanism linking diabetes mellitus and obesity. Diabetes Metab Syndr Obes 2014 Dec:7:587-591.
  5. A brief description of diabetes in India. J Pharmacy Res 2010 Aug;3(8):1719-1723.
  6. Obesity and free fatty acids. Endocrinol Metab Clin North Am 2008 Sep;37(3):635-646.
  7. Free fatty acids - do they play a central role in type 2 diabetes? Diabetes Obes Metab 2001 Aug;3(Suppl 1): S11-S19.
  8. Clinical and biochemical profile of lean type 2 diabetes mellitus. Indian J Endocrinol Metab 2011 Jul;15(Suppl 2):S40.
  9. Lean (underweight) NIDDM - peculiarities and differences in metabolic and hormonal status - a pilot study. J Assoc Physicians India 1995 May;43(5):339-342.
  10. Serum lipid and apolipoprotein levels in non-hypertensive lean NIDDM patients. J Intern Med 1991 Aug;230(2):131-134.
  11. The role of insulin sensitivity and hepatic lipase in the dyslipidemia of type 2 diabetes. Diabet Med 1991 Jul;8(6):560-566.
  12. A study on clinical and biochemical profile of low body weight type 2 diabetes mellitus. J Indian Med Assoc 2008 Nov;106(11):747-750.
  13. Lean versus obese diabetes mellitus patients in the United States minority population. J Diabetes Complications 2014 Jul-Aug;28(4):500-505.
  14. Normal weight diabetic patients versus obese diabetics: relation of overall and abdominal adiposity to vascular health. Cardiovasc Diabetol 2014 Oct 22;13:141.
  15. Prospective association between fasting NEFA and type 2 Diabetes: Impact of post-load glucose. Diabetologia 2010 May;53(5):866-874.
  16. Rising prevalence of NIDDM in urban population in India. Diabetologia 1997 Feb;40(2):232-237.
  17. Comparison of the release of adipokines by adipose tissue, adipose tissue matrix, and adipocytes from visceral and subcutaneous abdominal adipose tissues of obese humans. Endocrinology 2004 May;145(5):2273-2282.
  18. Fatty acids, obesity, and insulin resistance: time for a reevaluation. Diabetes 2011 Oct;60(10):2441-2449.
  19. The concurrent accumulation of intra-abdominal and subcutaneous fat explains the association between insulin resistance and plasma leptin concentrations: distinct metabolic effects of two fat compartments. Diabetes 2002 Apr;51(4):1005-1015.
  20. Lean diabetes mellitus: an emerging entity in the era of obesity. World J Diabetes 2015 May 15;6(4):613-620.
  21. Lean type 2 diabetes mellitus: profile, peculiarities and paradox, chapter 12. In: Siddharth, N., editor API Textbook of Medicine. 8th ed. vol 18. API, Mumbai; 2008. p. 94-104.
  22. Insulin clamp-derived measurements of insulin sensitivity and insulin secretion in lean and obese Asian type 2 diabetic patients. Metab Syndr Relat Disord 2010 Apr;8(2):113-118.
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.