This study aimed to evaluate serum leptin and high sensitivity C-reactive protein (hsCRP) concentrations in obese Ghanaians with or without type 2 diabetes and to find out the extent to which their levels are influenced by underlying disorders
Obese subjects with type 2 diabetes had lower leptin but higher hsCRP levels compared with obese non-diabetic controls. There were negative correlations within the control group for glucose vs % muscle mass (r = − 0.378, p = 0.016), leptin vs % muscle mass (r = − 0.555, p = 0.001) and within the obese diabetic group for leptin vs % muscle mass (r = − 0.602, p = 0.001). Obese persons without diabetes were about three times more likely to have higher leptin levels compared with their obese diabetic counterparts (Odds ratio = 3.315, p < 0.001). Obese females independently had a tenfold increase in leptin levels compared with obese males
Chronic disorders such as obesity and diabetes mellitus have reached epidemic proportions globally [1,2,3] with approximately eighty percent (80%) of the populace with type 2 diabetes mellitus either obese or overweight [4, 5]. Reports by International Diabetes Federation in 2015 revealed that an estimated (3.3–6.0) % of Ghanaians aged 20–79 years had diabetes mellitus with a further 7.8% being glucose impaired [1]. Inflammatory markers have generally been implicated in insulin resistance [6,7,8,9]. Leptin, a 16 kDa protein, secreted by the adipose tissue is a potential determinant of adiposity and risk for type 2 diabetes [10,11,12,13]. High sensitivity C-reactive protein (hsCRP), an acute phase protein is synthesized by the liver and increases in concentration following infection, inflammation or trauma [9]. Levels of hsCRP have been observed to be increased in obese persons with diabetes mellitus and correlate with measures of adiposity including body mass index (BMI) and waist circumference [14, 15]. The extent to which these biomarkers contribute to metabolic function and/or dysfunction is not fully understood especially in relation to gender and ethnicity. The purpose of this study was to evaluate serum leptin and hsCRP concentrations in Ghanaian obese subjects with and/or without type 2 diabetes and to find out the extent to which their levels are influenced by the underlying disorder. We hypothesized that obese subjects with type 2 diabetes will have higher leptin and hsCRP levels compared with their obese non-diabetic counterpart
The study design was a cross-sectional one conducted among 160 obese (BMI > 30 kg/m2) Ghanaian subjects between October 2014 and April 2015. Study participants included 80 type 2 diabetic persons attending the National Diabetes Management and Research Centre (NDMRC), Korle-Bu, Accra and 80 age and gender-matched obese staff/workers of the Korle-Bu Teaching Hospital, Accra, Ghana without diabetes mellitus. Consecutive subjects who agreed to the study and met the criteria for inclusion were recruited. An oral glucose tolerance test (OGTT), regarded as diagnostic of type 2 diabetes were performed on all volunteers. Obesity was defined based on BMI ≥ 30 kg/m2. Type 2 diabetes was confirmed by a physician at the National Diabetes Management and Research Centre (NDMRC), Korle-Bu, Accra, based on results of fasting blood glucose ≤ 6.9 mmol/L and a 2 h-OGTT > 11.1 mmol/L on two separate occasions. Case subjects were either being lifestyle managed or were on oral hypoglycemic drugs. A pre tested structured (Additional file 1: Questionnaire) was administered to assess the socio-economic status, medical history and medications, family history of diabetes mellitus, and level of physical activity of subjects. Habitual smokers, defined as subjects who smoked tobacco or other smoking products (and are still smoking) continuously for at least 6 months, persons with gestational diabetes, chronic illnesses (having a persistent ailment for more than 3 months), stroke or amputation were excluded from the study. Assuming an odds ratio of 2 among obese subjects for type 2 diabetes, at 95% confidence interval and a power of 80%, a sample size of 60 persons were adequate for this study. The study was approved (Protocol Identification Number: MS-Et/M.6–P3.2/2014-2015) by the Institutional Ethics and Protocol Review Committee of School of Medicine and Dentistry, College of Health Sciences, University of Ghana. Detailed explanations on purpose of the study, risk and benefits were made known to participants. Written informed consent was obtained from all participants. Height of all participants were measured using a stadiometer (Secca, Germany).
