Markers of metabolic disorders depending on the obesity phenotype

Abstract

Metabolic syndrome is considered one of the leading medical and social problems of modern healthcare, which is a challenge in the 21st century. In-depth study of the metabolic profile of obese individuals allows us to better understand the pathophysiology of metabolic diseases, identify high-risk groups in a timely manner, and contribute to the improvement of preventive and therapeutic strategies. The aim. Based on the study of the patterns of changes in markers of metabolic disorders depending on the obesity phenotype, to develop new approaches to the prognosis and ways to prevent the development of diseases. Material and methods. On the basis of the Vinnytsia Regional Clinical Endocrinology Center, 88 people were examined (men — 25 people, women — 63 people). The average age of the examined group was 37.42±11.77 years. All patients were collected, an objective examination was performed, and indicators of carbohydrate, lipid metabolism, adipocytokines and leading markers of metabolic disorders - the ratio of triglycerides to glucose, the ratio of leptin to triglycerides, leptin to BMI and leptin to adiponectin — were determined in the laboratory. Based on the results obtained, a database was created in the Statistica 7 software package. Results. All patients were divided into 4 clinical groups according to 4 obesity phenotypes (groups PhI, PhII, PhIII, and PhIV). In order to determine the existing insulin resistance, the ratio of triglycerides to glucose was used. The triglyceride-glucose index exceeded the reference norms in patients of all obesity phenotypes, which confirmed the existing insulin resistance in the examined patients. The level of leptin in all obesity phenotypes was above
the reference values (3.7-11.1 ng/ml). The level of adiponectin rapidly decreased with the progression of visceral obesity, triggering the development of an inflammatory reaction — leptin resistance. To confirm leptin resistance in patients, the ratio of adiponectin to leptin, leptin to BMI, and leptin to triglycerides was determined. Analyzing the obtained results of the adiponectin to leptin ratio, it was found that with the progression of body weight, the adiponectin to leptin ratio significantly decreased. The decrease in the adiponectin to leptin ratio confirms the presence of systemic inflammation and the risk of developing cardiovascular pathology in patients with increased body weight. The leptin/triglyceride ratio was the highest in patients of group PhIII — 12.6±1.22, compared with other obesity phenotypes and significantly differed from PhI, PhII, PhIV and the control group (p≤0.05). Conclusions. In obese patients in the absence of metabolic disorders, it is necessary to determine the ratio of leptin to triglycerides and adiponectin to leptin, triglycerides to glucose in order to early identify risk groups and initiate preventive measures.