Background: Low plasma adiponectin concentrations are associated with diabetes mellitus. Resuts from animal studies suggest that adiponectin plays an important role in regulating insulin action. Leptin levels found to be low in patients with diabetic ketoacidosis (DKA). The recent studies showed that insulin replacement during DKA increased leptin concentrations. In our study, we aimed to determine the effect of insulin replacement on serum leptin and adiponectin concentrations in patients with DKA.
Methods: Our study included 31 patients (F/M) with DKA. 18 of 31 patients have been treated with oral anti diabetic agents and 13 of 31 patients have been treated with insulin treatment before admission. Leptin and adiponectin concentrations are analyzed in samples which are collected on admission and at resolution of ketoacidosis in 2448 hours.
Results: Mean age of the the patients was 46.7±17.3 years, mean period of diabetes was 7.1±7.3 years, and body mass index was 26.5±4.3 kg/m2. There was a signifcant negative correlation between plasma adiponectin levels and blood ketone concentrations on admission (r=−0.66). Significant positive corelation between age and body masss index was also determined (r=0.477). While plasma adiponectin levels didnt change after DKA treatment (P=0.095), leptin levels increased significantly (P<0.001). In patients using oral antidiabetic agents adiponectin levels didnt change (P=0.103) but leptin levels increased significiantly (P=0.002) at the end of treatment. In the patients using insulin therapy, adiponectin levels didnt change (P=0.56), however leptin levels increased significantly (P<0.001).
Conclusions: In our study leptin levels are increased after the treatment of DKA. This result can be described with the increase of calori intake and the regulation of glucose utilization in adipocytes caused by insulin. Adiponectin levels found to be still low in DKA after the treatment. These results could be explained by early period of treatment.