Cardiometabolic Risk in Thai Adults with Type 2
Diabetes Mellitus: Obese versus Non-Obese
Supornpim Chearskul MD*, Apiradee Sriwijitkamol MD**,
Suwattanee Kooptiwut MD, PhD*, Smarn Ornreabroi BSc*,
Malika Churintaraphan MSc*, Namoiy Samprasert MSc*
Affiliation :
* Department of Physiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
** Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Background : Adiposity is an inflammatory condition contributing to the morbidity and mortality of several disorders,
including type 2 diabetes mellitus (T2DM) and cardiovascular disease.
Objective : To compare cardiometabolic risk factors between obese and non-obese Thai patients with T2DM.
Material and Method: The cross-sectional study was done in 20 obese (BMI ≥25 kg/m2) and 20 non-obese (BMI ≤23 kg/m2)
T2DM. Researchers measured fasting plasma glucose and lipids, serum levels of insulin, leptin, adiponectin, and soluble
tumor necrosis factor-alpha receptors type 1 and 2 (sTNF-R1 and sTNF-R2). Insulin sensitivity check index (QUICIKI) and
insulin resistance index (HOMA-IR) were calculated.
Results : Thai obese adults with T2DM had greater amounts of sTNF-R2 and HOMA-IR, higher ratios of leptin/adiponectin,
and more incidences of hypertension and hypertriglyceridemia in comparison to non-obese counterparts. Additionally,
HOMA-IR values in non-obese T2DM were greater than those reported among non-diabetic Thai adults. A reverse association
between inflammatory markers (both sTNF-Rs) and HDLC was detected. Leptin/adiponectin ratios correlated directly with
HOMA-IR, serum insulin, plasma triglycerides and BMI, whereas HOMA-IR did not relate to any studied plasma lipid.
Conclusion : The present study demonstrated an increased cardiometabolic risk in obese T2DM adults than non-obese
T2DM adults among the Thai population. The leptin/adiponectin ratio may be more relevant to predict the risk of
cardiovascular events in T2DM patients than HOMA-IR.
Keywords : Obesity, Type 2 diabetes mellitus (T2DM), Insulin resistance, Leptin/adiponectin ratio, sTNF-R
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