Adipsin and Leptin Levels in Type 2 Diabetic Patients on Sitagliptin and Metformin Versus Metformin Therapy.

Objectives: Adipsin and leptin are adipokines that link adipose tissue dysfunction and increased fat accumulation to obesity-related metabolic disorders. This study aimed to assess the effects of sitagliptin/metformin versus metformin monotherapy on the levels of adipsin, leptin, and lipid profile in type 2 diabetic patients.

Methods: This comparative case-control study included 120 participants divided into four groups: healthy participants, newly diagnosed type 2 diabetic patients, metformin-treated patients, and sitagliptin/metformin-treated patients.

Results: Newly diagnosed type 2 diabetic patients revealed significantly lower adipsin levels, with concomitant higher leptin levels compared to the healthy control group. Adipsin levels were significantly higher and leptin levels were significantly lower in both drug-treated patients compared to newly diagnosed group. Compared to healthy control, there were significantly higher levels of hemoglobin A1c (HbA1c), fasting blood glucose (FBG), total cholesterol (TC), triglyceride (TG), very-low-density lipoprotein (VLDL), low-density lipoprotein (LDL), and atherogenic index (AI) in the newly diagnosed patients, with significantly lower high-density lipoprotein (HDL) levels. Interestingly, in both treated groups, HbA1c, FBG, TC, TG, VLDL, and AI were significantly decreased compared to newly diagnosed patients. Concomitantly, there are significantly higher levels of HDL in drug-treated group compared to untreated patients.

Conclusion: Adipsin is low and leptin is high in diabetic patients which support its possible use as a biomarker for type 2 diabetes. Accordingly, the modification of these adipokines, via the use of drug therapy, has advantageous effects on the cardiovascular system in diabetic patients. Specifically, sitagliptin/metformin regulates adipsin, leptin, and lipid profile to a greater extent than metformin.