Relationship Between Acyl and Desacyl Ghrelin Levels with Insulin Resistance and Body Fat Mass in Type 2 Diabetes Mellitus

Abstract

Purpose

Although strong evidence suggests that ghrelin plays an important role in regulating energy balance, the effects of acylated ghrelin (AG) and deacylated ghrelin (DAG) on fat mass are largely undefined. This study aimed to investigate the differential associations of both forms of ghrelin with insulin resistance and body fat mass in patients with type 2 diabetes mellitus (T2DM).

Patients and Methods

A total of 162 patients with type 2 diabetes were recruited and classified based on BMI and visceral fat area (VFA) as VFA normal group (n = 78), normal-BMI VFA obesity group (n = 20) and high-BMI VFA obesity group (n = 64). VFA and subcutaneous fat area (SFA) were detected by bioelectrical impedance analysis. Blood samples were collected to measure fasting glucose, insulin, lipids, AG and DAG levels after clinical examination.

Results

Compared with VFA normal group, DAG levels were significantly lower (421.7 ± 106.0 and 388.7 ± 96.5 pg/mL vs 524.4 ± 141.5 pg/mL, P < 0.01) in the two VFA obesity groups. No significant difference was found in AG levels within three groups. Among all subjects, BMI, VFA, SFA, fasting insulin and HOMA-IR were negatively correlated with DAG but positively with AG/DAG ratio (P < 0.01). In contrast, AG was positively correlated with HOMA-IR and fasting glucose (P < 0.01). Multiple stepwise regression analysis showed that fasting glucose was the independent factor of AG, VFA and HOMA-IR were the independent factors related to DAG.

Conclusion

DAG levels have a strong negative association with excess body fat mass and insulin resistance, whereas AG levels are closely related to elevated blood glucose levels in T2DM patients.

Keywords:

• acylated ghrelin
• deacylated ghrelin
• body fat mass
• insulin resistance
• type 2 diabetes mellitus

Ethical Statement

This study was approved by the Ethics Committee of Jinling Hospital, Nanjing University, and was performed according to the Declaration of Helsinki. As our study was retrospective design, the individual Institutional Review Boards or the Data Protection and Research committees waived the requirement of informed consent due to appropriate handling of patient data and maintenance of patient data confidentiality.

Acknowledgments

This work was supported by Jiangsu Provincial Natural Science Foundation (BK20150558), Postdoctoral Foundation of China (2018M633693), and Jinling Hospital Foundation (YYBJ 2021046).

Disclosure

The authors report no conflicts of interest in this work.