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

Background: 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 a 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 is a significant higher levels of HDL in drug-treated group compared to untreated patients.
Conclusion: Adipsin are low and leptin are high in diabetic patients which support its possible use as biomarkers 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.