Metabolic and Hormonal Changes in Obese Subjects with and Without Diabetic Mellitus

work collaboration between all authors. Author SAH participated in the design of the protocol of the study, recruitment of the patients, coordination of the research, performance of the clinical part, analyses of the data and writing the draft of the paper. Author RFAE participated in the design of the protocol of the study, recruitment of the patients, analyses of the data and writing the draft of the paper. Author TKS performed the laboratory investigations and participated in the analyses of the results. All authors read and approved the manuscript. ABSTRACT Background: Increasing body weight is a risk factor for development of insulin resistance (IR) and type 2 diabetes mellitus (T2DM). Aim: We aimed to determine the relationship between insulin, C-peptide, leptin, cortisol, growth hormone (GH) and adiposity in obese and subjects with T2DM as data regarding this issue are still controversial. Study Design: Cross sectional study. Methodology: this study included 60 patients with T2DM, 60 obese non-diabetics and 30 healthy controls. Anthropometric parameters, glycemic and lipid profiles, insulin, C-peptide, leptin, cortisol and GH were measured. Results: Serum C-peptide (P=0.025, P=0.030, P=0.021), insulin (P=0.0001 for all) and leptin (P=0.001, P=0.02, P=0.0001) were higher in obese (n=22) and non-obese diabetics (n=38) and obese non-diabetics versus controls. Cortisol was higher in obese non-diabetics versus obese (P=0.017) and non-obese (P=0.007) diabetics and controls (P=0.0001). GH was higher in obese non-diabetics versus obese diabetics (P=0.031). IR was reported in obese (72.70%) and non-obese (71.00%) diabetics and obese non-diabetics (38.30%). Central obesity was reported in obese (59.10%) and non-obese (34.20%) diabetics and obese non-diabetics (45.00%). In obese diabetics, a positive correlation was reported between leptin with C-peptide (P=0.001). In non-obese diabetics , positive correlations were reported between IR and cortisol (P=0.025) and waist/hip ratio (WHR) with insulin (P=0.029) but a negative correlation was reported between glycosylated hemoglobin (HBAIc) and leptin (P=0.047). In obese non-diabetics , positive correlations were reported between leptin with HbA1c (P=0.01) and cortisol (P=0.003), WHR with insulin (P=0.0001) and cortisol with leptin (P=0.003). Conclusion: The association of insulin and leptin resistances and hypercortisolemia with obesity supports the notion that the regulatory defects of blood glucose and obesity are associated with long-term metabolic complications.