Main Article Content
Obesity, metabolic syndrome, adipokines, inflammation, oxidative stress
Objective: Adipose tissue dysfunction, increased systemic inflammation and oxidative stress are features of metabolic syndrome. The purpose of the present study was to determine the relationship between adipokines, inflammation, oxidative stress and metabolic syndrome components in obese women. Subjects and Methods: A total sample of 100 obese women (BMI=32.44±1.80 kg/m2) living in Erzincan aged 20-45 years were included in this cross-sectional survey. Serum biochemical (leptin, adiponectin, resistin, lipit profiles, fasting plasma glucose, fasting plasma insulin, high sensitivity C-reactive protein, tumor necrosis factor-alfa, interleukin-6, malondialdehyde, anthropometrical (body weight, height, waist and neck circumference) parameters and blood pressure were measured. Results: Results of this study indicate that waist circumference, neck circumference, systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting plasma insulin (FPI), HOMA-IR, triglyceride (TG), high sensitivity C-reactive protein (Hs-CRP), Tumor Necrosis Factor -alfa (TNF-α), leptin, leptin: adiponectin (L:A) ratio and malondialdehyde (MAD) were significantly higher but adiponectin and HDL-Cholesterol (HDL-C) were significantly lower in obese women with metabolic syndrome than in women without the syndrome (p <0.05). Waist circumference had positive correlation with Hs-CRP (r = 0.315, p < 0.05) and negative correlation with adiponectin (r =- 0.552, p < 0.01). TG had highly signiﬁcant positive correlation with Hs-CRP (r = 0.305, p < 0.05) but, negative correlation with IL-6 (r = -0.347, p < 0.05) and adiponectin (r=-0.440, p< 0.01). Hs-CRP was positively correlated with MDA (r=0.323, p< 0.05) and negatively correlated with DBP (r=-0.253, p< 0.05). TNF-α was significantly and positively correlated with leptin (r = 0.701, p < 0.01), resistin (r = 0.646, p < 0.01), MDA (r = 0.949, p < 0.01) and negatively correlated with adiponectin (r =-0.772, p < 0.01). Conclusion: High leptin and low adiponectin level,L:A ratio, Hs-CRP, TNF-α and MDA may act as a diagnostic marker for metabolic syndrome in obese women.
2. Frühbeck G, Toplak H, Woodward E, Yumuk V, Maislos M, Oppert JM. Obesity The gateway to ill health—An easo position statement on a rising public health, clinical and scientific challenge in Europe. Obes Facts 2013; 6: 117–120.
3. World Health Organization (WHO). WHO global ınfobase online [Internet]. 2018 [accessed 02.09.2010]. Access address: https://www.who.int/en/news-room/fact-sheets/detail/obesity-and-overweight.
4. Sağlık Bakanlığı Sağlık Araştırmaları Genel Müdürlüğü, Hacettepe Üniversitesi Sağlık Bilimleri Fakültesi Beslenme ve Diyetetik Bölümü, Ankara Numune Eğitim ve Araştırma Hastanesi. Türkiye Beslenme ve Sağlık Araştırması 2010: Beslenme Durumu ve Alışkanlıklarının Değerlendirilmesi Sonuç Raporu. Ankara (Turkey): Sağlık Bakanlığı; 2014. Report no 931.
5. Ansar H, Mirzaei K, Malek A, Najmafshar A, Hossein-nezhad A. Possible resting metabolic rate modification by the circulating RBP4 in obese subjects. Diabetes Metab Syndrome 2015;9(1):19-23.
6. Han TS, Lean ME. A clinical perspective of obesity, metabolic syndrome and cardiovascular disease. JRSM Cardiovasc Dis 2016; 5. http://www. ncbi.nlm.nih.gov/pmc/articles/PMC4780070/ [ accessed 27 Nov 2016].
7. Srikanthan K, Feyh A, Visweshwar H, Shapiro JI, Sodhi K. Systematic review of metabolic syndrome biomarkers: a panel for early detection, management, and risk stratification in the West Virginian population. Int J Med Sci 2016;13(1): 25–38.
8. Hebebrand J, Holm JC, Woodward E, et al. A proposal of the European association for the study of obesity to improve the ICD-11 diagnostic criteria for obesity based on the three dimensions etiology, degree of adiposity and health risk. Obes Facts 2017; 10: 284–307.
9. Al-Hamodi Z, AL-Habori M, Al-Meeri A, Saif-Ali R. Association of adipokines, leptin/adiponectin ratio and C-reactive protein with obesity and type 2 diabetes mellitus. Diabetol Metab Syndr 2014; 16;6(1):99.
10. Lancha A, Frühbeck G, Gómez-Ambrosi J. Peripheral signalling involved in energy homeostasis control. Nutr Res Rev 2012; 25: 223–48.
11. Kumari R, Kumar S, Kant R. An update on metabolic syndrome: Metabolic risk markers
and adipokines in the development of metabolic syndrome. Diabetes & Metabolic Syndrome: Clinical Research & Reviews 2019; 13(4):2409-17.
12. Blüher M, Mantzoros CS. From leptin to other adipokines in health and disease: facts and
expectations at the beginning of the 21st century. Metabolism 2015; 64:131–145.
13. Rodríguez A, Ezquerro S, Méndez-Giménez L, Becerril S, Frühbeck G. Revisiting the adipocyte: A model for integration of cytokine signaling in the regulation of energy metabolism. Am J Physiol Endocrinol Metab 2015; 309:691–714.
14. Ghadge AA, Khaire AA. Leptin as a predictive marker for metabolic syndrome. Cytokine 2019; 121:154735.
15. Stern JH, Rutkowski JM, Scherer PE. Adiponectin, leptin and fatty acids in the maintenance of metabolic homeostasis through adipose tissue crosstalk. Cell Metab 2016; 23: 770–84.
16. Asgary S, Ziaedin S, Ghorbani A, Keshvari M, Sahebkar A, Sarrafzadegan N. Relationship between serum resistin with metabolic syndrome and its components in an Iranian population. Diabetes, Metab Syndrome 2015; 9: 266-70.
17. López-Jaramillo P, Gómez-Arbeláez D, López-López J, et al. The role of leptin/adiponectin ratio in metabolic syndrome and diabetes. Horm Mol Biol Clin Investig 2014;18(1):37–45.
18. Frühbeck G, Catalán V, Rodríguez A, Gómez-Ambrosi J. Adiponectin-leptin ratio: A promising index to estimate adipose tissue dysfunction. Relation with obesity-associated cardiometabolic risk. Adipocyte 2018; 7: 57–62.
19. Frühbeck G, Catalán V, Rodríguez A, et al. Involvement of the leptin-adiponectin axis in inflammation and oxidative stress in the metabolic syndrome. Sci. Rep 2017;7: 6619.
20. Czarnywojtek A, Owecki M, Zgorzalewicz-Stachowiak M, et al. The role of serum C-reactive protein measured by high-sensitive method in thyroid disease. Arch Immunol Ther Exp 2014; 62 (6): 501–9.
21. Kovaroma M, Koller T, Štvrtinová V, Payer J. Thyroid-stimulating hormone concentration as an independent risk factor of venous thromboembolism regardless of thyroid function. Endokrynol Pol 2015;66(6):474-9.
22. Birben E, Sahiner UM, Sackesen C, Erzurum S, Kalayci O. Oxidative stress and antioxidant defense. World Allergy Organ J 2012;5(1):9–19.
23. Demircan N, Gurel A, Armutcu F, Unalacak M, Aktunc E, Atmaca H. The evaluation of
serum cystatin C, malondialdehyde, and total antioxidant status in patients with metabolic syndrome. Med Sci Monit 2008;14(2):97–101.
24. Grundy SM, Cleeman JI, Daniels SR, et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 2005;112(17):2735–52.
25. Pekcan G. Beslenme durumunun saptanması. Baysal A, Aksoy M, editörler. Diyet el kitabı. 7.baskı. Ankara: Hatiboğlu Basım ve Yayım San. Tic. Ltd. Şti.; 2013.
26. Stabe C, Vasques AC, Lima MM, et al. Neck circumference as a simple tool for identifying the metabolic syndrome and in-sulin resistance: results from the Brazilian Metabolic Syndrome Study. Clin Endocrinol 2013; 78: 874-81.
27. Nauck M, Warnick GR, Rifai N. Methods for measurement of LDL-cholesterol: a critical assessment of direct measurement by homogeneous assays versus calculation. Clin Chem 2002;48(2):236-54.
28. Starr J, Mako M, Juhn D, Rubenstein A. Measurement of serum proinsulin-like material: cross-reactivity of porcine and human proinsulin in the insulin radioimmunoassay. J Lab Clin Med 1978;91(4):683-92.
29. Roberts WL, Sedrick R, Moulton L, Spencer A, Rifai N. Evaluation of four automated high-sensitivity C-reactive protein methods: implications for clinical and epidemiological applications. Clin Chem 2000;46(4):461-8.
30. Wallace TM, Levy JC, Matthews DR. Use and abuse of HOMA modeling. Diab Care 2004; 27: 1487-95.
31. Kılıç İ, Ural A. Bilimsel araştırma süreci ve SPSS ile veri analizi. Ankara: Detay Yayıncılık; 2013.
32. Kang DR, Yadav D, Koh SB, Kim JY, Ahn SV. Impact of serum leptin to adiponectin ratio on regression of metabolic syndrome in high-risk individuals: the ARIRANG study. Yonsei Med J 2017; 58(2), 339-46.
33. Zakı ME, Kamal S, Youness E, et al. Association between serum visfatin, oxidative stress, ınflammation and metabolic syndrome in obese premenopausal women. J Clin Diagn Res 2019;13(2): 10-14.
34. Bener A, Yousafzai MT, Darwish S, Al-Hamaq AO, Nasralla EA, Abdul-Ghani M. Obesity index that better predict metabolic syndrome: body mass index, waist circumference, waist hip ratio, or waist height ratio. J Obes 2013;2013:269038. doi: 10.1155/2013/269038.
35. Hingorjo MR, Zehra S, Imran E, Qureshi MA. Neck circumference: a supplemental tool for the diagnosis of metabolic syndrome J Pak Med Assoc 2016; 66 (10): 1221-26.
36. Assyov Y, Gateva A, Tsakova A, Kamenov Z. A comparison of the clinical usefulness of neck circumference and waist circumference in individuals with severe obesity. Endocr Res 2017;42 (1):6-14.
37. Abdolahi H, Iraj B, Mirpourian M, Shariatifar B. Association of neck circumference as an indicator of upper body obesity with cardio-metabolic risk factors among first degree relatives of diabetes patients. Adv Biomed Res 2014; 3: 237.
38. Jensen MD. Lipolysis: contribution from regional fat. Annu Rev Nutr. 1997; 14: 127–39.
39. Cui T, Yan BH, Liu Z, Yang H, Gyan M, Ma YX. Neck circumference: A valuable anthropometric measurement to detect metabolic syndrome among different age groups in China. Diabetes Metab Res Rev 2018;34(3).
40. Namazi N, Larijani B, Surkan PJ, Azadbakht L. The association of neck circumference with risk of metabolic syndrome and its components in adults: a systematic review and meta-analysis. Nutr Metab Cardiovasc Dis 2018; 28(7), 657-74.
41. Yosaee S, Khodadost M, Esteghamatı A, et al. Adiponectin: an indicator for metabolic syndrome. Iran J Public Health 2019;48(6):1106-1115.
42. Lopez-Jaramillo P, Gomez-Arbelaez J, Lopez C, et al. The role of leptin/adiponectin ratio in metabolic syndrome and diabetes. Horm Mol Biol Clin Investig 2014;18(1):37-45.
43. Fantuzzi G. Adipose tissue, adipokines, and inflammation. J Allergy Clin Immunol 2005;115:911-9.
44. Kim JY, Ahn SV, Yoon JH, et al. Prospective study of serum adiponectin and incident metabolic syndrome: the ARIRANG study. Diabetes Care 2013; 36:1547-53.
45. Srikanthan K, Feyh A, Visweshwar H, Shapiro JI, Sodhi K. Systematic review of metabolic syndrome biomarkers: a panel for early detection, management, and risk stratification in the West Virginian population. Int J Med Sci 2016;13(1):25–38.
46. Zhang J, Kho P, Ov K, Chenghe S. Adiponectin, resistin and leptin: possible markers of metabolic syndrome. Endocrinol Metab Syndr 2015; 4:4.
47. Lopez-Jaramillo P. SSA 04-3 leptin/adiponectin in cardiometabolic disease. J Hypertens 2016;34(Suppl 1-ISH 2016 Abstract Book : e7)
48. von Frankenberg AD, do Nascimento FV, Gatelli LE, et al. Major components of metabolic syndrome and adiponectin levels: a cross-sectional study. Diabetol Metab Syndr 2014;6: 26.
49. Gauthier A, Dubois S, Bertrais S, et al. The leptin to adiponectin ratio is a marker of the number of metabolic syndrome criteria in French adults. J Metab Syndr 2011;31: 1–6.
50. Shafiee G, Ahadi Z, Qorbani M, Kelishadi R, Ziauddin H, Larijani B. Association of adiponectin and metabolic syndrome in adolescents: the caspian- III study. J Diabetes Metab Disord 2015;14: 89.
51. Emerging Risk Factors Collaboration. C-reactive protein, fibrinogen, and cardiovascular disease prediction. N Engl J Med 2012; 367: 1310–20.
52. Kovářová M, Koller T, Štvrtinová V, Payer J. Thyroid-stimulating hormone concentration as an independent risk factor of venous thromboembolism regardless of thyroid function. Endokrynol Pol 2015;66(6):474-79.
53. Kucharska A, Sawicka-Gutaj N, Owecki M. New lower cutoff for serum high sensitive C-reactive protein in obese women indicates the risk of metabolic syndrome. Arch Physiol Biochem 2019; 125(1): 30-34.
54. Mirhafez SR, Ebrahimi M, Saberi Karimian M, et al. Serum high-sensitivity C-reactive protein as a biomarker in patients with metabolic syndrome: evidence-based study with 7284 subjects. Eur J Clin Nutr 2016;70: 1298–1304.
55. Crewe C, An YA, Scherer PE. The ominous triad of adipose tissue dysfunction: inflammation, fibrosis, and impaired angiogenesis. J Clin Invest 2017;127:74–82.
56. Frühbeck G, Catalán V, Rodríguez A, et al. Normalization of adiponectin concentrations by leptin replacement in ob/ob mice is accompanied by reductions in systemic oxidative stress and inflammation. Sci Rep 2017; 7(1): 2752.