Adipokine patterns in type 1 and type 2 diabetes mellitus: comparative analysis of adiponectin–leptin ratio, visfatin, and TNF-α

Abstract

Adipokines play an important role in metabolism, insulin sensitivity, and inflammation, and may provide distinct contributions to the pathophysiology of type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM). The differences in roles of the adiponectin-leptin ratio (ALR), visfatin, and tumor necrosis factor-alpha (TNF-α) in the various subtypes of diabetes are still not fully understood. This cross-sectional study involved 141 participants, divided into healthy controls (n = 47), patients with T1DM (n = 47), and patients with T2DM (n = 47). Serum adiponectin, leptin, visfatin, TNF-α, fasting plasma glucose (FPG), glycated hemoglobin (HbA1c), and serum insulin levels were measured. The ALR was calculated. Insulin resistance and β-cell function were examined using homeostasis model assessment (HOMA) indices. We performed group comparisons, correlation studies, logistic regression tests, and receiver operating characteristic (ROC) curve analyses. The differences observed were all statistically significant. Participants with T2DM showed a more adverse metabolic profile, characterized by greater waist circumference and higher levels of FPG, HbA1c, serum insulin, leptin, and TNF-α, along with lower levels of adiponectin and ALR. Participants with T1DM also exhibited altered adipokine profiles compared to controls, notably with increased levels of leptin and TNF-α. All diabetic groups had decreased levels of visfatin, with the T2DM group showing the largest reduction. ROC analysis demonstrated effective discrimination of TNF-α, ALR, and visfatin in this group. This study highlights the different inflammatory and adipokine profiles across diabetes subtypes. The assessment of these biomarkers enhances the understanding of metabolic differences between T1DM and T2DM. However, these findings are exploratory and require validation in large, controlled studies.