Adiponectin, leptin, and novel adipokines (resistin, visfatin, omentin) as biomarkers of metabolic and immune dysregulation in type 1 diabetes

A. R. M. Chyad

doi:10.15421/0225210

A. R. M. Chyad Mustansiriyah University

Keywords: type 1 diabetes, adiponectin, leptin, resistin, visfatin, omentin.

Abstract

A diponectin, leptin, and newly introduced adipokine s like resistin, visfatin, and omentin are useful in regulating metabolism and immunity and hence may serve as biomarkers to identify metabolic and inflammatory dysregulation in type 1 diabetes. The objective of this study was to measure serum adiponectin, leptin, and the novel adipokine (resistin, visfatin, and omentin) concentrations in patients with type 1 diabetes and the possibility of measuring them as biomarkers of metabolic and immune dysregulation. This was a case-control study (April – September 2025) comprising 150 diabetic and 50 age and sex matched healthy controls in Nasiriyah, Iraq to assess metabolic and adipokine profiles. Following informed consent, venous fasting blood was collected, processed and stored. Measurement of glucose, HbA1c, C-peptide and autoimmune markers (GAD 65, ICA, IAA) was done. Serum adipokines, adiponectin, leptin, resistin, visfatin, and omentin were measured in duplicate with ELISA to ma x imise accuracy. Demographic compatibility was established by comparative study of 150 type 1 diabetes patients versus 50 healthy controls, there was no significant difference in age or sex. The patients were more hypertrophic in terms of BMI (24.9 ± 3.6 vs. 23.7 ± 3.1 kg/m 2 ; P = 0.048) and severely hyperglycemic in terms of HbA1c (8.2 ± 1.5% vs. 5.1 ± 0.6 % ; P = 0.001). The random and O GT glucose levels and C peptide were significantly higher and lower, respectively, which verified the insulin secretion impairment. There was a high level of autoimmunity ( autoantibodies GAD65 68% ICA 54%, IAA 39). There was an increase in leptin, resistin and visfatin (all P < 0.001) and a decrease in omentin. Correlation analysis showed that adiponectin was significantly negatively correlated with leptin, resistin, visfatin, and positively correlated with omentin, which demonstrated that adipokines are intricately related in the metabolic and immune regulation processes. The analysis shows that patients with type 1 diabetes have adipokine imbalance, that is, reduced adiponectin and omentin, elevated leptin, resistin, and visfatin, which appears in chronic hyperglycemia and inflammation. These alterations indicate that they may be used as biomarkers of immune and metabolic disruptions.

References

Abdalla, M. M. I. (2024). Therapeutic potential of adiponectin in prediabetes: Strategies, challenges, and future directions. Therapeutic Advances in Endocrinology and Metabolism, 15, 1–19.

Abdulmuttaleb, N. A., Oliwi Nasir, A. A., Alkubaisy, S., & Mohsein, O. A. (2025). Investigation of genetic variations in APLN and APLNR genes and their potential role in cardiovascular diseases. Reports of Biochemistry and Molecular Biology, 13(4), 525–539.

Ajeed, A. M., Naif, N. H., Farag, A. H., & Mohsein, O. A. (2025). Assessing the impact of sleeve gastrectomy on micronutrient levels and inflammatory markers – a case-control study. European Journal of Clinical and Experimental Medicine, 23(2), 369–377.

Al-Isawi, S. A., Al-Zubaidy, Z. H., Ismaeel, G. L., & Mohsein, O. A. (2025). The impact of trace elements and cytokines on the pathogenesis and severity of acne. Regulatory Mechanisms in Biosystems, 16(2), e25080.

Apostolopoulou, M., Lambadiari, V., Roden, M., & Dimitriadis, G. D. (2025). Insulin resistance in type 1 diabetes: Pathophysiological, clinical, and therapeutic relevance. Endocrine Reviews, 46(3), 317–348.

Begum, M., Choubey, M., Tirumalasetty, M. B., Arbee, S., Mohib, M. M., Wahiduzzaman, M., Mamun, M. A., Uddin, M. B., & Mohiuddin, M. S. (2023). Adiponectin: A promising target for the treatment of diabetes and its complications. Life, 13(11), 2213.

Delmis, J., Oreskovic, S., Elvedji Gasparovic, V., Starcevic, M., Herman, M., Dessardo, N., Starcevic, V., & Ivanisevic, M. (2023). Relationship of glucose, C-peptide, leptin, and BDNF in maternal and umbilical vein blood in type-1 diabetes. Nutrients, 15(3), 600.

Engin, A. (2024). Adiponectin resistance in obesity: Adiponectin leptin/insulin interaction. Obesity and lipotoxicity. Springer International Publishing. Pp. 431–462.

Fan, S., Xu, Y., Lu, Y., Jiang, Z., Li, H., Morrill, J. C., Cai, J., Wu, Q., Xu, Y., Xue, M., Arenkiel, B. R., Huang, C., & Tong, Q. (2021). A neural basis for brain leptin action on reducing type 1 diabetic hyperglycemia. Nature Communications, 12(1), 2662.

Galderisi, A., Moran, A., Evans-Molina, C., Martino, M., Santoro, N., Caprio, S., & Cobelli, C. (2021). Early impairment of insulin sensitivity, β-cell responsiveness, and insulin clearance in youth with stage 1 type 1 diabetes. The Journal of Clinical Endocrinology and Metabolism, 106(9), 2660–2669.

Giandalia, A., Alibrandi, A., Giorgianni, L., Lo Piano, F., Consolo, F., Longo Elia, G., Asztalos, B., Cucinotta, D., Squadrito, G., & Russo, G. T. (2021). Resistin levels and inflammatory and endothelial dysfunction markers in obese postmenopausal women with type 2 diabetes mellitus. Diabetology and Metabolic Syndrome, 13, 98.

Harrison, L. C. (2021). The dark side of insulin: A primary autoantigen and instrument of self-destruction in type 1 diabetes. Molecular Metabolism, 52, 101288.

Hayder, Z. S., & Kareem, Z. S. (2021). Biological associations between resistin, adiponectin, visfatin and ghrelin hormones with some coagulation markers. Iraqi Journal of Agricultural Sciences, 52(1), 108–120.

Hussein, A. A., Ahmed, N. A., Sakr, H. I., Atia, T., & Ahmed, O. M. (2023). Omentin roles in physiology and pathophysiology: An up-to-date comprehensive review. Archives of Physiology and Biochemistry, 130(6), 800–813.

Ito, Y., Sun, R., Yagimuma, H., Taki, K., Mizoguchi, A., Kobayashi, T., Sugiyama, M., Onoue, T., Tsunekawa, T., Takagi, H., Hagiwara, D., Iwama, S., Suga, H., Konishi, H., Kiyama, H., Arima, H., & Banno, R. (2022). Protein tyrosine phosphatase 1B deficiency improves glucose homeostasis in type 1 diabetes treated with leptin. Diabetes, 71(9), 1902–1914.

Jung, H. N., & Jung, C. H. (2021). The role of anti-inflammatory adipokines in cardiometabolic disorders: Moving beyond adiponectin. International Journal of Molecular Sciences, 22(24), 13529.

Kaza, M., Tsentidis, C., Vlachopapadopoulou, E., Sakou, I.-I., Karanasios, S., Mastorakos, G., & Karavanaki, K. (2022). The effect of metabolic profile on leptin, adiponectin, and hs-CRP in children and adolescents with type 1 diabetes. Children, 9(8), 1162.

Khan, Y. N., Ashfaq, M., Bader-u-Nisa, Yasir, M., Waseem, H., & Kanpurwala, M. A. (2021). IAA, GAD65 AND IA2 antibodies in type 1 children and adolescents. Annals of Abbasi Shaheed Hospital and Karachi Medical and Dental College, 26(3), 114–120.

Kurpiewska, E., Ciężki, S., Jamiołkowska-Sztabkowska, M., Polkowska, A., Starosz, A., Grubczak, K., Moniuszko, M., Bossowski, A., & Głowińska-Olszewska, B. (2023). Excessive BMI is associated with higher C-peptide level at recognition but also with its greater loss in two years clinical observation in children with new onset type 1 diabetes. Frontiers in Immunology, 14, 1176403.

Lateef, D., Nasser, N., & Mohsein, O. (2024). The relationships between aplein, vaspin and thyroid hormone levels in obese diabetic and non-diabetic women. Journal of Experimental and Clinical Medicine, 41(2), 239–245.‏

Marques, V., Afonso, M. B., Bierig, N., Duarte-Ramos, F., Santos-Laso, Á., Jimenez-Agüero, R., Eizaguirre, E., Bujanda, L., Pareja, M. J., Luís, R., Costa, A., Machado, M. V., Alonso, C., Arretxe, E., Alustiza, J. M., Krawczyk, M., Lammert, F., Tiniakos, D. G., Flehmig, B., … Rodrigues, C. M. P. (2021). Adiponectin, leptin, and IGF-1 are useful diagnostic and stratification biomarkers of NAFLD. Frontiers in Medicine, 8, 683250.

Naif, N. H., Ahmed, E. M., Thamer, N. A., & Muhsein, O. A. (2025). The impact of inflammatory and adipokine biomarkers on breast cancer progression and patient outcomes. Bulletin of Pharmaceutical Sciences Assiut University, 48(1), 511–522.

Popoviciu, M. S., Kaka, N., Sethi, Y., Patel, N., Chopra, H., & Cavalu, S. (2023). Type 1 diabetes mellitus and autoimmune diseases: A critical review of the association and the application of personalized medicine. Journal of Personalized Medicine, 13(3), 422.

Rajasekar, A. (2023). Correlation of salivary visfatin levels in obese and NON-OBESE population with periodontal status. Journal of Oral Biology and Craniofacial Research, 13(1), 67–70.

Roy, P. K., Islam, J., & Lalhlenmawia, H. (2023). Prospects of potential adipokines as therapeutic agents in obesity-linked atherogenic dyslipidemia and insulin resistance. The Egyptian Heart Journal, 75, 24.

Stofkova, A. (2010). Resistin and visfatin: Regulators of insulin sensitivity, inflammation and immunity. Endocrine Regulations, 44(1), 25–36.

Suh, J., Lee, H. I., Lee, M., Song, K., Choi, H. S., Kwon, A., Kim, H.-S., & Chae, H. W. (2022). Insulin requirement and complications associated with serum C-peptide decline in patients with type 1 diabetes mellitus during 15 years after diagnosis. Frontiers in Endocrinology, 13, 869204.

Sun, S., Shen, X., Huang, Q., & Sun, J. (2025). Significance of combined screening for GADA, ICA, and IAA in new-onset type 2 diabetes mellitus in adults for early diagnosis of latent autoimmune diabetes. Clinical and Investigative Medicine, 48(1), 24–28.

Yan, S.-T., Sun, J., Gu, Z.-Y., Miao, X.-Y., Ma, L.-C., Sun, B.-R., Fu, X.-M., Liu, H.-Z., Yang, G., Fang, F.-S., & Li, H. (2022). The bidirectional association of C-peptide with cardiovascular risk in nondiabetic adults and patients with newly diagnosed type 2 diabetes mellitus: A retrospective cohort study. Cardiovascular Diabetology, 21, 201.

Yüksel, A., Telci, A. G. S., & Kubat Üzüm, A. (2025). The relationship between visfatin, resistin and CRP parameters and insulin resistance in obese and non-obese type 2 diabetic individuals. The European Research Journal, 11(3), 436–448.

Zhao, Y., & Li, H. (2022). Association of serum leptin and insulin levels among type 2 diabetes mellitus patients: A case-control study. Medicine, 101(41), e31006.