Hyperinsulinaemia and hyperleptinaemia are BMI independent features of morbid obesity in a Qatari, compared to a Caucasian population: Effect of surgical weight loss

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: SAT 677-696-Obesity Physiology & Epidemiology
Saturday, June 15, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board SAT-679
Mashael Aljaber*1, Carlo Casale2, Aysha Ahmad Bakhamis1, Nelson Ndubuisi Orie3, Shen Lei4, Mohamed Elrayess5 and Mohammed Alsayrafi1
1Anti Doping Lab Qatar, Doha, Qatar, 2Adipokines and Metabolism Research Group, Centre for Clinical Pharmacology & Division of Medicine, University College London, 3ADL Qatar, Doha, Qatar, 4UCL, 5ADLQ, Doha, Qatar
Background: Recent trends suggest that the sharpest increases in the prevalence of obesity are in the Middle East, especially in Qatar. Early & rapid onset of the disease in this population, along with a primarily abdominal & omental deposition of adipose tissue, is closely associated with insulin resistance, whilst longer duration of obesity in Caucasians is associated with maintenance of insulin sensitivity, independently of BMI. The impact of more aggressive treatments for obesity, such as surgery, on the metabolic health of the Qataris is not known.

Objectives: To test the hypothesis that inherent differences between the Qataris and Caucasians in adipose tissue secretory function and sensitivity to insulin determines their response to interventions that reduce their adipose tissue mass.

Methods: Non-diabetic morbidly obese subjects were recruited from Qatari and Caucasian patients awaiting weight reduction surgery (Al-Emadi Hospital, Doha, Qatar and Whittington Hospital, London, UK). Anthropometric measures were recorded. Blood samples were obtained before, and in a sub-set after weight loss for determination of lipids, glucose, insulin and adipokines. Subjects were dichotomized into metabolically healthy obese (MHO) and pathologically obese (PO) groups based on their HOMA index (fasting plasma glucose < 6.8 mmol/l and insulin levels < 6.5 miU/ml).

Results: Qatari, compared to Caucasian, subjects were younger (29.8 vs 35.3 years, p=0.02), had higher insulin (16.1 vs 7.9miu/ml, p=0.01), leptin (77.8 vs 51.2ng/ml, p=0.001), IL-6 (3.9 vs 2.4 pg/ml, p=0.05) and total cholesterol (4.6 vs 4.0 mmol/l, p=0.01). However, their diastolic blood pressure and triglyceride were lower than in the Caucasians. When both studied groups were dichotomized into MHO and PO, prevalence of MHO in Qatar was significantly lower than that of the Caucasians (13% versus 28%). Additionally, MHO Caucasians had lower blood pressure and triglycerides than PO Caucasians, whereas there were no differences between Qatari MHO and PO groups. Three months after surgery, both populations showed significant BMI reduction associated with reduction in insulin, HOMA and leptin.

Conclusion: Obesity in Qatari subjects was accompanied by greater degree of hyperinsulinaemia and hyperleptinaemia compared to Caucasians, suggesting elevated fat mass contribution to the BMI in Qataris. The lower prevalence of MHO in Qataris also reflects the largely insulin resistant phenotype of the population. In Caucasians the PO subjects were hypertensive and hypertriglyceridaemic compared to the MHO, while these differences were not apparent in the Qatari MHO and PO groups. The greater incidence and younger age of onset of obesity may warrant more aggressive treatment for obesity amongst the Qatari.

Nothing to Disclose: MA, CC, AAB, NNO, SL, ME, MA

*Please take note of The Endocrine Society's News Embargo Policy at http://www.endo-society.org/endo2013/media.cfm