Concentrations of adiponectin, leptin and ghrelin and interrelationships with body fatness and glycemic control before and after a culturally sensitive diabetes education program for Hispanic community patients with type 2 diabetes.
The Hispanic population in the U.S. is disproportionately affected by type 2 diabetes with age-adjusted prevalences that are nearly twice that of non-Hispanic whites. This population also has higher morbidity and mortality due to complications of type 2 diabetes. This study examines archival data obtained from a three month prospective cohort study of a culturally sensitive diabetes education program for Hispanics with type 2 diabetes. This study was entitled "Effects of Diabetes Education in the Hispanic Community." The purpose of this study was to analyze changes in adipose tissue function (serum concentrations of adiponectin and leptin) and appetite regulation (serum concentration of ghrelin) before and after the three month education program and to understand the interrelationships of any changes in these parameters with glycemic control, body mass index and body composition as measured by dual X-ray absorptiometry among study participants.;Fifty-nine subjects met the inclusion criteria and were invited to participate. Forty-four participants enrolled in the study and began the intervention in February 2005 and 34 completed the trial in May 2005. The diabetes education classes were conducted in Spanish by trained health professionals and covered ten topics including blood glucose monitoring, nutrition and exercise, motivation, weight control, and foot care. Study personnel weighed participants and measured waist and hip circumferences at class sessions and body mass index (BMI) was calculated. Fasting blood draws were taken at baseline and after the three month intervention period and analyzed for serum concentrations of blood glucose, hemoglobinA1c, insulin, adiponectin, leptin, and ghrelin. Dual X-ray absorptiometry (DXA) was performed at baseline and after three months. Paired samples t-tests for continuous data were utilized to examine changes in study parameters before and after the intervention. Univariate correlational analysis was utilized to assess the relationship between changes in anthropometric measurements and serum parameters and multiple regression analyses was performed to evaluate the independent predictors of change in adiponectin, leptin and ghrelin.;We found that adiponectin concentration at baseline and after three months correlated negatively with body weight and waist circumference as well as insulin concentration (not significant at baseline). Leptin concentration correlated positively with body weight, BMI, waist and hip circumferences and all DXA measures of adiposity but negatively with waist-to-hip ratio. Ghrelin concentrations at baseline and three months were inversely correlated to body weight and waist and hip circumferences, as well as to truncal fat as measured by DXA as well as insulin concentrations.;Between baseline and three months body weight and waist circumference decreased, as did all DXA measures of adiposity and glucose and hemoglobinA1c concentrations. Adiponectin and ghrelin concentrations did not change significantly between baseline and three months while leptin concentrations were significantly decreased. This decrease correlated with decrease in body weight, but not to change in other measures of adiposity, insulin concentrations or glycemic control. In conclusion, in a study with a pre- and posttest design, the diabetes education program seemed to improve adiposity, glycemic control and leptin concentrations in the short-term.