Characteristics of eating behavior and the level of hormones regulating the appetite in patients with type 2 diabetes mellitus and body mass index more than 35 kg /m2

Background. The role of the hormones in eating behavior in the regulation of appetite has been well studied, but their relationship with various types of eating behavior has not been established. Aims. To study the frequency of different types of eating behavior, hunger/satiety feeling estimated by the visual analog scale and levels of leptin and gastrointestinal tract hormones that are involved in appetite regulation, fat and carbohydrate metabolism (ghrelin and glucagon-like peptide 1) in patients with diabetes mellitus type 2 and obesity. Materials and methods. The study included 35 people with obesity (BMI>35 kg/m2) and diabetes mellitus type 2 (T2DM) who received the stable sugar-lowering therapy, the median body mass index (BMI) was 40,1 [36,5; 49,6] kg/m2, the median age was 58 [52,5; 64] years. Blood tests for insulin, leptin, ghrelin, glucagon-like peptide-1, C-peptide, glucose, glycated hemoglobin and lipids profile were done in all cases, also HOMA-IR and HOMA-β were calculated. All patients completed questionnaires determining eating behavior type and hunger/satiety feeling severity. Results. In patients with T2DM and obesity a high frequency of combination of different types of eating behavior were found, it was 54,3%. Among the isolated types, restrictive eating behavior was more common – in 40%. In patients with different types of eating behavior the tendency to difference in the level of hormones regulating appetite was found, but it was not significant. High frequency of an appropriate reduction of postprandial ghrelin level was found in patients with restrictive type of eating behavior. Correlation between the level of hormones regulating appetite and hunger/satiety feeling was weak, it might reflect the resistance to these hormones in patients with severe obesity and T2DM. At the same time the relationship between the ghrelin level and the β-cells functional state parameters was significant. Conclusions. The severity of leptin and ghrelin resistance correlated with each other in T2DM and obesity patients; the severity of ghrelin resistance was associated with the beta cells functional state; according to our data postprandial ghrelin level may have opposite changes in patients with T2DM and obesity and its adequate reduction is more common for patients with restrictive type of eating behavior