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.

Ekaterina V Tichonenko
ORCID iD: 0000-0001-5290-3218
SPIN-code: 1910-5991
Almazov National Medical Research Centre, Saint-Petersburg, Russia
Russian Federation, Akkuratova Street , 197341 Saint - Petersburg , Russia

Postgraduate student, Researcher of the Research Laboratory of Diabetology of institute endocrinology

Uliana A Tsoi
ORCID iD: 0000-0003-4013-4831
SPIN-code: 3294-2857
Almazov National Medical Research Centre, Saint-Petersburg, Russia
Russian Federation, Akkuratova Street , 197341 Saint - Petersburg , Russia

PhD, Head of the Research Laboratory of neuroendocrinology of institute endocrinology

Elena Yu Vasilieva
ORCID iD: 0000-0003-3185-3957
SPIN-code: 8546-5546
Almazov National Medical Research Centre, Saint-Petersburg, Russia
Russian Federation, Akkuratova Street , 197341 Saint - Petersburg , Russia

assistent of professor of the Department of Clinical Laboratory Diagnostics
Head of the Central Clinical and Diagnostic Laboratory

Alina Yu Babenko

Author for correspondence.
ORCID iD: 0000-0002-0559-697X
SPIN-code: 9388-1077
Almazov National Medical Research Centre, Saint-Petersburg, Russia
Russian Federation, Akkuratova Street , 197341 Saint - Petersburg , Russia

Sc.D., Head of the Research Laboratory of Diabetology of institute endocrinology

  • Kemps E, Herman CP, Hollitt S, et al. The role of expectations in the effect of food cue exposure on intake. Appetite. 2016;103:259-264. doi: 10.1016/j.appet.2016.04.026.
  • Travagli RA, Anselmi L. Vagal neurocircuitry and its influence on gastric motility. Nature Reviews Gastroenterology & Hepatology. 2016;13(7):389-401. doi: 10.1038/nrgastro.2016.76.
  • Ziauddeen H, Alonso-Alonso M, Hill JO, et al. Obesity and the Neurocognitive Basis of Food Reward and the Control of Intake. Advances in Nutrition. 2015;6(4):474-486. doi: 10.3945/an.115.008268.
  • Engel JA, Jerlhag E. Role of Appetite-Regulating Peptides in the Pathophysiology of Addiction: Implications for Pharmacotherapy. CNS Drugs. 2014;28(10):875-886. doi: 10.1007/s40263-014-0178-y.
  • Adamska E, Ostrowska L, Górska M, Krętowski A. The role of gastrointestinal hormones in the pathogenesis of obesity and type 2 diabetes. Gastroenterology Review. 2014;2:69-76. doi: 10.5114/pg.2014.42498.
  • Ronveaux CC, Tomé D, Raybould HE. Glucagon-Like Peptide 1 Interacts with Ghrelin and Leptin to Regulate Glucose Metabolism and Food Intake through Vagal Afferent Neuron Signaling. The Journal of Nutrition. 2015;145(4):672-680. doi: 10.3945/jn.114.206029.
  • Howick K, Griffin B, Cryan J, Schellekens H. From Belly to Brain: Targeting the Ghrelin Receptor in Appetite and Food Intake Regulation. International Journal of Molecular Sciences. 2017;18(12):273. doi: 10.3390/ijms18020273.
  • Shiiya T. Plasma Ghrelin Levels in Lean and Obese Humans and the Effect of Glucose on Ghrelin Secretion. J. Clin. Endocrinol. Metab. 2002;87(1):240-244. doi: 10.1210/jcem.87.1.8129.
  • St-Pierre DH, Rabasa-Lhoret R, Lavoie ME, et al. Fiber intake predicts ghrelin levels in overweight and obese postmenopausal women. European journal of endocrinology / European Federation of Endocrine Societies. 2009;161(1):65-72. doi: 10.1530/eje-09-0018.
  • St-Pierre DH, Karelis AD, Coderre L, et al. Association of Acylated and Nonacylated Ghrelin with Insulin Sensitivity in Overweight and Obese Postmenopausal Women. J. Clin. Endocr. Metab. 2007;92(1):264-269. doi: 10.1210/jc.2006-1603.
  • Mannucci E, Tesi F, Ricca V, et al. Eating behavior in obese patients with and without type 2 diabetes mellitus. Int. J. Obes. 2002;26(6):848-853. doi: 10.1038/sj.ijo.0801976.
  • Inui A. Preface[Hot Topic: Medicinal Strategies in the Treatment of Obesity (Guest Editor: Akio Inui)]. Current Medicinal Chemistry - Central Nervous System Agents. 2003;3(3):1-2. doi: 10.2174/1568015033477767.
  • Covasa M, Swartz T. The Role of Glucagon-Like Peptide-1 (Glp-1) in Eating Behavior. 2011:189-201. doi: 10.1007/978-0-387-92271-3_14.
  • Rask E, Olsson T, Soderberg S, et al. Impaired Incretin Response After a Mixed Meal Is Associated With Insulin Resistance in Nondiabetic Men. Diabetes Care. 2001;24(9):1640-1645. doi: 10.2337/diacare.24.9.1640.
  • Sominsky L, Spencer SJ. Eating behavior and stress: a pathway to obesity. Front. Psychol. 2014;5. doi: 10.3389/fpsyg.2014.00434.
  • Buss J, Havel PJ, Epel E, et al. Associations of ghrelin with eating behaviors, stress, metabolic factors, and telomere length among overweight and obese women: Preliminary evidence of attenuated ghrelin effects in obesity? Appetite. 2014;76:84-94. doi: 10.1016/j.appet.2014.01.011.
  • Mannucci E, Rotella F, Ricca V, et al. Eating disorders in patients with Type 1 diabetes: A meta-analysis. J. Endocrinol. Invest. 2014;28(7):417-419. doi: 10.1007/bf03347221.
  • Звенигородская Л.А., Кучеренко Т.В. Типы пищевого поведения и гормоны пищевого поведения у больных с метаболическим синдромом.// Экспериментальная и клиническая гастроэнтнрология. – 2007. – №1. – С.24–27.[Zvenigorodskaya LA, Kucherenko TV. Tipy pishchevogo povedeniya i gormony pishchevogo povedeniya u bol’nykh s metwbolicheskim sindromom. Experimental’naya i klinicheskaya gastroenterologiya. 2007;(1):24-27.(in Russ)]
  • Froguel P, Taheri S, Lin L, et al. Short Sleep Duration Is Associated with Reduced Leptin, Elevated Ghrelin, and Increased Body Mass Index. PLoS Med. 2004;1(3):e62. doi: 10.1371/journal.pmed.0010062.
  • Asarian L, Geary N. Sex differences in the physiology of eating. American Journal of Physiology-Regulatory, Integrative and Comparative Physiology. 2013;305(11):R1215-R1267. doi: 10.1152/ajpregu.00446.2012.

Supplementary files

There are no supplementary files to display.


Abstract - 258

PDF (Russian) - 108

Copyright (c) 2018 Tichonenko E.V., Tsoi U.A., Vasilieva E.Y., Babenko A.Y.

Creative Commons License
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.