الفهرس 
Review of the Literature
Chapter One AdipocytokinesOnly 14 pages are availabe for public view
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Abstract
This study was done on two groups:
Group one (patients group) consisted of twenty patients, who was fulfilling the criteria of MONW (9 female and 11 male), while the control
group was consisting of twenty age and sex, matched healthy volunteers (8 female and 12 male).
Both groups subjected to the following:
1. A detailed history and clinical examination to fulfill inclusion and exclusion criteria.
2. Routine Laboratory tests including:
• Complete blood picture, CBC.
• Erythrocyte sedimentation rate (ESR).
• Complete renal and liver functions.
• Fasting and postprandial blood sugar.
• Urine and stool analysis.
3. Complete lipids profile including serum triglycerides, total cholesterol, LDL-cholesterol and HDL-cholesterol.
4. Measurement of Fasting serum insulin using standard ELISA kit.
5. Calculation of insulin resistance according to HOMA model.
6. Measurement of serum adiponectin using standard ELISA kit.
7. Measurement of serum interleukin-6 using standard ELISA kit.
We found in our study that serum adiponectin was low in MONW individuals. There was also a positive correlation between serum adiponectin and HDL-C in both groups. A negative correlation between serum adiponectin and all of the following parameters age, BMI, waist circumference, fasting blood glucose, serum TG, total cholesterol, LDL-C, serum insulin, I.R. and Interleukin-6 in both groups.
Serum level of IL-6 was found to be higher in MONW individuals group in comparison to normal individuals group. There was a negative
correlation between serum adiponectin and serum levels of interleukin-6 in patients group more than the control group.
Insulin resistance was higher in MONW group. There was a negative correlation between serum adiponectin level and insulin resistance in control and patients groups. Plasma adiponectin levels reduced in non obese humans, particularly those with visceral obesity, and to correlate inversely with insulin resistance and IL-6
It was evident that adiponectin levels in insulin-resistant subjects were uniformly low, regardless of the obesity status of the individual subjects. These demonstrate a clear and significant relationship between insulin resistance and plasma adiponectin concentrations. Adiponectin is an insulin-sensitizing hormone. The plasma level of this hormone is the best predictor of the subsequent development of type 2 diabetes
Increased adipose tissue production of IL-6 may affect adipose tissue development and function and, hence, adiponectin production. Oxidative stress may contribute to the development of insulin resistance in obese and MONW men, as oxidative stress lower glucose-induced insulin secretion from pancreatic -cells.
Adiponectin augments glucose uptake of myocytes and regulates energy homeostasis, glucose and lipid metabolism Adiponectin might play a key role in relation to the development of insulin resistance.
Conclusion and Recommendation:
We concluded that high IL-6 and low adiponectin levels could indicate insulin resistance in MONW individuals. Also IL-6 and adiponectin concentrations were related to fat mass distribution in the MONW. Adiponectin is an insulin-sensitizing hormone and the plasma level of this hormone is the best predictor of the subsequent development of type2 diabetes. Adiponectin value might be an attractive biomarker for the prediction of insulin resistance and metabolic syndrome. Adiponectin could be evaluated for screening and early diagnosis of insulin resistance in MONW subjects.
We recommend the need of further studies to know the possibility of the use of adiponectin in therapy of MONW, also the use of adiponectin as insulin sensitizer in type 2diabetes and metabolic syndrome. Previously adiponectin was found to be one of therapeutic strategy for the treatment of insulin resistance, type2 diabetes, the metabolic syndrome, and cardiovascular disease
We also recommend the need of further studies to prevent the development of insulin resistance and metabolic syndrome by using drugs which can reduce the level of IL-6, or increase the level of adiponectin.