الفهرس 
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Abstract
Insulin resistance syndrome occurs frequently in the general population. A large segment of the adult population of industrialized countries develops the metabolic syndrome, produced by genetics, hormonal, and life style factors such as obesity, physical inactivity and certain nutrient excess.The aim of our work was to examine the relationship between ET-1 and leptin concentrations with some anthropometric and metabolic variables characteristic of insulin resistance syndrome. The effects of energy restriction either alone or in combination with metformin on some anthropometric and metabolic variables characteristic of insulin resistance syndrome were also studied. The study consisted of 90 obese female patients with age ranging from 47 to 53 years. They were divided into two groups. Group I included 60 obese female patients with either IGT or newly diagnosed type 2 diabetes with insulin resistance syndrome, group II included 30 obese females matched in age and BMI with group I and were taken as a control. Patients in Group I was divided into two groups. Group 1 received LCD (1200 kcal/day) alone. Group 2 received low calorie diet and metformin (850 mg twice daily). The study continued for 6 months. From this study, we found that patients with IRS were obese, BMI (33.57 1.7) with significant increase in WHR compared to obese controls. Also there was significant increase in SBP, DBP, fasting, postprandial plasma glucose, fasting insulin and HOMA-IR ,leptin and ET-1 in obese patients with IRS compared to obese controls. We can conclude that insulin resistance syndrome is a constellation of clinical and biochemical anomalies clustering in subjects with upper body fat distribution. It appears that there is interrelationship between insulin ET-1 and leptin and it seems that they interact to produce many components of IRS.LCD and metformin are effective and safe measures in the management of obese patients with IRS as they improve many components of this syndrome. Their effects may be explained partly by their effect on insulin resistance, plasma leptin and ET-1.