Skip to main content Skip to main navigation menu Skip to site footer

Association of appetite hormone levels with HbA1c in obese type-2 diabetes mellitus patients

  • Edward Kurnia Setiawan Limijadi ,
  • Nyoman Suci Widyastiti ,
  • Meita Hendrianingtyas ,
  • Banundari Rachmawati ,


Background: Nesfatin-1 and leptin are hormones that control appetite and affect glycemic control. Nesfatin-1 and leptin levels are affected by body mass index (BMI). Hemoglobin A1c (HbA1c) is an objective parameter to assess long-term glycemic control. This present research aims to know the relationship between levels of nesfatin-1 and leptin with HbA1c values ​​as an indicator of long-term objective glycemic control in patients with T2DM with obesity.

Methods: Cross-sectional study on 54 obese T2DM subjects. Measurement of nesfatin-1 and leptin levels using the enzyme linked immunosorbent assay (ELISA) method. The value of HbA1c was measured by the fluorescent immunoassay (FIA) method. The correlation between nesfatin-1 and leptin with Hb1c was tested using the Spearman correlation analysis test (p <0.05 was considered significant).

Results: The median value of nesfatin-1 levels was 1,824.0 (134.0-5,255.0) pg/mL, the median value of leptin levels was 14.0 (0.4 - 66.4) ng/mL, and the median value of HbA1c was 7.70 (4.9-15.0)%. There is no correlation between nesfatin-1 levels and HbA1c values (p = 0.282 and r = 0.149). There is no correlation between leptin levels and HbA1c values (p value = 0.895 and r = 0.018).

Conclusion: HbA1c levels are not associated with an increased appetite, as evidenced by no association between appetite biomarkers and glycemic control.


  1. Kementerian Kesehatan RI. Data dan Informasi: Profil Kesehatan Indonesia 2019. 2020.
  2. World Health Organization. Diabetes [Internet]. Fact Sheet. 2020 [cited 2020 Nov 18]. Available from:
  3. Al-Goblan AS, Al-Alfi MA, Khan MZ. Mechanism linking diabetes mellitus and obesity. Diabetes, Metab Syndr Obes Targets Ther. 2014;7:587–91.
  4. Ford ES, Mokdad AH. Epidemiology of Obesity in the Western Hemisphere. J Clin Endocrinol Metab. 2008;93(11):1–8.
  5. Bandaru P, Shankar A. Association between plasma leptin levels and diabetes mellitus. Metab Syndr Relat Disord. 2011;9(1):19–23. Woods SC, D’Alessio DA. Central control of body weight and appetite. J Clin Endocrinol Metab. 2008;93(11):37–50.
  6. Baratta M. Leptin-from a signal of adiposity to a hormonal mediator in peripheral tissues. Med Sci Moni. 2002;8:282–92.
  7. Kelesidis T, Kelesidis I, Chou S, Mantzoros CS. Narrative review: The role of leptin in human physiology: Emerging clinical applications. Ann Intern Med. 2010;152(2):93–100.
  8. Myers MG, Cowley MA, Münzberg H. Mechanisms of leptin action and leptin resistance. Annu Rev Physiol. 2008;70:537–56.
  9. Ayada C, Toru Ü, Korkut Y. Nesfatin-1 and its effects on different systems. Hippokratia. 2015;4–10.
  10. Oh-I S, Shimizu H, Satoh T, Okada S, Adachi S, Inoue K, et al. Identification of nesfatin-1 as a satiety molecule in the hypothalamus. Nature. 2006; 443(7112):709–12.
  11. Kim SH, Ahn MB, Cho WK, Cho KS, Jung MH, Suh BK. The relation of
  12. serum nesfatin-1 level with anthropometric and metabolic parameters in
  13. children and adolescents: A prospective observational study. Medicine
  14. (Baltimore). 2019;98(19):15460.
  15. Kelesidis T, Kelesidis I, Chou S, Mantzoros CS. Narrative review: The role of leptin in human physiology: Emerging clinical applications. Ann Intern Med. 2010;152(2):93–100.
  16. Najam SS, Awan FR, Islam M, Khurshid M, Khan AR, Siddique E, et al. Leptin Correlation with Obesity, Diabetes and Gender in a Population from Faisalabad, Pakistan. Arch Med. 2016;8(5):1–5.
  17. Higgins T. HbA1c - An analyte of increasing importance. Clin Biochem. 2012;45(13–14):1038–45.
  18. Sisodia RK, Chouhan M. The study of correlation between Body Mass Index and glycemic control-HbA1c in diabetes type 2 patients. Int J Adv Med. 2019;6(6):1788.
  19. Mellergård E, Johnsson P, Eek F. Sociodemographic factors associated with HbA1c variability in type 2 diabetes: a prospective exploratory cohort study. BMC Endocr Disord. 2020;20(1):1–8.
  20. Xu D, Yu Y, Xu Y, Ge J. Plasma nesfatin-1: Potential predictor and diagnostic biomarker for cognitive dysfunction in T2DM patient. Diabetes, Metab Syndr Obes Targets Ther. 2021;14(August):3555–66.
  21. Korani MA, Sonbol A. The relation between plasma levels of nesfatin-1 and different grades of diabetic kidney disease in patients with type 2 diabetes. Egypt J Intern Med. 2018;30(2):68–71.
  22. Wu R, Chen Z, Xu Y, Ge J, Lü X. Change in plasma nesfatin-1 concentration within high-fat diet induced nonalcoholic fatty liver disease rat models. Wei Sheng Yan Jiu. 2016 May;45(3):452–7
  23. Vinitha R, Ram J, Snehalatha C, Nanditha A, Shetty AS, Arun R, et al. Adiponectin, leptin, interleukin-6 and HbA1c in the prediction of incident type 2 diabetes: A nested case-control study in Asian Indian men with impaired glucose tolerance. Diabetes Res Clin Pract.
  24. ;109(2):340–6.
  25. Taghdir M, Djazayeri A, Djalali M, Eshraghian M, Rajab A, Yegane HS. Relationships of serum leptin concentration with insulin, glucose, hba1c levels and insulin resistance in overweight post-menopausal diabetic women. ARYA Atheroscler J. 2010;5(4):175–80.

How to Cite

Limijadi, E. K. S., Nyoman Suci Widyastiti, Meita Hendrianingtyas, & Banundari Rachmawati. (2023). Association of appetite hormone levels with HbA1c in obese type-2 diabetes mellitus patients. Bali Medical Journal, 12(1), 729–732.




Search Panel

Edward Kurnia Setiawan Limijadi
Google Scholar
BMJ Journal

Nyoman Suci Widyastiti
Google Scholar
BMJ Journal

Meita Hendrianingtyas
Google Scholar
BMJ Journal

Banundari Rachmawati
Google Scholar
BMJ Journal