Hormonal predictors of the insulin sensitive phenotype in humans

Mohamed Badie Ahmed; Abdella M. Habib; Saif  Badran; Abeer  Alsherawi; Sherouk Essam Elnefaily; Mansour  Binfayed; Atalla  Hammouda; Graeme E. Glass; Ibrahem  Abdalhakam; Abdul-Badi  Abou-Samra; Suhail A. Doi

doi:10.17305/bb.2025.12210

Authors

Mohamed Badie Ahmed Department of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, Qatar; Plastic Surgery Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar https://orcid.org/0000-0001-8727-9101
Abdella M. Habib Department of Basic Medical Sciences, College of Medicine, QU Health, Qatar University, Doha, Qatar
Saif Badran Division of Plastic & Reconstructive Surgery, Washington University School of Medicine, Saint Louis, MO, USA
Abeer Alsherawi Plastic Surgery Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar; College of Medicine, QU Health, Qatar University, Doha, Qatar
Sherouk Essam Elnefaily Faculty of Pharmacy, Cyprus International University, Nicosia, North Cyprus
Mansour Binfayed Plastic Surgery Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
Atalla Hammouda Plastic Surgery Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
Graeme E. Glass Division of Craniofacial Surgery, Department of Plastic Surgery, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
Ibrahem Abdalhakam Qatar Metabolic Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar
Abdul-Badi Abou-Samra Qatar Metabolic Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar
Suhail A. Doi Department of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, Qatar

DOI:

https://doi.org/10.17305/bb.2025.12210

Keywords:

Obesity, adipokines, gut hormones, body contouring surgery, insulin sensitivity, pancreatic polypeptide, PP, gastric inhibitory polypeptide, GIP, leptin, liver-expressed antimicrobial peptide 2, LEAP2

Abstract

Clinical obesity, a chronic condition marked by excessive fat accumulation, often leads to insulin resistance and a heightened risk of comorbidities. This study aimed to identify hormonal predictors of an insulin-sensitive phenotype (ISP) in patients undergoing body contouring surgeries, focusing on the relationship between gut hormones, adipokines, and fat mass. ISP was defined as the highest tertile of HOMA insulin sensitivity. We prospectively followed patients undergoing abdominoplasty, lower body lift, or thigh lift at Hamad General Hospital from January 2021 to December 2023. Body composition, glycemic indices, and hormonal levels were assessed, with data analyzed using descriptive statistics and regression models. The study included 34, 22, and 27 subjects at visits 1, 2, and 3, respectively. Fat percentage decreased slightly at visits 2 and 3 compared to baseline, though not significantly. Median levels of glucagon-like peptide-1 (GLP-1), gastric inhibitory polypeptide (GIP), pancreatic polypeptide (PP), liver-expressed antimicrobial peptide 2 (LEAP2), and amylin varied significantly across visits, initially rising at visit 2 before declining at visit 3. Logistic regression revealed that ISP was negatively associated with serum GIP. LEAP2, and leptin levels while positively associated with PP. History of bariatric surgery was only weakly associated with the ISP after hormonal associations were accounted for. Notably, total body fat percentage did not predict ISP after accounting for hormonal factors. This study highlights GIP, PP, leptin, and LEAP2 as key predictors of ISP, with GIP being the primary negative regulator. These findings underscore the importance of hormonal interplay in insulin sensitivity, emphasizing the role of gut hormones and adipokines in predicting ISP in humans.