Hospital Based Pilot Study: Association of Kisspeptin Levels With Insulin Secretion in Diabetes Mellitus

INTRODUCTION:

Since the discovery of kisspeptin as a "gate-keeper" of hypothalamo-pituitary-gonadal axis, there has been tremendous interest in the molecule. Kisspeptins are a group of peptides derived from the kiss gene, which share a common C-terminal decapeptide with an arginine-phenylalanine residue at the amino terminal.(1, 2) These peptides and their target receptor GPR54 are highly expressed in hypothalamus, anterior pituitary, islets of langerhans, and gonads. (2-5) The relevance of kisspeptin as regulatory molecule for the reproductive system has been well documented in significant number of trials. (6, 7) This leads to the possibility that kisspeptin could be involved in an equally pivotal role in the other sites, where it is located, namely pancreas.

Investigators have demonstrated that kisspeptin plays a role in regulating beta cell activity.(8) Despite previous conflicting results suggesting glucose mediated insulin secretion and insulin inhibition in different studies,(9, 10) current evidence favours role of kisspeptin in glucose mediated insulin secretion.(11) One of earliest evidence of relation of insulin resistance with falling kisspeptin levels was demonstrated by Panidis et al in 2006.

While various animal experiments have suggested that kisspeptins regulate insulin secretion, we do not know if this is also true in humans. The investigators hypothesize that kisspeptin levels are significantly low in individuals who have low endogenous insulin secretion.

Thus investigators plan this study to understand the link between endogenous insulin secretion and kisspeptin levels among individuals with various levels of insulin secretory defect as seen in diabetics. We believe that this will help understand the physiologic mechanisms, and kisspeptin based insulin regulation among individuals with diabetes mellitus.