Obesity and Insulin Resistance Associated with Diabetes in PWS Patients, Study Finds

Ashraf Malhas, PhD avatar

by Ashraf Malhas, PhD |

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Obesity and insulin resistance are significant risk factors for developing type 2 diabetes in patients with Prader-Willi syndrome (PWS), highlighting the importance of regular monitoring of glucose, or sugar, levels in these patients.

Severe obesity in childhood, which may develop into type 2 diabetes, is a common feature in patients with PWS. However, the extent of the association between Prader-Willi and diabetes, and its processes, are not fully understood.

Although a previous study had estimated the prevalence of diabetes in Prader-Willi patients to be 7 to 24 percent, no such research has been conducted in South Korea.

The study, “Prevalence and risk factors for type 2 diabetes mellitus with Prader-Willi syndrome: a single center experience,” published in the Orphanet Journal of Rare Diseases, aimed to assess the prevalence and associated risk factors for type 2 diabetes in PWS patients in South Korea.

The study included 84 patients 10 and older who had a confirmed diagnosis of Prader-Willi syndrome from 1994 to 2016. And, of 211 PWS patients diagnosed over the study period, 29 patients (13.7%) had type 2 diabetes. This group of patients, therefore, offered the opportunity to compare a diabetic and a nondiabetic group of PWS patients.

Researchers compared the two groups considering several parameters, such as body mass index (BMI), insulin resistance (using the homeostasis model assessment known as HOMA-IR), and the presence of dyslipidemia (abnormal blood lipid levels) and hypogonadism (abnormal sex hormone secretion), among others.

Results indicated that compared to the nondiabetic group, the diabetic group had a higher mean BMI (35.7 vs. 28.3 kg/m2), a higher incidence of obesity (23 vs. 22), and a higher degree of insulin resistance.

Additional analysis indicated that, in patients older than 18, obesity, HOMA-IR, dyslipidemia, and hypogonadism were significantly linked to and considered as risk factors for diabetes.

Also, seven patients in the diabetes group also had diabetic microvascular complications, which were significantly correlated with advanced age and HOMA-IR.

The results suggest that the prevalence of type 2 diabetes in Korean PWS patients is similar to that reported in other populations. They also indicate that BMI and HOMA-IR can be used as markers to assess the risk of developing diabetes in Prader-Willi patients.

The researchers suggest their results highlight the importance of “early intervention to prevent severe obesity and the regular monitoring of glucose homeostasis parameters to predict the occurrence of [type 2 diabetes] in PWS.”