Merve Çatak, Bahadır Demir, Müberra Kulu, Filiz Özsoy, Muzaffer Katar
Journal of Clinical Practice and Research - 2025;47(5):512-518
INTRODUCTION Adipose tissue is regarded in the current literature as an endocrine organ. Beyond storing fat, it is involved in the synthesis and secretion of various endocrinologically active compounds called adipokines.1 Apelin, chemerin, omentin-1, resistin, and nesfatin-1 are among these adipokines. They have multiple complex functions, including the regulation of body weight, appetite, glucose balance, and blood pressure.1 Elevated levels of resistin, chemerin, and apelin have been associated with endocrinological diseases and obesity.1,2 In contrast, nesfatin-1 and omentin levels have been reported to be decreased in obese individuals.1,3 Recent studies have also shown that adipokines are involved in neuroendocrine and immune system interactions,4 and may serve as novel markers in diseases related to these systems.5 Recent literature has proposed that obesity may be conceptualized within an addiction framework, highlighting the roles of neuroendocrine and immune system interactions.6 However, defining obesity solely as a form of food addiction may be an oversimplification.7 Neurobehavioral studies have identified notable parallels between obesity and substance use disorders, particularly involving the brain's dopaminergic pathways.8,9 One proposed mechanism suggests that intermittent access to sugar, similar to addictive substances, may trigger compulsive consumption behaviors.9,10 Additionally, findings from questionnaire-based assessments of compulsive eating behavior indicate that individuals with higher scores tend to show increased neural activation in the amygdala, anterior cingulate cortex, and orbitofrontal cortex.11 Based on these findings, mental health experts classify obesity within the addiction model, as stressful life events can trigger uncontrollable eating episodes and certain foods possess addictive properties. It has been suggested that obesity may represent a form of eating addiction, akin to alcohol and substance dependence, and its etiology should therefore be considered within the framework of addiction.12 As highlighted in the literature, the interaction of genetic, environmental, and individual factors plays a shared role in the development of both addiction and obesity.6,12 In light of this, our study aims to determine whether adiponectin-group hormones, which are involved in obesity and insulin resistance, exhibit a similar profile in both addiction and obesity. Additionally, the roles of adiponectins in addiction and obesity will be comparatively analyzed. MATERIALS AND METHODS The Ethics Committee of Gaziosmanpaşa University granted approval for the study (date: 04.10.2021, number: 83116987 - 720). All procedures were conducted in accordance with the ethical standards outlined in the Declaration of Helsinki. Power analysis was performed to determine the sample size using the G*Power program (Foul, Erdfelder, Lang, and Buchner, 2007). An F Test (analysis of variance, ANOVA) for repeated measurements indicated that the minimum sample size required was 66 for an effect size of 0.40, a 5% margin of error, and a 95% confidence interval across three groups.The study comprised 90 participants, divided into three groups: obese individuals (BMI >30) who presented to the Endocrinology outpatient clinic; patients diagnosed with opioid use disorder undergoing inpatient treatment at the Alcohol and Substance Addiction Treatment and Education Center (AMATEM) unit; and healthy controls with BMI between 18 and 24, matched for demographic characteristics with the other groups. The obesity group included individuals classified as obese according to the World Health Organization (WHO) criteria (BMI >=30). Individuals with chronic illnesses, those taking weight-reducing medication, and participants receiving ongoing psychiatric therapy were excluded. Patients in the addiction group were diagnosed with OUD according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria13 and were receiving inpatient treatment at the AMATEM clinic. Only patients who voluntarily consented to participate were included. Participants in this group had a BMI between 18 and 24 and did not present with comorbid conditions such as diabetes mellitus or hypertension that could affect laboratory parameters or require chronic treatment. Clinical interviews confirmed that these participants did not have additional psychiatric disorders requiring treatment according to DSM-5 criteria. Participants in both the healthy control and OUD groups were selected based on a BMI range of 18 to 24. Additionally, all participants across the three groups were between 18 and 45 years of age. Demographic Data Form The researcher-designed demographic data form included variables such as age, marital status, and education level. It also contained clinical assessment questions regarding whether the participants or their families had ever received psychiatric treatment and whether they had a history of alcohol or substance use.
