Zaya, M., Mahmood, A. (2026). The Potential Role of Cholinesterase in Diabetes Mellitus and Metabolic Syndrome. , 23(1), 24-32. doi: 10.33899/iraqij.p.2025.159682.1148
Muwafaq Hadi Zaya; Ahmed A. J. Mahmood. "The Potential Role of Cholinesterase in Diabetes Mellitus and Metabolic Syndrome". , 23, 1, 2026, 24-32. doi: 10.33899/iraqij.p.2025.159682.1148
Zaya, M., Mahmood, A. (2026). 'The Potential Role of Cholinesterase in Diabetes Mellitus and Metabolic Syndrome', , 23(1), pp. 24-32. doi: 10.33899/iraqij.p.2025.159682.1148
Zaya, M., Mahmood, A. The Potential Role of Cholinesterase in Diabetes Mellitus and Metabolic Syndrome. , 2026; 23(1): 24-32. doi: 10.33899/iraqij.p.2025.159682.1148

The Potential Role of Cholinesterase in Diabetes Mellitus and Metabolic Syndrome

Iraqi Journal of Pharmacy
Article 3, Volume 23, Issue 1, March 2026, Pages 24-32    PDF (806.64 K)
Document Type: Review Paper
DOI: 10.33899/iraqij.p.2025.159682.1148
Authors
Muwafaq Hadi Zaya* ; Ahmed A. J. Mahmood
Department of Pharmaceutical Chemistry, College of Pharmacy, University of Mosul, Mosul, Iraq.
Abstract
Background: Diabetes mellitus is the most prevalent chronic disease in the world, that is deadly or severely lowers quality of life and affects females more than males. Persistent hyperglycemia and episodes of hypoglycemia contribute to systemic metabolic disturbances and a sustained low-grade inflammatory state, which plays a critical role in the pathogenesis of both type 1 and type 2 diabetes. Cholinesterase enzymes—acetylcholinesterase and butyrylcholinesterase—are involved in the degradation of acetylcholine, a neurotransmitter with anti-inflammatory and insulin-modulating properties. Recent evidence suggests a link between increased butyrylcholinesterase activity and systemic inflammation in diabetic and metabolic syndrome patients, highlighting its potential as a prognostic biomarker. Aim: to characterize and investigate the role of cholinesterase enzymes in predicting and monitoring the prognosis of diabetes mellitus as well as metabolic syndrome as its risk factor of such clinical condition. Method: Several excellent databases, including PubMed, Scopus, Web of Science, and Google Scholar databases), have been used in this review. These databases were selected due to their extensive coverage, search capabilities, and inclusion of reputable, peer-reviewed publications, which guarantee the accuracy and dependability of the data collected. Results: Studies show that butyrylcholinesterase activity is raised in both type 1 and type 2 diabetes and is linked to inflammation and metabolic syndrome. This enzyme correlates with worsening metabolic health, suggesting its potential as a marker for disease monitoring. Conclusions: Butyrylcholinesterase may serve as a useful biomarker for predicting and monitoring diabetes mellitus and metabolic syndrome, due to its role in inflammation and acetylcholine regulation.

Highlights

  • Butyrylcholinesterase activity is elevated in diabetes and linked to inflammation and metabolic dysfunction.

  • Cholinesterase enzymes may serve as novel biomarkers for monitoring diabetes and metabolic syndrome progression.

  • Elevated BChE correlates with insulin resistance, dyslipidemia, and abdominal obesity in both adults and children.

  • Cholinergic pathways, especially α7nAChR activation, offer promising therapeutic targets in diabetes management.

  • Animal studies confirm the role of cholinesterase activity and modulation in glucose and lipid metabolic control.

Keywords
Diabetes mellites; Metabolic syndrome; Cholinesterase; Acetylcholinesterase; Butyrylcholinesterase; Inflammation
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