Abstract
Leptin is an adipo-myokine that regulates appetite and energy expenditure by a neuroendocrine feedback loop. Leptin levels are positively correlated with BMI in the spinal cord injury population and leptin levels are greater in individuals with spinal cord injury compared to uninjured controls. Leptin is produced in multiple tissues, including fat, bone, and skeletal muscle and is a putative biomarker of sedentary behavior in older adults. We assessed body composition leptin, adiponectin, and IL-6 levels in 205 men with chronic spinal cord injury. We found no association between age, injury duration, injury level, injury completeness, or walking status and leptin. There was a significant positive association between lean mass and leptin in men with SCI that was independent of fat. Adjusting for body composition, leptin levels were positively associated with IL-6 and negatively associated with adiponectin levels. When considering men with SCI and sarcopenic obesity, only fat mass remained positively associated with leptin. We found no association between IL-6, adiponectin, or lean mass and leptin in the sarcopenic obesity group. Our findings suggest that lean mass is an under recognized, but substantial, source of circulating leptin. Furthermore, SCI-related sarcopenic obesity may result in dysregulated adipo-myokine metabolism with local and systemic physiologic effects.
Highlights
Leptin has classically been identified as an adipokine produced by adipocytes that regulates weight balance and energy expenditure by a neuroendocrine feedback loop between adipose tissue and the hypothalamus [1]
60% of participants used a wheelchair as their primary mobility mode with the majority (72%) using manual wheelchairs
We found no association between age, injury duration, injury level, injury completeness, or Variable Age Injury duration body mass index (BMI) Total fat mass (%) Total lean mass ln adiponectin ln IL-6 Walking status Wheelchair user Walk with or without aid Injury completeness Motor complete Motor incomplete Injury level Tetraplegia Paraplegia Obesity status Obese Not obese Sarcopenia status Sarcopenia No sarcopenia Sarcopenic-obesity status Sarcopenic-obesity No sarcopenic-obesity
Summary
Leptin has classically been identified as an adipokine produced by adipocytes that regulates weight balance and energy expenditure by a neuroendocrine feedback loop between adipose tissue and the hypothalamus [1]. Transgenic mice lacking leptin receptor isoforms consistently demonstrate an obese phenotype with significantly more adipose tissue and less lean mass compared to wild type mice [2]. Leptin levels are positively correlated with obesity in the general population [3] and positively associated with sedentary behavior, even after adjusting for various possible confounding factors including demographics, medications, and body mass index (BMI) [4,5,6]. Lean mass and leptin in spinal cord injury [90SI5015-01-00] https://www.hhs.gov/ LRM and RAB. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript
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