Effect Of Central Obesity Research Articles

Genome-wide association study reveals shared and distinct genetic architecture underlying fatty acid and bioactive oxylipin metabolites in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL).

Bioactive fatty acid-derived oxylipin molecules play key roles in mediating inflammation and oxidative stress, which underlie many chronic diseases. Circulating levels of fatty acids and oxylipins are influenced by both environmental and genetic factors; characterizing the genetic architecture of bioactive lipids could yield new insights into underlying biological pathways. Thus, we performed a genome wide association study (GWAS) of n=81 fatty acids and oxylipins in n=11,584 Hispanic Community Health Study/Study of Latinos (HCHS/SOL) participants with genetic and lipidomic data measured at study baseline (58.6% female, mean age = 46.1 years, standard deviation = 13.8 years). Additionally, given the effects of central obesity on inflammation, we examined interactions with waist circumference using two-degree-of-freedom joint tests. Heritability estimates ranged from 0% to 47.9%, and 48 of the 81oxylipins and fatty acids were significantly heritable. Moreover, 40 (49.4%) of the 81 oxylipins and fatty acids had at least one genome-wide significant (p< 6.94E-11) variant resulting in 19 independent genetic loci involved in fatty acid and oxylipin synthesis, as well as downstream pathways. Four loci (lead variant minor allele frequency [MAF] range: 0.08-0.50), including the desaturase-encoding FADS and the OATP1B1 transporter protein-encoding SLCO1B1, exhibited associations with four or more fatty acids and oxylipins. The majority of the 15 remaining loci (87.5%) (lead variant MAF range = 0.03-0.45, mean = 0.23) were only associated with one oxylipin or fatty acid, demonstrating evidence of distinct genetic effects. Finally, while most loci identified in two-degree-of-freedom tests were previously identified in our main effects analyses, we also identified an additional rare variant (MAF = 0.002) near CARS2, a locus previously implicated in inflammation. Our analyses revealed shared and distinct genetic architecture underlying fatty acids and oxylipins, providing insights into genetic factors and motivating future multi-omics work to characterize these compounds and elucidate their roles in disease pathways.

The Effect of Central Obesity in Children with Allergic and Non‐Allergic Rhinitis

The Effect of Central Obesity in Children with Allergic and Non‐Allergic Rhinitis

Central obesity is selectively associated with cerebral gray matter atrophy in 15,634 subjects in the UK Biobank

BackgroundObesity is a risk factor for both cardiovascular disease and dementia, but the mechanisms underlying this association are not fully understood. We examined associations between obesity, including estimates of central obesity using different modalities, with brain gray matter (GM) volume in the UK Biobank, a large population-based cohort study.MethodsTo determine relationships between obesity and the brain we used brain MRI, abdominal MRI, dual-energy X-ray absorptiometry (DXA), and bioelectric whole-body impedance. We determined whether obesity was associated with any change in brain gray matter (GM) and white matter (WM) volumes, and brain network efficiency derived from the structural connectome (wiring of the brain) as determined from diffusion-tensor MRI tractography. Using Waist-Hip Ratio (WHR), abdominal MRI and DXA we determined whether any associations were primarily with central rather than peripheral obesity, and whether associations were mediated by known cardiovascular risk factors. We analyzed brain MRI data from 15,634.ResultsWe found that central obesity, was associated with decreased GM volume (anthropometric data: p = 6.7 × 10−16, DXA: p = 8.3 × 10−81, abdominal MRI: p = 0.0006). Regional associations were found between central obesity and with specific GM subcortical nuclei (thalamus, caudate, pallidum, nucleus accumbens). In contrast, no associations were found with WM volume or structure, or brain network efficiency. The effects of central obesity on GM volume were not mediated by C-reactive protein or blood pressure, glucose, lipids.ConclusionsCentral body-fat distribution rather than the overall body-fat percentage is associated with gray matter changes in people with obesity. Further work is required to identify the factors that mediate the association between central obesity and GM atrophy.

Effects of Central Obesity on Esophageal Epithelial Barrier Function.

We assessed if obesity perturbs the esophageal epithelial barrier function independent of promotion of gastroesophageal reflux (GER). Thirty-eight participants were divided into 4 groups: Obesity-/GER-, Obesity+/GER-, Obesity-/GER+, and Obesity+/GER+. Esophageal intercellular space and desmosome density (structural integrity) and fluorescein leak (functional integrity) were measured. The Obesity+/GER- group demonstrated increased intercellular space, reduced desmosome density, and increased fluorescein leak compared with control subjects. These changes were similar but not additive to findings seen in Obesity-/GER + and Obesity+/GER+ patients. Central obesity impairs structural and functional integrity of the esophageal barrier independent of GER, likely predisposing to esophageal injury.

PULSE WAVE REFLECTION AND GENDER DIFFERENCE IN OBESE INDIVIDUALS

Objective: Although obesity is considered a cardiovascular risk factor due to its association with metabolic syndrome, recent studies in obese subjects with heart failure have shown that they have reduced adverse outcomes compared to non-obese individuals. This is consistent with the “obesity paradox”. However, body mass index (BMI) conventionally used to classify obesity, does not distinguish body shape or body fat distribution. This study aimed to explore the association between BMI and/or central obesity parameters and measures of arterial hemodynamics to assess the effect of obesity on function of large arteries. Design and method: Data was obtained from 832 normal individuals and stable patients with regular heart rate attending an outpatient health assessment clinic at Ruijin North Hospital, Shanghai. Subjects were divided into 3 groups according to their Body Mass Index (BMI &lt; 24 normal, 24–28 overweight, &gt; 28 obese; Chinese classification). Radial arterial waveforms and carotid-femoral pulse wave velocity (cfPWV) (SphygmoCor, AtCor Medical, Sydney) were measured with subjects recumbent, and calibrated to brachial cuff systolic (BSP) and diastolic pressure (BDP). Results: Central augmentation pressure (CAP), augmentation index (CAIx, a measure of wave reflection) and pressure amplification were lowest in the obese group (p &lt; 0.001). BSP, CSP and cfPWV were highest in the overweight group, but only in females (p &lt; 0.05). In males, CAP, CAIx and pressure amplification were significantly less as BMI increased (p &lt; 0.05). In both sexes, central obesity measure of weight-to-height ratio (WHtR) was significantly different between BMI classes (p &lt; 0.05). WHtR may be more appropriately correlated with hemodynamic parameters despite remaining differences between sexes (p &lt; 0.05). Conclusions: Obesity in humans is associated with changes in the arterial pressure waveforms that are opposite of those usually described in aging and aortic stiffening. Differences are more obvious in males than females, and features of the “obesity paradox” are apparent when obesity is defined by BMI class only. Further study is warranted to investigate differences of associations between males and females, and effect of central obesity in males and females.

Effect of Central Obesity on Spread of Spinal Anesthesia

Effect of Central Obesity on Spread of Spinal Anesthesia

Effect of Central Obesity and Hyperandrogenism on Selected Inflammatory Markers in Patients with PCOS: A WHtR-Matched Case-Control Study.

White blood cell counts (WBC), lymphocyte-to-monocyte ratio (LMR), and monocyte-to-high-density lipoprotein cholesterol ratio (MHR) are used as chronic inflammation markers. Polycystic ovary syndrome (PCOS) is a constellation of systemic inflammation linked to central obesity (CO), hyperandrogenism, insulin resistance, and metabolic syndrome. The waist-to-height ratio (WHtR) constitutes a highest-concordance anthropometric CO measure. This study aims to access WBC, LMR, and MHR in PCOS and healthy subjects, with or without CO. Establishing relationships between complete blood count parameters, high-sensitivity C-reactive protein (hsCRP), and hormonal, lipid and glucose metabolism in PCOS. To do this, WBC, LMR, MHR, hsCRP, anthropometric, metabolic, and hormonal data were analyzed from 395 women of reproductive age, with and without, PCOS. Correlations between MHR, and dysmetabolism, hyperandrogenism, and inflammation variables were examined. No differences were found in WBC, LMR, MHR, and hsCRP between PCOS and controls (p > 0.05). PCOS subjects with CO had higher hsCRP, MHR, and WBC, and lower LMR vs. those without CO (p < 0.05). WBC and MHR were also higher in controls with CO vs. without CO (p < 0.001). MHR correlated with anthropometric, metabolic, and endocrine parameters in PCOS. WHtR appeared to strongly predict MHR in PCOS. We conclude that PCOS does not independently influence WBC or MHR when matched for CO. CO and dysmetabolism may modify MHR in PCOS and control groups.

The effect of central obesity on inflammation, hepcidin, and iron metabolism in young women.

In overweight and obesity (OW/OB), greater total body fat predicts higher serum hepcidin (SHep) which can impair iron homeostasis and increase risk for iron deficiency (ID). However, the effect of body fat distribution on SHep and iron homeostasis is unclear. In central obesity, interleukin (IL)-6 released from visceral adipose tissue into portal blood could strongly stimulate hepatic hepcidin synthesis. Thus, our hypothesis was that higher amounts of android fat, rather than gynoid fat, would predict impaired iron metabolism in OW/OB. In this cross-sectional study, we enrolled 117 otherwise-healthy women into two groups: normal weight; BMI < 25 (n = 36) and OW/OB; BMI ≥ 25 (n = 81); we then subdivided the OW/OB using DEXA into tertiles based on the ratio of android fat/total body fat (AF/TBF). We measured inflammation and iron status, and assessed iron absorption in two ways: by measuring erythrocyte isotope incorporation from a labeled test meal containing 6 mg 57Fe (representing dietary iron); and by measuring change in serum iron (ΔSeFe) after a 100 mg oral iron challenge (representing supplemental iron). Greater AF/TBF correlated with higher CRP, AGP, SHep, and TIBC, and lower transferrin saturation and SeFe/SHep ratio (for all, p < 0.05). Greater AF/TBF correlated with lower supplemental iron absorption (ΔSeFe) (p = 0.08) but not lower dietary iron absorption. In multiple regressions, AF/TBF positively predicted CRP (p < 0.001) and SHep (p < 0.05); a model including AF/TBF and serum ferritin as covariates explained 65% of the variance in SHep. AF/TBF negatively predicted TSAT (p < 0.05) and iron absorption (ΔSeFe) (p = 0.07). In contrast, the ratio of gynoid fat/total body fat was not significantly associated with these variables. Body fat distribution affects iron metabolism: women with greater central adiposity have higher SHep, greater impairments in iron homeostasis, and reduced iron absorption from a supplemental iron dose.

Effects of central obesity on maternal complications in Korean women of reproductive age

BackgroundConsidering the obesity-related complications in pregnancy and during delivery, prepregnancy central obesity may also affect pregnancy-related complications. This study aimed to assess the relationship between prepregnancy central obesity and adverse maternal outcomes in Korean women, by using the Korean National Health Insurance Service (NHIS) cohort. MethodsIn this population-based retrospective cohort study, we used data from the NHIS database, which contains information of health-care utilisation, diagnosis and prescription, and mortality for almost the whole Korean population, together with data from the NHIS health checkup database from 2005 to 2015. The NHIS health checkup data (645−280 days before childbirth) of mothers who had deliveries (total, 783,406 deliveries) from 2006 to 2015 were collected. For maternal adverse outcome data, we searched for diagnoses of maternal complications made during the period of 280 days before each delivery. The odds for maternal complications according to 8 body mass index (BMI) and 10 waist circumference (WC) categories were analysed using logistic regression. ResultsThe incidence rates of eclampsia/preeclampsia, caesarean section, multiple gestation, and polycystic ovary syndrome (PCOS) increased according to the increase of BMI and WC. In contrast, the incidence rate of premature rupture of membrane (PROM) was inversely correlated with BMI and WC. In the low BMI (<17.5 and 17.5–19.9 kg/m2) and low WC (<60 and 60.0–64.0 cm) groups, the odds of threatened abortion were elevated. ConclusionPrepregnancy WC was closely linked to some maternal complications, including eclampsia/preeclampsia, cesarean section, PCOS, and PROM, in a manner similar to prepregnancy BMI.

Effect of central obesity on cardiac structure in middle aged men having health examination from the Kailuan group

Effect of central obesity on cardiac structure in middle aged men having health examination from the Kailuan group

Effect of central obesity on serum lipid profile in non-diabetic, non-hypertensive subjects - A preliminary study

International Journal of Multidisciplinary Studies (IJMS) is published by the Faculty of Graduate Studies - University of Sri Jayewardenepura. IJMS provides a supportive environment for multidisciplinary researchers to publish their contribution to the academy of knowledge and wisdom. Focus of the journal is on multidisciplinary research which should cover at least two distinct disciplines.

Effect of central obesity on the events of new-onset cerebral infarction among type 2 diabetes mellitus patients

To analyze the effect of central obesity on new-onset cerebral infarction events among type 2 diabetes mellitus patients in the Kailuan Group. This was a prospective cohort study. In a total of 101 510 employees who had been carried out a healthy examination in Kailuan Group from Jul. 2006 to Oct. 2007. 8 306 type 2 diabetes mellitus patients were selected. According to the baseline waist measurement, the observed population was divided into two groups-with central obesity or without. The total period of follow-up was 38-53 (48.05 ± 3.09) months. 1) Mean age, BMI, the levels of SBP, DBP, pulse pressure, FPG, TC, LDL-C, uric acid significant increased in the central obesity group were higher than in the non-obese group (P < 0.01). 2) The incidence of new onset cerebral infarction in obese group was higher than that in the non-obese group (3.1% vs. 1.6%, 6.8%, P < 0.01; 3.3% vs. 1.7%, P < 0.01 in male respectively. 3) Results from the multiple logistic regression analysis showed that, compared with the non-obese group, the obese group had an increase of relative risk (RR) on new onset cerebral infarction events after adjustment on age, gender and other risk factors, with RR value as 2.07 (95%CI:1.39-3.09, P < 0.01). Type 2 diabetes mellitus patients with central obesity seemed to have increased the risk of new-onset cerebral infarction events.

Eating frequency is inversely associated with blood pressure and hypertension in Korean adults: analysis of the Third Korean National Health and Nutrition Examination Survey

A lower eating frequency (EF) has been suggested to be important in the development of cardiovascular risk factors such as obesity and hyperlipidemia. However, the association between EF and blood pressure (BP) remains unclear. The aim of this study was to explore the association of EF with BP and hypertension after adjusting for confounding variables, including body mass index (BMI) and waist circumference (WC). This cross-sectional study used data from the Third Korean National Health and Nutrition Examination Survey. A total of 4625 subjects aged ≥ 19 years were included. To explore the association of EF with BP and hypertension, we performed multiple linear regression analyses and multiple logistic regression analyses for survey design, respectively. EF was inversely associated with systolic BP (SBP) and diastolic BP (DBP). As EF increased from ≤ 2 to 3, 4 and ≥ 5 times per day, estimated adjusted means of both SBP and DBP decreased, showing a significant linear trend independent of obesity (SBP: 120.66, 120.23, 119.18 and 117.92 mm Hg, respectively; P<0.001; DBP: 78.36, 77.78, 77.25 and 76.50 mm Hg, respectively; P=0.004). The inverse association between EF and hypertension was gradually attenuated and significant after adjustment for confounding variables including BMI and WC (P=0.040). This study suggests that lower EF is significantly associated with higher BP, which may be partially mediated by the effect of central obesity. Further prospective studies are needed to verify this causal relationship.

Does adiponectin protect against the cardiovascular dysfunction associated with central adiposity in young women with polycystic ovary syndrome?

Purpose: To investigate the relationships between regional adiposity, adiponectin (APN), insulin resistance and cardiovascular function in young women with polycystic ovary syndrome (PCOS). Methods: We studied 180 women aged 16-45y (85 with PCOS, 95 healthy controls) free from overt cardiovascular disease or treated diabetes. Biochemical assays included high molecular weight APN, insulin resistance (HOMA-IR), and glucose and insulin area under the curve (AUC) following oral glucose tolerance test. Regional fat and lean mass were assessed by dual energy x-ray absorptiometry and computed tomography (total, subcutaneous and visceral fat area). Systolic and diastolic function measures included tissue Doppler velocities from echocardiography. Arterial stiffness was assessed using central pulse wave velocity (PWV) from applanation tonometry. Results: After adjusting for age and body mass index (BMI), PCOS subjects had higher glucose AUC, insulin AUC, HOMA-IR, testosterone (p-values all <.005) and, unexpectedly, APN (p=.02). There were no between group differences in cardiovascular measures following adjustment. APN was negatively associated with lean leg mass (r=-.620) and visceral fat (r=-.523) in PCOS subjects (both p<.001) but not in controls, while it was negatively associated with subcutaneous fat in both groups (PCOS r=-.387 [p<.001], controls r=-.244 [p=.022]). In controls, visceral fat (β=.206, p=.036) and age (β=.530, p<.001) were independent predictors of PWV; visceral fat (β=-.274, p=.003), age (β=-.586, p<.001) and insulin AUC (β=-.178, p=.039) were independent predictors of diastolic function. In contrast, there were no independent predictors of PWV in a similar model of PCOS subjects and age was the only independent predictor of diastolic function (β=-.488, p=.001). Conclusion: Despite having a worse metabolic profile, these young women with PCOS had similar cardiovascular function to control subjects of the same age and BMI. APN is a secretory protein which may have a cardio-protective effect. It has an inverse relationship with adiposity, and plasma levels are usually lower in insulin resistant states. APN levels were unexpectedly higher in PCOS subjects when age and BMI were controlled; the association with regional adiposity was different between the groups. Central adiposity was associated with arterial stiffness and diastolic dysfunction in control subjects but not in those with PCOS. Young women with PCOS may be protected against the effects of central obesity on arterial stiffness and diastolic function by a compensatory increase in APN.

Effect of Central Obesity on Prostate Specific Antigen Measured by Computerized Tomography: Related Markers and Prostate Volume

We assessed the effects of central adiposity represented by visceral adipose tissue on prostate volume, prostate specific antigen, and prostate specific antigen mass and mass ratio. This cross-sectional study included 6,389 Asian men 30 to 79 years old. Prostate volume was estimated by transrectal ultrasound. Visceral and subcutaneous adipose tissue was measured by computerized tomography. Multivariate linear regression analysis was done between prostate specific antigen related variables and obesity indexes such as body mass index, waist circumference, and visceral and subcutaneous adipose tissue after adjusting for age. Body mass index, waist circumference and subcutaneous adipose tissue were inversely associated with prostate specific antigen (p for trend <0.001) but visceral adipose tissue showed no associations with prostate specific antigen (p for trend = 0.740). Waist circumference, and visceral and subcutaneous adipose tissue were positively associated with prostate specific antigen mass (p for trend = 0.014, <0.001 and 0.036, respectively). However, body mass index did not show this association (p for trend = 0.372). Body mass index, waist circumference and subcutaneous adipose tissue negatively affected the prostate specific antigen mass ratio (each p for trend <0.05) but there was no such significant correlation for visceral adipose tissue (p for trend = 0.187). When adjusted for visceral adipose tissue body mass index was not associated with prostate volume (p for trend = 0.152) but visceral adipose tissue remained positively associated with prostate volume even after adjusting for body mass index (p for trend = 0.005). Visceral adiposity is the main determining factor of the prostate volume increase and prostate specific antigen production.

The influence of hip circumference on the relationship between abdominal obesity and mortality

Background Higher waist circumference and lower hip circumference are both associated with increased cardiovascular disease (CVD) risk, despite being directly correlated. The real effects of visceral obesity may therefore be underestimated when hip circumference is not fully taken into account. We hypothesized that adding waist and hip circumference to traditional risk factors would significantly improve CVD risk prediction.Methods In a population-based survey among South Asian and African Mauritians (n = 7978), 1241 deaths occurred during 15 years of follow-up. In a model that included variables used in previous CVD risk calculations (a Framingham-type model), the association between waist circumference and mortality was examined before and after adjustment for hip circumference. The percentage with an increase in estimated 10-year cumulative mortality of >25% and a decrease of >20% after waist and hip circumference were added to the model was calculated.Results Waist circumference was strongly related to mortality only after adjustment for hip circumference and vice versa. Adding waist and hip circumference to a Framingham-type model increased estimated 10-year cumulative CVD mortality by >25% for 23.7% of those who died and 15.7% of those censored. Cumulative mortality decreased by >20% for 4.5% of those who died and 14.8% of those censored.Conclusions The effect of central obesity on mortality risk is seriously underestimated without adjustment for hip circumference. Adding waist and hip circumference to a Framingham-type model for CVD mortality substantially increased predictive power. Both may be important inclusions in CVD risk prediction models.

Central Obesity and Comorbidity Risk in Hemodialysis Patients: A Cross Sectional Study in Lebanon

Introduction: Abdominal deposition of fat has been described as the type of obesity that offers the greatest risk for the health of individuals, and is associated with increased mortality, and morbidity. Conicity index (Ci), Body mass index (BMI), and waist hip ratio (WHR) are used to predict the risk of obesity related diseases. However, it has not been ex amined whether these indicators can predict the comorbidities in hemodialysis subjects in Lebanon. Objective: to determine the effect of central obesity on comorbidities in hemodialysis patients in Lebanon. Material and Method: This is a cross-sectional study of obesity in 60 hemodialysis subjects in Lebanon. A linear regression analysis was used to determine the relationship between BMI, Ci, WHR, and comorbidities measured by Charlson (CCI) and Davies comorbidities indexes. Results: Ci values were significantly associated with age, and CCI; the abdominal fat deposition evaluated by the conicity index and WHR were a predictor of the comorbidities according to CCI (= 2.96; p = 0.01), and Davies comorbidity index (= 1.19; p = 0.05) scores. BMI was a weak predictor of comorbidity. Conclusion: Abdominal obesity by using simple anthropometric measurements e.g. Ci, and WHR values can similarly predict the presence of comorbidities in hemodialysis patients. Maintaining appropriate Ci and WHR values might be important to improve outcome in hemodialysis patients.

Effect of Central Obesity, Low High-Density Lipoprotein Cholesterol and C-Reactive Protein Polymorphisms on C-Reactive Protein Levels During Treatment With Rosuvastatin (10 mg Daily)

Plasma levels of high-sensitivity C-reactive protein (hsCRP) are an important predictor of cardiovascular disease, and achievement of lower targets of hsCRP with rosuvastatin treatment was associated with improved cardiovascular outcomes. The aim of this study was to examine whether hsCRP levels were related to genetic variants and traditional cardiovascular risk factors in Chinese patients treated with rosuvastatin 10 mg/day. The relations were analyzed between on-treatment plasma hsCRP concentrations and cardiovascular risk factors and 14 single-nucleotide polymorphisms in CRP and other candidate genes. In 281 patients with a median plasma hsCRP level of 0.81 mg/L (interquartile range 0.46 to 1.86), higher hsCRP levels were significantly associated with female gender, greater waist circumference (WC), having diabetes, higher triglycerides, and lower high-density lipoprotein (HDL) cholesterol. Three single-nucleotide polymorphisms (rs1205, 3872G>A and rs2808630, 5237A>G in CRP and rs1169288, I27L in HNF1A) were independently associated with hsCRP levels before and after adjustment for other variables. WC and the CRP rs1205 polymorphism showed the strongest relations with hsCRP, and in multiple regression analysis, gender, WC, diabetes, triglycerides, HDL cholesterol, and the 3 genetic variants explained 35.5% of the variance in hsCRP levels. The 2 CRP polymorphisms, female gender, higher WC, and lower HDL cholesterol were associated with risk for having CRP concentrations ≥ 1 mg/L. In conclusion, central obesity, low HDL cholesterol, and CRP polymorphisms are major determinants of higher hsCRP levels in Chinese patients receiving treatment with rosuvastatin.

Targeting MCP-1 to Reduce Vascular Complications of Obesity

Obesity is a risk factor for complications of atherosclerotic vascular disease such as myocardial infarction. Recent studies and several patents have demonstrated that the cardiovascular risk associated with obesity is correlated particularly with visceral adiposity. Excess visceral adiposity may increase vascular risk due to secretion of cytokines and chemokines by cellular constituents of the adipose tissue. The secretory profile of various adipose depots may be regulated by the influx of macrophages that has been shown to occur with expansion of fat stores. This macrophage infiltration may lead to a chronic low grade, systemic, inflammatory state. Since circulating markers of inflammation are associated with cardiovascular events, the inflammation triggered by visceral fat may contribute to an increased risk for vascular complications. While the vasculopathic effects of central obesity may be best treated by weight loss, long term weight loss is difficult to achieve, even with currently available pharmacotherapies. Therapies that target macrophage accumulation in fat or secretory products of adipose tissue may be potentially beneficial in reducing the vascular risk associated with obesity. A potential therapeutic target is monocyte chemoattractant 1 (MCP-1), which is a potent chemokine that is elevated in obesity. Since MCP-1 promotes atherosclerosis, inhibition of MCP-1 may be effective in reducing the vascular risk associated with obesity.

Association of Serum Leptin Levels With Homeostasis Model Assessment–Estimated Insulin Resistance and Metabolic Syndrome: The Key Role of Central Obesity

Leptin is correlated with several features of metabolic syndrome; however, possible confounders (eg, obesity) of this association are not known. This study evaluated the relationship between leptin, metabolic syndrome, and insulin resistance in an Iranian population and further investigated whether this relationship is confounded by obesity or central obesity. A total of 387 participants (18-65 years old) who referred to a large university general hospital for routine health examinations were categorized into 2 groups with (n = 130) and without (n = 257) metabolic syndrome. Fasting plasma glucose, insulin, lipids, and leptin levels were measured and the homeostasis model assessment of insulin resistance (HOMA-IR) was calculated. Metabolic syndrome was defined according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria. Age- and sex-adjusted leptin levels were significantly higher in patients with than those without metabolic syndrome (29.62 +/- 1.67 vs. 18.50 +/- 1.21 ng/mL, P < 0.001). After adjustment for age, sex, and body mass index (BMI), leptin values were significantly correlated with HOMA-IR (P < 0.001), metabolic syndrome, and its components (P < 0.05). After adjustment for waist circumference, however, these associations were no longer statistically significant. We demonstrated that high leptin levels are associated with insulin resistance and metabolic syndrome independent of BMI but these associations are significantly mediated through the effects of central obesity.