Leptin Values Research Articles

Ghrelin, leptin and insulin in healthy children: Relationship with anthropometry, gender, and age distribution

ObjectivesThis study aimed to establish the relationship between total ghrelin, acyl ghrelin, des-acyl ghrelin, leptin, and insulin with anthropometry, gender, and age distribution in healthy children. ResultsData from 111 healthy children aged 4months to 10years were studied. All the participants underwent a pre-study screening clinical evaluation and were separated in 3 age groups. All had blood collected to assay. Anthropometric parameters were measured according to World Health Organization. In order to determine the correlation between dependent and independent variables, a multiple linear regression analysis was used. Overall median age of subjects was 60.0months. After multiple regression analysis, correlation between total ghrelin, acyl ghrelin and des-acyl ghrelin remained significant with age. Correlation between leptin values and age, body mass index-for-age ratio, height-for-age ratio, and female gender remained significant. There was no significant correlation between insulin and ghrelin, and between insulin and leptin in all age groups. There was an inverse significant correlation between total ghrelin and des-acyl ghrelin with leptin in the whole group. ConclusionsGhrelin showed an inverse correlation with age and leptin showed a direct correlation with anthropometric parameters and female gender in healthy children. Insulin did not show any correlation.

Circunferência da cintura e relação cintura/estatura: úteis para identificar risco metabólico em adolescentes do sexo feminino?

OBJETIVO: Avaliar se a medida da circunferência da cintura e a relação cintura/estatura (RCE) são preditoras de fatores de risco cardiovasculares em adolescentes do sexo feminino. MÉTODOS: Avaliaram-se 113 adolescentes de 14 a 19 anos quanto à antropometria (peso, estatura e circunferência da cintura), parâmetros bioquímicos e clínicos (colesterol total, LDL-C, HDL-C, triglicerídeos, glicemia de jejum, insulina, homeostasis model assessment to assess insulin resistance - HOMA-IR, leptina, homocisteína e pressão arterial). Considerou-se como ponto de corte de obesidade abdominal valores de cintura e RCE>percentil 90. RESULTADOS: As adolescentes com obesidade abdominal apresentaram valores significantemente maiores de triglicerídeos (exceto para a RCE), insulina, HOMA-IR, leptina, pressão arterial sistólica e diastólica; o HDL-C foi mais baixo no grupo com cintura >percentil 90, porém sem significância estatística (p=0,052). CONCLUSÕES: O presente estudo demonstrou que a cintura e a RCE são medidas úteis para identificar adolescentes do sexo feminino com maior risco cardiovascular; contudo, a circunferência da cintura, isoladamente, apresentou melhor desempenho.

Obesity Prevention and Treatment

Obesity Prevention and Treatment

Gestational Diabetes Mellitus Causes Changes in the Concentrations of Adipocyte Fatty Acid–Binding Protein and Other Adipocytokines in Cord Blood

OBJECTIVETo determine the concentrations of adipocyte fatty acid–binding protein (AFABP) and other adipocytokines in maternal and cord serum of pregnant women with gestational diabetes mellitus (GDM) and of control subjects and to relate them to indexes of insulin sensitivity.RESEARCH DESIGN AND METHODSIn 86 control and 98 GDM pregnant women, venous blood was collected before vaginal delivery and arterial blood from cord immediately after delivery. Serum insulin and adipocytokines were measured by enzyme-linked immunosorbent assay (ELISA).RESULTSGDM women had higher prepregnancy BMI, and data were adjusted for it. Maternal serum insulin, insulin-to-glucose ratio, homeostasis model assessment (HOMA), AFABP, and retinol-binding protein 4 (RBP4) were higher and adiponectin was lower in GDM than in control subjects, whereas serum glucose, insulin, insulin-to-glucose ratio, HOMA, nonesterified fatty acids, and RBP4 were higher and glycerol, AFABP, and adiponectin were lower in cord blood serum of GDM than of control subjects. AFABP and adiponectin in cord serum of control subjects were higher than in maternal serum; in GDM women no difference was found for AFABP in cord versus maternal serum, although adiponectin remained higher in cord. Values of leptin in both groups were lower in cord than in maternal serum, and those of RBP4 were lower in only GDM women.CONCLUSIONSIt is suggested that fetal tissues are the main source of cord arterial serum AFABP, and in GDM fetuses AFABP values correlate with adiposity markers. A downregulation of adiponectin and upregulation of RBP4 in GDM mothers and their fetuses may be related to their insulin-resistant condition, whereas changes in AFABP do not seem to be related.

The response of serum leptin, cortisol and zinc concentrations to concurrent training

To investigate the effects of concurrent training (CT) on serum leptin, cortisol and zinc concentrations in physically active adults. Ten subjects aged (27.1±4.8 years, BMI 25.49 ± 2.65) were recruited to participate in three sessions: control session (CS), concurrent training 1 (CT1) and concurrent training 2 (CT2) sessions with five days of resting between them. In each session blood samples for leptin, cortisol and zinc determination were collected. CT1 session included indoor cycling class followed by strength training. CT2 session included strength training, followed by indoor cycling class. In CS there were no exercises. The Shapiro-Wilk test, repeated ANOVA test and Tukey Post-Hoc test were used. There was a reduction in leptin levels after CT1 (Δ% = -16.04; p = 0.05) and CT2 (Δ% = -8.54; p = 0.02). Cortisol also showed a reduction after CT1 (Δ% = -26.32; p = 0.02) and CT2 (Δ% = -33.57; p = 0.05), whereas zinc did not show any significant alterations after any of the training sessions. There was also significant difference for the leptin and cortisol values between CT1 and CT2. CT promoted reduction in serum leptin and cortisol levels independently of the training order, while no significant changes in zinc concentrations were observed.

English

The purpose of this study was to measure serum leptin and insulin levels of 16 female judokas between the ages of 16 and 19 in the Turkish national judo team and to compare the values before and after 6-week training program height and weight values of athletes participated in the study were measured before and after the training period. The percentage of body fat was measured by Holtain brand skin fold and body mass index (BMI) was calculated with the weight (kg) / Heigth (m2) formula. Aerobic capacity was measured by 20 m shuttle run test and anaerobic capacity was measured by vertical jump test. Insulin and leptin values of female judokas participated in the study were measured from the blood samples taken from venous vessels. Measurement values were expressed as ng/ml. Wilcoxon paired two-sample test and SPSS (Statistical Package for the Social Sciences) version 16 statistical program package were applied for the arithmetic mean and standard deviation of data and Z values obtained from study and calculated at the p <0.05 significance level at the end of the statistical analysis, a reduction of -3.52 at weight values and a significant difference (according to p <0.05) of 3.52 at BMI values of pre-and post-training values, -3.21 at body fat percentage, -3.52 at aerobic power, -2.43 at anaerobic power and -1.97 at leptin levels were observed. Also, a non-significant change of 0.57 (according to p <0.05) at pre-and post-training values of insulin level was observed. At the end of this study, it was observed that judo competition term preparation training decreases weight, body mass index, and body fat content and leptin values but not changes the insulin value.   Key words: Leptin, insulin, judokas, aerobic power, anaerobic power.

Plasma adipocytokine and ghrelin levels in relation to bone mineral density in prepubertal rhythmic gymnasts

The aim of the present study was to investigate possible differences in plasma adipocytokine and ghrelin levels and body composition parameters in prepubertal rhythmic gymnasts (RG) and untrained controls (UC), and to examine the relationships of bone mineral density (BMD) with hormonal status in prepubertal children with different physical activity patterns. Eighty-nine 7- to 9-year-old girls participated in the study (RG, n = 46; UC, n = 43). Body composition and BMD were measured by dual-energy X-ray absorptiometry. Bone maturity was estimated by using a radiograph of the nondominant hand. The measured whole-body, lumbar spine (LS), and femoral neck (FN) BMD values were significantly higher (P < 0.05) in gymnasts than in controls. In addition, RG presented significantly lower and higher values (P < 0.05) for leptin and ghrelin concentrations, respectively, in comparison with UC. No differences were observed for adiponectin levels between the studied groups. No relationships between measured BMD values with leptin and ghrelin were observed even after adjustment for age and fat mass (FM) in RG. Whole-body and LS BMD values were significantly correlated with leptin after controlling for age and FM (r = 0.32, P < 0.05) in UC. Femoral neck BMD remained significantly correlated with ghrelin after adjusting for age and FM (r = -0.4, P < 0.05) in UC. No relationships were found between measured BMD values and adiponectin even after controlling for age and FM values in both groups. In conclusion, although all measured BMD values were significantly higher in RG, plasma adipocytokine and ghrelin concentrations were not directly related to bone mineralization in prepubertal RG in contrast to UC.

Role of Baseline Leptin and Ghrelin Levels on Body Weight and Fat Mass Changes after an Energy-Restricted Diet Intervention in Obese Women: Effects on Energy Metabolism

Hormones related to energy balance control may play an important role on weight loss resistance after low-caloric diet (LCD) intervention. To investigate the predictive value of baseline leptin and ghrelin on body fat mass (FM) loss after 12 wk of LCD intervention and to study whether these associations could be related to changes in resting metabolic rate (RMR). The study comprised a total of 78 obese women (age 36.7 ± 7 yr). We measured, before and after the LCD intervention, FM (dual-energy x-ray absorptiometry) and RMR (kilojoules per kilogram body weight per day, indirect calorimetry). We also analyzed fasting serum leptin and ghrelin, and leptin to ghrelin ratio was calculated. FM and RMR changes (data at baseline - data after the intervention) were assessed. Baseline serum leptin (r = -0.301; age- and baseline FM-adjusted P = 0.009) and ghrelin (r = 0.314, adjusted P = 0.014) levels as well as leptin to ghrelin levels (r = -0.331; adjusted P = 0.009) were significantly correlated with FM changes. Leptin to ghrelin ratio was significantly correlated with RMR at baseline and after the LCD (both P < 0.010). Baseline leptin to ghrelin ratio significantly predicted changes in RMR after the LCD (r = 0.298; P = 0.019) regardless of age, baseline RMR, and total body weight (r = 0.307; P = 0.016) or FM loss (r = 0.312; P = 0.015). Obese women with higher leptin and lower ghrelin levels at baseline seem to be more resistant to FM loss. The leptin to ghrelin ratio could be proposed as a biomarker for predicting metabolic adaptations to energy restriction treatment and, if confirmed in future studies, as a predictor of treatment success/failure.

Metabolic Activity of Human Chorionic Gonadotropin (hCG) on Glycemia and Leptinemia in Experimental Animals Fed a Cafeteria Diet

Abstract Objectives: To elucidate the relationship of hCG administration to glycemia, Non Esterified Fatty Acids (NEFA), leptin and adiponectin levels on experimental animals previously submitted to a cafeteria diet, and then to a Low Calorie Diet (LCD). Design: Forty-one rats were selected (21 females, 20 males) and divided into seven (0-6) groups. Animals from groups 1 to 6 were fed a &amp;quot;cafeteria diet&amp;quot; with a mean energy content of 10% protein, 30% carbohydrate and 60% fat. Animals from group 0 were fed the standard laboratory diet. After the fattening period, animals from groups 1 to 6 were submitted to a restricted diet consisting of one-third the average daily intake for rats. hCG was administered for five weeks according to a specific protocol. The effects of hCG treatment were evaluated using analysis of variance (ANOVA). Results: These assessments were compared: (1) glycemia, adiponectins, leptins and non-esterified fatty acids (NEFA); (2) weight; (3) formulation effect; and (4) dose effect. Differences in leptins were observed between the Control group and Injectable A (p=0.026), Intrarectal Suspension A (p=0.20), Intrarectal Suspension B (p&amp;lt;0.001), and Intrarectal Suspension C (p&amp;lt;0001) groups. In all cases, the average values were higher for the control group. Significant differences were found in the groups treated with Injectable B, Intrarectal Suspension B (p=0.025) and Intrarectal Suspension C (p=0.037). Groups receiving Intrarectal Suspension B or C showed significantly lower mean leptin values. Differences in glycemia were detected between the Control group and Intrarectal Suspension A (p=0.021) and Intrarectal Suspension B (p=0.020) groups. Groups treated with Intrarectal Suspension A or B showed lower mean blood glucose values. Conclusions: Results show the activity of hCG (both urinary and recombinant) on glycemia and leptins levels in experimental animals in different formulations.hCG administration significantly decreased blood sugar and leptin levels, whereas adiponectins were only relatively sensitive to hCG.

Relationship between osteoporosis and adipose tissue leptin and osteoprotegerin in patients with chronic obstructive pulmonary disease

Introduction The role of fat–bone interactions in the pathogenesis of osteoporosis in chronic obstructive pulmonary disease (COPD) is poorly understood. Our aim was to investigate expressions of leptin and osteoprotegerin (OPG) in the adipose tissue, and their relationships to osteoporosis in patients with COPD. Methods In 39 patients with stable COPD, bone mineral density (BMD) and body composition was assessed by Dual Energy X-Ray Absorptiometry. Serum leptin was determined by the enzyme-linked immunosorbent assay, and bone turnover markers osteocalcin and β-crosslaps by the electrochemiluminiscence immunoassays. Subcutaneous adipose tissue samples were analyzed using real-time PCR. Results Twenty-one patients without, and 18 with osteoporosis were enrolled (35 men; age 62.2 ± 7.3 years). Compared to patients without osteoporosis, those with the disease had significantly lower serum levels and adipose tissue expressions of leptin, in association with increased serum β-crosslaps ( p = 0.028, p = 0.034, p = 0.022, respectively). Log adipose tissue leptin was inversely related to serum β-crosslaps ( p = 0.015), and directly to serum leptin ( p < 0.001) and to the total, femoral, and lumbar BMD and T-score ( p < 0.02 for all relationships). Adipose tissue OPG expression was related to all variables of bone density except for lumbar BMD and T-score ( p < 0.05 for all relationships). Log adipose tissue leptin and OPG expressions predicted femoral T-score independently of age, gender and pulmonary function ( p < 0.001, adjusted R 2 = 0.383; p = 0.008, adjusted R 2 = 0.301, respectively). Introducing body mass (or fat mass) index into these models eliminated independent predictive value of leptin and OPG expressions. Conclusion Our results suggest that adipose tissue leptin and OPG expressions are related to osteoporosis in patients with COPD, and appear to act as mediators between fat mass and BMD.

Lipid and Hematological Parameters in Hyperleptinemic Healthy Arab Male Youth in Jordan

To analyze the influence ofhyperleptinemia on fasting lipid and hematological parameters in healthy Arab male youth in Jordan, this cross-sectional study was carried out in April 2009 on a sample of 120 students aged 18-24 years. Subjects were stratified by fasting leptin into two groups (control, <12.7 ng mL(-1) vs. hyperleptenimic, e_< 12.7 ng mL(-1)) and BMI (normal weight, < 25 kgm(-2) vs. overweight/obese, BMI e_< 25 kg m(-2)). Fasting serum leptin, blood glucose, lipid profile and hematological parameters values were determined by standard kit methods. Mean serum leptin concentrations were more than five times as high in hyperleptenemic subjects than in control subjects (p < 0.001). Compared with control group, significant elevations (p < 0.01) were observed in the means total cholesterol, LDL cholesterol and triglyceride levels of hyperleptenemic group whereas no significant differences was detected in HDL-cholesterol. Except the changes of WBC count, MCH and slightly MCHC, there were no differences between both groups in any other term of hematological parameters. In conclusion, changes in lipid variables and some hematological parameters may increase plasma viscosity as a step during atherosclerosis pathogenesis in male youth at risk for dyslipidemia and cardiovascular diseases. Thus, hyperleptinemia could be a useful index in identifying healthy youth male subjects but this hypothesis needs further investigation.

Metabolic adaptations in neonatal mother-deprived rabbits

In order to study the metabolic adaptation in response to 48 h transient doe-litter separation (DLS) in young rabbits (5 rabbits/d group) between postnatal 9 and 11 d, plasma concentrations of thyroid hormones T3 and T4, insulin, leptin, glucose, triglycerides (TG), and free fatty acids (FFA) were examined before (6-8 d), during (9-11 d), and after separation (12-16 d). T3 concentrations in newborn control rabbits gradually increased from 0.6 ng/mL at postnatal 6 d to 1.0 ng/mL at postnatal 16 d, whereas those of T4 remained fairly constant (25 ng/mL) up to postnatal 14 d, when T4 gradually declined to 8 ng/mL. T3 values of DLS newborn rabbits did not differ from those of controls at postnatal 10 and 11 d, but were lower (P&lt;0.05) at postnatal 12 d, while T4 concentrations in DLS animals increased, although not significantly, between postnatal 10 and 12 d compared to controls. Insulin concentrations in young control rabbits ranged between 0.6 and 1.0 mg/L in the early postnatal days, whereas those for leptin averaged 2-3 ng/mL. Insulin and leptin values in DLS newborn rabbits were lower (P&lt;0.05) at postnatal 10 and 11 d, but thereafter rebounded to levels close to those of controls. Glycaemia showed a comparable trend in both groups, ranging between 170 and 190 mg/dL up to postnatal 14 d, but thereafter decreased (P&lt;0.05) to values of 120-130 mg/dL independently of treatment. Concentrations of TG varied greatly from day to day around a mean value of 300 mg/dL, whereas those of FFA remained at approximately the same steady-state levels from postnatal 6 to 16 d, averaging 0.8 mM without any significant differences between groups. In conclusion, these findings confirm that newborn rabbits can cope with the metabolic stress of starvation associated with DLS by lowering insulin and leptin concentrations while maintaining those of thyroid hormones, an overall endocrine response which, together with temporary increase of glucorticoids, successfully maintains an adequate energy balance.

Waist circumference modifies the relationship between the adipose tissue cytokines leptin and adiponectin and all-cause and cardiovascular mortality in haemodialysis patients

the relationships between the adipose tissue cytokines leptin and adiponectin (ADPN) and clinical outcomes have not been well studied in haemodialysis (HD) patients and remain highly controversial. As central obesity is an important modifier of the effect of various risk factors for clinical outcomes, we tested the hypothesis that waist circumference (WC) modifies the link between these cytokines and both overall and cardiovascular death in HD patients. a total of 537 HD patients participated in a prospective cohort study. leptin and ADPN were inversely related to each other and robustly associated with WC (P < 0.001). During follow-up (average 29 months, range 1-47 months) 182 patients died, including 115 from cardiovascular causes. In analyses adjusting for potential confounders, there were strong interactions between leptin and WC in relationship to both all-cause (P < 0.001) and cardiovascular death (P = 0.002). Accordingly, a fixed excess of leptin signalled a gradually increasing risk for all-cause and cardiovascular mortality in patients with a large WC but an opposite effect in those with a relatively small WC. An interaction between ADPN and WC for all-cause (P = 0.01) and cardiovascular mortality (P = 0.01) emerged only in models excluding the leptin-WC interaction, suggesting that these adipokines share a common pathway leading to adverse clinical events in HD patients. the predictive value of leptin and ADPN for all-cause and cardiovascular death in HD patients appears to be critically dependent on WC. These findings support the hypothesis that disturbances in adipokine levels are involved in adverse clinical outcomes in HD patients with abdominal obesity.

Pediatric burn and key regulatory cytokines: Impact of burn surface area and sepsis on the clinical outcomes

AbstractBurn is an injury which is not only devastating for the patients but also puts a great burden on the society by consuming enormous health care resources. Despite improvements in burn wound care and treatment, understanding the role of key pro-/anti-inflammatory cytokines in pathogenesis of burn injury, sepsis and survival requires clarification. This work aimed at measuring plasma levels of the following cytokines: leptin, tumor necrosis factor (TNF)-α, interleukin (IL)-6, transforming growth factor (TGF)-α, and basic fibroblast growth factor (bFGF), procalcitonin (PCT) and C-reactive protein (CRP) in children with thermal burn (n = 42; 22 males and 20 females with an age range of two months up to 7 years) vs. sex and age matched healthy controls (n = 26; 12 males and 14 females with an age range of six months up to 8 years). The venous samples were drawn from patients at 2nd and 8th day postinjury. The relationship between measured plasma cytokines with length of hospital stay, total burn surface area (TBSA), sepsis, survival and complete blood count were investigated. The fatality rate was 28.6% (n = 12). At the 2nd day of postinjury, burn cases showed significantly higher values of WBC, CRP, PCT, TNF-α, IL-6, leptin, bFGF, and TGF-α than healthy controls. At the 8th day of postinjury, sepsis caused further significant elevations of WBC, CRP, PCT, TNF-α and IL-6 levels but significantly lower TGF-α levels than cases without sepsis. At the 8th day of postinjury, patients with larger TBSA (&gt; 30%) demonstrated significantly higher values of WBC, CRP, PCT, TNF-α, and IL-6, but significantly lower levels of bFGF and TGF-α than cases with smaller TBSA (≤ 30%). At the 8th day of postinjury, non-survivors showed significantly higher levels of WBC, CRP, PCT, TNF-α and IL-6, but significantly lower levels of leptin, bFGF, and TGF-α than survivors. Correlation studies showed significant positive correlation between TBSA and each of IL-6, TNF-α and leptin levels. Except for bFGF and TGF-α levels that were reduced, the increases in other parameters (PCT, TNF-α and IL-6) were directly proportionate to the burn severity, sepsis and fatality. Both bFGF and TGF-α correlated with poor prognostic burn healing in severe septic cases. PCT and/or IL-6 are valuable biomarkers for early detection of burn infections. TGF-α, bFGF and leptin being immuno- and angiogenic modulators might reduce inflammation and post-burn immune dysfunction and enhance burn healing.

1093 Serum Leptin Levels According to Gender in Obese Children

Overall prevalence of obesity in children has increased over the world. Leptin plays an important role in the pathogenesis of obesity. In obese persons leptin levels are higher than physiological concentration. The objective of this study was to evaluate the relationship between leptin and gender in obese children. Matherial and Method: A prospective study was carried out in the Ist Pediatric Clinic from Targu- Mures between September and 2005 December 2008; a lot of 86 children divided into two lots with similar age and sex structure: lot I with high BMI (17 girls, 24 boys) and lot II with low BMI (18 boys, 27 girls). Leptin serum conentrations were measured and correlations between serum leptin and gender were examined by linear regression and Pearson product-moment correlation analyses. Results: Comparing the values of serum leptin in girls with high BMI and low BMI, we observed that leptin is much higher in group with high BMI than in the group with low BMI, with a significant difference between the two groups (p < 0.01); significant differences exist between leptin in girls with high BMI compared to leptin in boys with high BMI (p < 0,01). In boys, with aging, leptin values approaching to those of adults, with a negative linear correlation between age and leptin regardless of BMI. Conclusion: In guys, whether with high or low BMI, leptin values are similar and much lower compared to lots of girls. High leptin levels appear in all obese children with high BMI.

Leptin and Interleukin-1&amp;#946; Modulate Neuronal Glutamate Release and Protect Against Glucose-Oxygen-Serum Deprivation

Molecular mechanism underlying leptin-mediated neuronal protection against glucose-oxygen-serum deprivation (GOSD) insult was investigated by focusing on the interactions among leptin, Interleukin-1beta (IL-1beta) and glutamate and their impacts on the growth of neurons under GOSD. The trypan blue dye exclusion assay, 4', 6-diamidino-2-phenylindole (DAPI) assay, cytokine antibody array assay, immunocytochemical staining assay, glutamate determination kit, immunoblocking and chemical blocking strategies were applied to serve the study goal. Results showed that in response to 6 h of GOSD, cortical neurons can secrete significant amounts of leptin and IL-1beta to protect neurons from GOSD-induced cell damage. Serine/threonine kinase Akt (Akt) and extracellular signal-related kinase (ERK) inhibitors significantly reversed leptin-mediated neuroprotection. GOSD-induced IL-1beta was further enhanced by leptin in Akt/ERK-dependent manner. Blockade of endogenous leptin with specific antibodies significantly inhibited GOSD-induced IL-1beta expression and increased glutamate release from GOSD neurons. IL-1 blockade with IL-1 receptor antagonist (IL-1ra) on the other hand, inhibited leptin-mediated neuroprotection and suppression of glutamate release from GOSD neurons. Pre-treating GOSD neurons with leptin and IL-1beta in combined significantly increased their survival but decreased their releases of glutamate. The results indicate that leptin may act through Akt and ERK signaling pathways to protect neurons from GOSD insult; the protection was in part IL-1beta dependent and through which the glutamate release from GOSD neurons was inhibited. Therapeutic values of leptin and IL-1beta were suggested in the treatment of cerebral ischemia at early stage.

Hyperleptinemia positively correlated with metabolic syndrome in renal transplant recipients

Our aim was to evaluate the relationship between metabolic syndrome and fasting serum leptin concentration in renal transplant recipients. Fasting blood samples were obtained from 55 renal transplant recipients. Metabolic syndrome and its components were defined using the diagnostic criteria of the International Diabetes Federation. Thirteen patients (23.6%) had metabolic syndrome. Fasting leptin concentrations were positively correlated with metabolic syndrome (p=0.003). Univariate linear regression analysis indicated fasting serum leptin values were positively correlated with waist circumference (r=0.284; p=0.036), body mass index (r=0.358; p=0.007), body fat mass (r=0.610; p<0.001), triglycerides (r=0.268; p=0.048), high-sensitivity C-reactive protein (hs-CRP) (r=0.377; p=0.005), triceps skinfold (r=0.335; p=0.012), and mid-arm fat area (r=0.351; p=0.009). Multivariate forward stepwise linear regression analysis of the significant variables revealed that body fat mass (R2 change=0.373; p<0.001) and hs-CRP (R2 change=0.045; p=0.049) were the independent predictors of fasting serum leptin concentration. Serum leptin concentration correlates positively with metabolic syndrome in renal transplant recipients.

Association of plasma leptin levels and insulin resistance in diabetic women: a cross-sectional analysis in an Iranian population with different results in men and women

Objectives. The objective of this study was to assess the association of serum leptin levels with insulin resistance (IR), metabolic syndrome (MetS), lipid levels, and glucose control in an Iranian type 2 diabetic population.Findings. In this cross-sectional analysis, 132 type 2 diabetic patients (79 women) and 71 healthy non-diabetic and non-hypertensive individuals (40 women; as control subjects) were included. Homeostasis model assessment (HOMA) of insulin values ≥ 1.8 for females and 1.7 for males was regarded as the cut-point of IR. MetS was defined according to updated 2005 NCEP ATP III criteria. The leptin correlated with HOMA-IR values without adjustment (r = 0.24; p < 0.005) and with adjustment for sex and diabetes (r = 0.44; p < 0.005). Sex had significant effect on the BMI adjusted association of HOMA-IR (quintiles) and leptin (df = 4 F(12.7) = 3.5; p = 0.011). In diabetic women (but not men), leptin levels were different between those with and without IR (27.3 ± 1.9 vs. 18.2 ± 3.3; p < 0.05). BMI adjusted leptin values were different between subjects with and without MetS (22.2 ± 1.7 vs.14.8 ± 1.2; p < 0.001). No association was noticed between BMI-adjusted leptin with glycated hemoglobin or blood lipid levels.Conclusions. In this study, plasma leptin concentration correlated with IR independent of the effect of obesity in female but not male diabetic subjects.

MRI assessment of lean and adipose tissue distribution in female patients with Cushing’s disease

Chronic hypercortisolemia due to Cushing's disease (CD) results in abnormal adipose tissue (AT) distribution. Whole-body magnetic resonance imaging (MRI) was used to examine lean and AT distribution in female patients with CD to further understand the role of glucocorticoid excess in the development of abnormal AT distribution and obesity. Cross-sectional and case-control study. Fifteen women with CD and 12 healthy controls. Mass of skeletal muscle (SM) and AT in the visceral (VAT), subcutaneous (SAT), and intermuscular (IMAT) compartments from whole-body MRI and serum levels of insulin, glucose, and leptin were measured. CD patients had leptin values that correlated to total AT (TAT) and SAT (P < 0.05) but not to VAT. CD patients had higher VAT/TAT ratios (P < 0.01) and lower SAT/TAT ratios (P < 0.05) compared to controls. TAT, VAT, and trunk SAT (TrSAT) were greater in CD patients (P < 0.01). SM was less in CD (P < 0.001) but IMAT was not different. TAT, VAT, trSAT, and the proportion of AT in the visceral depot were greater in CD although the proportion in the subcutaneous depot was less. SM was less but IMAT was not different. These findings have implications for understanding the role of cortisol in the abnormal AT distribution and metabolic risk seen in patients exposed to chronic excess glucocorticoids.

MAJOR ADIPOSE TISSUE CYTOKINES LEPTIN AND ADIPONECTIN INTERACT WITH CENTRAL OBESITY IN EXPLAINING THE VARIABILITY IN ALL-CAUSE AND CARDIOVASCULAR DEATH IN A HIGH RISK POPULATION: PP.9.345

The relationship between the adipose tissue cytokines leptin and adiponectin and major clinical outcomes like survival and cardiovascular events is still undefined. We made detailed analyses of these associations in a high risk population like End Stage Renal Disease (ESRD). Leptin and Adiponectin are much increased in a substantial proportion of ESRD patients. Therefore, ESRD constitutes a natural model for testing the relationship of high levels of these cytokines and clinical outcomes. Since abdominal fat is an important modifier of the effect of various risk factors for death and cardiovascular complications, we specifically tested the hypothesis waist circumference (WC) modifies the link between these cytokines and overall and cardiovascular (CV) death in a cohort of 537 hemodialysis patients. Leptin and adiponectin were inversely related each other and robustly associated with waist circumference (all P < 0.001). During the follow-up period (average: 29 months, range 1–47 months) 182 patients died, 113 of them of CV causes. In multivariable Cox models including traditional and non-traditional risk factors there were strong interactions between serum leptin and WC in relationship to both, all-cause (P < 0.001) and CV death (P = 0.002). Accordingly, a fixed excess in serum leptin signalled a gradually lower risk for all-cause and CV mortality in patients with waist circumference < 110 cm but an opposite effect in those with WC above this threshold. An interaction between adiponectin and WC for all-cause (P = 0.01) and CV mortality (P = 0.01) emerged only in models excluding the leptin-WC interaction, suggesting that these adipokines share a common pathway conducive to adverse clinical events in ESRD patients. The predictive values of Leptin and Adiponectin for all-cause and CV death in ESRD patients appear critically dependent on WC. Overall these findings generate the hypothesis that intervention studies in ESRD patients with abdominal obesity and deranged adipokines levels may translate into better clinical outcomes.