Obesity results from an imbalance between energy intake and expenditure. Furthermore, obesity has long been recognized to have detrimental effects on health including an increased risk of cardiovascular disease (CVD) [1]. In this regard, the recent cloning of the mouse (ob) and human (OB) obese genes and the characterization of its protein product, leptin [2], has been a breakthrough of potentially great importance for the understanding of the pathophysiology of obesity.Leptin has been shown to lower body weight by reducing food intake and increasing energy expenditure in leptin-deficient obese mice (ob/ob) and also to normalize blood glucose levels in the same animals [2][3][4][5][6][7][8]. Leptin is secreted by white adipose cells and is exclusively expressed in adipose tissue (AT) [2,[9][10][11][12][13]. In this regard, numerous studies have reported a strong relationship between adiposity and plasma leptin concentrations or its AT mRNA levels [14][15][16][17][18][19][20][21]. Furthermore, expression of the obese gene is Diabetologia (1997Diabetologia ( ) 40: 1178Diabetologia ( -1184 Plasma leptin concentrations: gender differences and associations with metabolic risk factors for cardiovascular disease Summary The cloning of the obese gene and the characterization of its protein product, leptin, has permitted the study of a new hormone potentially involved in the regulation of adipose tissue mass. The present study examined the gender differences in fasting plasma leptin concentration and its relationship to body fatness, adipose tissue distribution and the metabolic profile in samples of 91 men (mean age ± SD: 37.3 ± 4.8 years) and 48 women (38.5 ± 6.8 years). Plasma leptin concentrations were strongly associated with body fat mass measured by underwater weighing [men: r = 0.80, p < 0.0001; women: r = 0.85, p < 0.0001]. In both genders, plasma leptin levels were also strongly correlated with waist girth as well as cross-sectional areas of abdominal subcutaneous and visceral adipose tissue measured by computed tomography. Women had, on average, plasma leptin concentrations that were three times higher than men. Furthermore, this gender difference remained significant when comparing men and women matched for similar levels of body fat mass. The associations between plasma leptin and lipoprotein concentrations were dependent of adiposity. In both men and women, elevated fasting plasma leptin levels were associated with higher plasma insulin concentrations, but only in women was the association maintained after correction for fat mass. Thus, results of the present study show that women have higher plasma leptin levels compared to men, independent of the concomitant variation in total body fat mass. Furthermore, our results also suggest that, in women, the association between plasma leptin and insulin concentrations is independent of adiposity, a finding which provides further support to the observation that adipose tissue leptin secretion may be upregulated by insulin.