High Leptin/Adiponectin Ratio and Serum Triglycerides Are Associated With an “At‐Risk” Phenotype in Young Severely Obese Patients

Abstract

“At‐risk” severely obese subjects are characterized by insulin resistance, and higher visceral fat and plasma lipid levels compared with metabolically healthy obese (MHO) subjects, although both groups have a high BMI and fat mass. The aim of this study was to measure several serum adipokines and gastrointestinal hormones in a young severely obese population from Southern Italy to identify biochemical markers of the “at‐risk” insulin‐resistant obese profile. We studied 160 unrelated white young adults (mean age = 25.2 years, mean BMI = 44.9 kg/m2, 65% women) affected by obesity for at least 5 years. Serum concentrations of glucagon, ghrelin, gastric inhibitory peptide, glucagon like peptide‐1, interleukin‐6, tumor necrosis factor α, leptin, adiponectin, adipsin, and visfatin were measured. The leptin/adiponectin (L/A) ratio and fatty liver index (FLI) were calculated. We found a prevalence of 21.3% of MHO patients in our young severely obese patients. At univariate analysis, the “at‐risk” group had higher mean levels of BMI (P < 0.0001), leptin (P = 0.039, men) and the L/A ratio (P = 0.003), and lower mean levels of visfatin (P = 0.026) than the MHO group. The L/A ratio, serum triglycerides, and male sex were significantly associated with “at‐risk” obesity and accounted for 19.5% of insulin resistance at multivariate analysis. In conclusion, we demonstrate that a high serum L/A ratio and high levels of serum triglycerides may be markers of “at‐risk” obesity, independent of waist circumference (WC) and BMI, in young severely obese population.

Increased Cardiometabolic Risk Factors and Inflammation in Adipose Tissue in Obese Subjects Classified as Metabolically Healthy

“…Some authors have found higher adiponectin concentrations in MHO as compared with MAO, which has been related to reduced inflammation and improved metabolic function (25,26). The similarly reduced levels observed in the current study have been reported previously (7,27,28) and together with the comparable concentrations of leptin and resistin suggest that MHO and MAO show a very similarly altered adipokine profile. To our knowledge, this is the only study analyzing the circulating concentrations of SAA, VEGF, and MMP9 in MHO subjects.…”

“…Furthermore, fibrinogen concentrations in both cohorts and the leukocyte number, analyzed only in cohort 1, were elevated in both obese groups. Our results regarding inflammation are similar to those reported in previous studies (12,13,26,27,32,34) but contrast with others (8,24,26,35,36). The younger age of the MHO subjects in most of the latter studies may explain this discrepancy.…”

Ovarian adipocytokines are associated with early in vitro human embryo development independent of the action of ovarian insulin

“…These results may be counterintuitive at first glance because hyperleptinemia and hypoadiponectinemia are considered "high risk" markers for metabolic pathology [14]. However, we would argue that pathological states of metabolism such as obesity and IR are inherently different from those in endocrinologically normal women.…”

“…Together, they regulate long term satiety and energy expenditure [11]. Moreover, the ratio of leptin to adiponectin (L:A ratio) is a stronger indicator of abdominal adiposity and IR than either component alone [14,25].…”

Growth Signals, Inflammation, and Vascular Perturbations

“…[21][22][23] In vitro, animal and epidemiological evidence linking leptin [23][24][25] or adiponectin 21,[26][27][28] individually to cancer risk is mixed. Associations among the adiponectin-to-leptin ratio and the metabolic syndrome [29][30][31] and some cancers 32-34 are reported. Further characterization of these links is needed.…”