Hyperleptinemia as a Robust Risk Factor of Coronary Artery Disease and Metabolic Syndrome in Type 2 Diabetic Patients

Abstract

Abstract. Leptin has been linked to adiposity, insulin resistance, and coronary artery disease (CAD). We examined whether the leptin concentrations are associated with the risk of CAD and metabolic syndrome (MS). The plasma leptin concentrations were measured in 556 diabetic patients (341 men and 215 women). The odds ratio (OR) of CAD and MS were increased on moving from the lowest quartile (Q1) of leptin concentration to the highest quartile (Q4) and remained significant after adjusting for age, sex, BMI, concentrations of total cholesterol, triglyceride, or high-sensitivity C-reactive protein (hsCRP), and treatment modalities for hyperglycemia. The frequency of CAD was highest in the insulin resistant group (Q4 of homeostasis model assessment-insulin resistance index [HOMA-IR]) at Q4 of leptin concentration (34.5%), compared with that of Q4 of leptin (26.4%) or HOMA-IR (21.9%). In multivariate analysis, plasma leptin concentration was identified as the most significantly independent predictor for CAD (OR 10.24, 95% CI 3.01 to 45.05). Other variables with associated with CAD were age, sex, hypertension, low-HDL cholesterolemia, and hsCRP. In conclusion, hyperleptinemia might be an independent risk factor for CAD and MS in diabetic subjects. And the simultaneous measurement of insulin resistance and leptin concentration might be helpful for screening subjects with a high-risk of CAD.

Adipose tissue dysfunction and hypertriglyceridemia: mechanisms and management

“…These patients suffer from hypertriglyceridemia and insulin resistance and leptin replacement therapy improves both lipid and glucose levels (9). However, most obese patients have elevated leptin levels, but due to leptin resistance they show signs of metabolic syndrome (47).…”

Association Between Hypertension and Coronary Artery Disease as Assessed by Coronary Computed Tomography

“…The 8 factors in Table II are independent risk factors for CAD 15 . Although plasma leptin might also be a risk factor for CAD, there is no consensus regarding this point 16,17 . In this study, HTN was the most important factor associated with the presence or absence of CAD among the 8 factors considered, although it is well known that the clustering of metabolic disorders induces CAD.…”

Associations between LEP G2548A polymorphisms and lipids metabolism

“…Alongside obesity, Hoffstedt et al (2002) reported that the LEP G2548A variant can also affect the expression of leptin and its secretion in adipose tissue. Moreover, some of previous studies suggested its role also in the genetic prediction of other obesity related disorders including diabetes mellitus and cardiovascular diseases (Mendoza-Núñez et al, 2006;Han et al, 2008;Kim et al, 2008).…”

“…There are several studies indicating the significant association between polymorphisms in LEP gene and obesity (Duarte et al, 2006), hypertension (Mendoza-Núñez et al, 2006), coronary artery diseases and metabolic syndrome (Kim et al, 2008), insulin resistance (Chiu et al, 2004), type 2 diabetes mellitus (Han et al, 2008) and cancer (Mohammadzadeh et al, 2015). The G2548A polymorphism (rs7799039: guanine > adenine) are studied widely because it has been associated with leptin production and secretion (Suriyaprom et al, 2014).…”