Leptin mediate central obesity on the severity of cardiovascular autonomic neuropathy in well-controlled type 2 diabetes and prediabetes.

Abstract

BACKGROUND:

Evidences support the view that central obesity is an independently cardiovascular risk. It is thought that leptin contributes to autonomic dysfunction and cardiovascular risks in type 1 and type 2 diabetes mellitus (T1DM and T2DM). This raises the possibility that leptin might mediate the relationship between central obesity and the severity of cardiovascular autonomic neuropathy (CAN) in patients with well-controlled T2DM and prediabetes.

METHODS:

The complete cardiovascular reflex tests and biomarkers were assessed for each patient. The severity of CAN was assessed using composite autonomic scoring scale (CASS). A single-level three-variable mediation model was used to investigate the possible relationships among central obesity [as indicated by waist circumference (WC)], leptin level, and severity of CAN (as indicated by CASS value).

RESULTS:

A total of 107 patients were included in this study: 90 with diabetes and 17 with prediabetes. The results demonstrate that increased WC is associated with increased severity of CAN (r = 0.242, P = 0.017). We further discovered that leptin level is positively correlated with WC (r = 0.504, P < 0.0001) and the CASS value (r = 0.36, P < 0.0001). Further mediation analysis shows that leptin level serves as mediators between higher WC and higher CASS.

CONCLUSIONS:

Our results highlighted the relationship among leptin, central obesity, and severity of CAN. As the leptin level serves as mediator between central obesity and severity of CAN, a longitudinal study is needed to confirm that control of WC can decrease leptin levels and can be effective in reducing CAN progression.

• Authors: Yun-Ru Lai, Meng Hsiang Chen, Wei Che Lin, Wen-Chan Chiu, Ben-Chung Cheng, Jung-Fu Chen, Nai-Wen Tsai, Chih-Cheng Huang, Cheng-Hsien Lu
• Journal: Journal of translational medicine (J Transl Med) Vol. 18 Issue 1 Pg. 396 (10 19 2020) ISSN: 1479-5876 [Electronic] England
• PMID: 33076921 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Leptin

Topics

• Body Mass Index
• Diabetes Mellitus, Type 2 (complications)
• Humans
• Leptin
• Longitudinal Studies
• Obesity, Abdominal (complications)
• Prediabetic State (complications)
• Risk Factors
• Waist Circumference