The relation of leptin and insulin with obesity-related cardiovascular risk factors in US adults

Visceral adipose tissue quantity and dysfunction and the occurrence of major bleeding in patients with established cardiovascular disease

OBJECTIVES

To determine the association between both visceral fat quantity and adipose tissue dysfunction, and major bleeding in patients with established cardiovascular disease.

METHODS

Patients from the Second Manifestations of ARTerial disease study with established cardiovascular disease were included. Visceral fat was measured using ultrasound and adipose tissue dysfunction was depicted using metabolic syndrome criteria (revised National Cholesterol Education Program). Cox regression models were fitted to study the relation with major bleeding defined as Bleeding Academic Research Consortium (BARC) type 3 or 5, or International Society on Thrombosis and Haemostasis (ISTH) major bleeding. Sensitivity analyses were performed using C-reactive protein levels to reflect adipose tissue dysfunction.

RESULTS

In 6927 patients during a median follow up of 9.2 years, a total of 237 BARC type 3 or 5 bleedings and 224 ISTH major bleedings were observed. Visceral fat quantity was not related to major bleeding (HR 1.01, 95%CI 0.88-1.16 for BARC type 3 or 5 bleeding and HR 1.00, 95%CI 0.87-1.15 for ISTH major bleeding), nor was metabolic syndrome (HR 0.97, 95%CI 0.75-1.26 for BARC type 3 or 5 bleeding and HR 0.98, 95%CI 0.75-1.28 for ISTH major bleeding). Sensitivity analyses using C-reactive protein levels showed similar results. No effect modification was observed by sex, antithrombotic therapy, presence of metabolic syndrome or diabetes.

CONCLUSION

In patients with cardiovascular disease, no association was found between visceral fat quantity measured with ultrasound or measures of adipose tissue dysfunction and the risk of major bleeding, irrespective of antithrombotic agent use.

Impact of Obesity on the Course of Management of Inflammatory Bowel Disease—A Review

It is already well-known that visceral adipose tissue is inseparably related to the pathogenesis, activity, and general outcome of inflammatory bowel disease (IBD). We are getting closer and closer to the molecular background of this loop, finding certain relationships between activated mesenteric tissue and inflammation within the lumen of the gastrointestinal tract. Recently, relatively new data have been uncovered, indicating a direct impact of body fat on the pattern of pharmacological treatment in the course of IBD. On the other hand, ileal and colonic types of Crohn’s disease and ulcerative colitis appear to be more diversified than it was thought in the past. However, the question arises whether at this stage we are able to translate this knowledge into the practical management of IBD patients or we are still exploring the scientific background of this pathology, having no specific tools to be used directly in patients. Our review explores IBD in the context of obesity and associated disorders, focusing on adipokines, creeping fat, and possible relationships between these disorders and the treatment of IBD patients.

The association between serum inflammatory biomarkers and incident hypertension among postmenopausal women in the Buffalo OsteoPerio Study

Several serum inflammatory biomarkers have been associated with blood pressure and hypertension prevalence in cross-sectional studies. Few of these associations have been evaluated prospectively. We examined associations for 10 serum inflammatory biomarkers with incident hypertension among 471 postmenopausal women (mean age = 65) in the Buffalo OsteoPerio Study. Concentrations of C-reactive protein, interleukin (IL)-2, IL-4, IL-6, IL-8, IL-10, tumor necrosis factor (TNF)-α, monocyte chemoattractant protein (MCP)-1, adiponectin, and leptin were measured using multiplexed sandwich immunoassays on fasting serum samples collected at baseline (1997–2001). Incident hypertension (195 cases) was defined as physician-diagnosed hypertension and treatment with medication identified on annual mailed health surveys during follow-up (mean 10 years). Cox regression was used to estimate hazard ratios (HR) and 95% confidence intervals (CI) between log-transformed biomarkers (per 1-SD) and hypertension. When adjusted for age, leptin was significantly associated with hypertension risk (HR=1.55, 95% CI: 1.04, 2.29), however, the association was attenuated and not significant after adjustment for demographic and lifestyle factors, including BMI. Significant (P<0.10) interactions were observed for smoking (never, ever) with CRP (HR: Never, 1.31; Ever, 0.91; P=0.06) and MCP-1 (HR: Never, 0.59; Ever, 5.11; P=0.004); for BMI (<25, ≥25) with MCP-1(HR: <25, 3.45; ≥25, 0.95; P=0.07); for systolic BP with IL-10 (HR: <120, 0.85; 120–139, 1.11; P=0.07); and for diastolic BP with MCP-1 (HR: <80, 1.29; 80–89, 0.84; P=0.03) and with adiponectin (HR: <80, 0.86; 80–89, 1.50; P=0.03). This study adds needed understanding on prospective associations between several serum inflammatory biomarkers and hypertension risk in older postmenopausal women, among whom hypertension burden is substantial.

Serum leptin concentrations in Mongolian women

OBJECTIVE

The aim of our study is to elucidate the association between leptin and obesity in Mongolian women.

METHOD

Total 181 women participated in the study including 118 Mongolians and 63 Han. Body mass index (BMI) was calculated by weight (kg) divided by square height (m²). Percent body fat (%fat) was detected by bioelectrical impedance analysis (BIA). Fasting serum leptin was determined by ELISA.

RESULT

The average BMI and %fat of Mongolian and Han women was 25.14 ± 4.48 kg/m², 24.30 ± 3.62 kg/m² and 36.10 ± 6.23%, 33.84 ± 5.98%, respectively. Fasting serum leptin level in obese women (BMI ≥ 25) was remarkably higher than in normal weight women (18.5 < BMI < 25) in Mongolian and Han ethnic groups (all P < 0.001). Fasting serum leptin level in Mongolian women had borderline significance compared with it in Han women (P = 0.049). Multiple linear regression models revealed that ethnicity, %fat and BMI were associated with serum leptin concentrations independent of age.

CONCLUSION

In Mongolian and Han women, fasting serum leptin level was positively associated with BMI and %fat (all P < 0.001).

Cardiometabolic risk reduction in an intensive cardiovascular health program

BACKGROUND AND AIMS

Insulin and leptin are important markers of insulin resistance and vascular inflammation in metabolic and cardiovascular diseases. This study evaluated changes in circulating levels of insulin and leptin during a cardiovascular health program to improve our understanding of cardiometabolic risk reduction.

METHODS AND RESULTS

Participants (n=76) completed a prospective, nonrandomized program designed to stabilize or reverse progression of coronary artery disease through dietary changes, exercise, stress management, and group support. Controls (n=76) were matched to participants based on age, gender, and disease status. Traditional cardiovascular risk factors were assessed at baseline, 12 weeks, and 52 weeks by standard methods. Dietary data were collected by 72-h recall and evaluated by Food Processor® v8.4.0. Ultrasensitive insulin and leptin levels were measured by radioimmunoassay. Participants successfully reduced their total caloric intake from >2000 calories per day to ≈ 1700 calories per day (p<0.05 compared to controls), lowered daily fat intake by >60% (p<0.001 compared to controls), and increased carbohydrate intake by >30% (p<0.001). Repeated-measures ANOVA indicated significant beneficial changes (p<0.001 compared to controls) in plasma insulin (-19%) and leptin (-33%) during the lifestyle program, as well as improvement in traditional cardiovascular risk factors. Response was similar between men and women for most risk factors and was not markedly influenced by medication use.

CONCLUSION

Lifestyle changes focusing on diet, physical activity, and stress reduction can successfully modify both cardiovascular and metabolic risk factors, with the potential to mediate cardiometabolic risk through beneficial anti-inflammatory and anti-oxidative effects on the vasculature.