Correlation of the leptin:adiponectin ratio with measures of insulin resistance in non-diabetic individuals

Abstract

Aims/hypothesisObesity is the dominant cause of insulin resistance. In adult humans it is characterised by a combination of adipocyte hypertrophy and, to a lesser extent, adipocyte hyperplasia. As hypertrophic adipocytes secrete more leptin and less adiponectin, the plasma leptin:adiponectin ratio (LAR) has been proposed as a potentially useful measure of insulin resistance and vascular risk. We sought to assess the usefulness of the LAR as a measure of insulin resistance in non-diabetic white adults.MethodsLeptin and adiponectin levels were measured in 2,097 non-diabetic individuals from the Ely and European Group for the Study of Insulin Resistance (EGIR) Relationship between Insulin Sensitivity and Cardiovascular Risk (RISC) study cohorts. LAR was compared with fasting insulin and HOMA-derived insulin sensitivity (HOMA-S) in all individuals and with the insulin sensitivity index (M/I) from hyperinsulinaemic–euglycaemic clamp studies in 1,226 EGIR RISC participants.ResultsThe LAR was highly correlated with HOMA-S in men (r = −0.58, p = 4.5 × 10−33 and r = −0.65, p = 1.1 × 10−66 within the Ely and EGIR RISC study cohorts, respectively) and in women (r = −0.51, p = 2.8 × 10−36 and r = −0.61, p = 2.5 × 10−73). The LAR was also strongly correlated with the clamp M/I value (r = −0.52, p = 4.5 × 10−38 and r = −0.47, p = 6.6 × 10−40 in men and women, respectively), similar to correlations between HOMA-S and the M/I value.Conclusions/interpretationThe leptin:adiponectin ratio is a useful measure of insulin resistance in non-diabetic white adults. These data highlight the central role of adipocyte dysfunction in the pathogenesis of insulin resistance. Given that variations between fasting and postprandial leptin and adiponectin levels tend to be small, the leptin to adiponectin ratio might also have potential value in assessing insulin sensitivity in the non-fasted state.Electronic supplementary materialThe online version of this article (doi:10.1007/s00125-009-1508-3) contains supplementary material, which is available to authorized users.

Circulating Adipokine Levels and Endometrial Cancer Risk in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial

“…When estimates from comparable leptin levels are compared between the two studies, similar results are observed. In addition, associations for the ratio of adiponectin:leptin with endometrial cancer reported in the current study are similar with those reported in B~FIT (13), however continued evaluation is needed to determine if this ratio is indeed a more sensitive measure of insulin resistance, as has been suggested (20)(21), and its relationship with endometrial cancer risk.…”

“…Few studies of adipokines and endometrial cancer risk have included measures of both adiponectin and leptin (8,10,13) and only two have reported associations for their ratio (8,13). The leptin:adiponectin ratio has been suggested to be a surrogate marker of insulin resistance in both diabetic and non-diabetic women (20)(21) and has been shown to be positively associated with breast and colorectal cancer (22)(23).…”

Fine-tuned iron availability is essential to achieve optimal adipocyte differentiation and mitochondrial biogenesis

“…In this last model, iron depletion reversed these phenotypes [38]. Adipocyte hypertrophy, which is the 'diabetogenic' adipocyte phenotype, is characterised by increased leptin and reduced adiponectin biosynthesis [39]. In the present study, we found that iron administration exerted inverse effects on LEP and ADIPOQ gene expression.…”

Effects of the traditional Mediterranean diet on adiponectin and leptin concentrations in men and premenopausal women: do sex differences exist?

“…Moreover, leptin-to-adiponectin ratio has been suggested to be a better marker of cardiovascular disease and type 2 diabetes risk than adiponectin concentration alone 9,10 . In this study, this ratio was unchanged in response to the MedDiet in both sexes, suggesting that the decrease in adiponectin concentration found in response to the MedDiet in men may have, overall, a rather mild negative impact on cardiovascular health.…”

“…In the case of leptin, mixed results have been obtained, some studies observed that a high leptin concentration is a predictor of coronary events and type 2 diabetes independently of adiposity 5,6 while others showed that the association between leptin concentrations and these major chronic diseases is largely explained by concomitant variations in body weight or BMI 7,8 . It has been recently suggested that the leptin-to-adiponectin ratio could be a better marker of cardiometabolic alterations and insulin resistance than adiponectin or leptin alone 9,10 .…”