Plasma leptin level is associated with cardiac autonomic dysfunction in patients with type 2 diabetes: HSCAA study

Abstract

BackgroundIt has been shown that visceral fat accumulation is associated with autonomic dysfunction, though the precise mechanism remains unclear. A recent basic study found that leptin can directly modulate autonomic function through the dorsomedial hypothalamus in relation to obesity. Here, we investigated the mutual relationships among plasma leptin, visceral fat accumulation, and cardiac autonomic dysfunction in patients with type 2 diabetes.MethodsThis cross-sectional study included 100 diabetic patients, and 100 age- and gender-matched non-diabetic patients with cardiovascular risk factors. Plasma leptin and soluble leptin receptor levels, visceral fat area (VFA), and heart rate variability (HRV) were determined in addition to classical cardiovascular risk factors.ResultsIn the type 2 diabetic patients, VFA was significantly (p < 0.05) and inversely associated with HRV parameters (SDNN: r = −0.243; SDANN5: r = −0.238), while the plasma level of leptin, but not soluble leptin receptor, was also significantly (p < 0.05) and inversely associated with HRV parameters (SDNN: r = −0.243; SDANN5: r = −0.231). Multiple regression analysis showed that plasma leptin was significantly associated with SDNN and SDANN5 independent of other factors, including age, gender, presence of hypertension and dyslipidemia, duration of diabetes, HbA1c, and eGFR. Furthermore, the relationship of leptin with SDNN and SDANN5 (β = −0.279 and −0.254, respectively) remained significant (p < 0.05) after adjustment for VFA. In patients without diabetes, no significant associations were observed between leptin and any of the HRV parameters.ConclusionsHyperleptinemia may be involved in cardiac autonomic dysfunction in patients with type 2 diabetes and visceral obesity.

Plasma brain-derived neurotrophic factor concentration is a predictor of chronic kidney disease in patients with cardiovascular risk factors – Hyogo Sleep Cardio-Autonomic Atherosclerosis study

“…In addition, autonomic dysfunction, nocturnal hypertension, and sleep disturbance are frequently observed in patients with such risk factors [3–5] and those have been shown to be predictors of renal function decline [6–8], though the precise mechanism remains unclear. Reduced estimated glomerular filtration rate (eGFR) (<60 ml/min/1.73m 2 ) is considered to be a risk factor for end-stage renal failure (ESRD), hospitalization, cardiovascular events, and death [9], thus elucidation of predictors for development of CKD is essential for treatment of patients with cardiovascular risk factors.…”

Parathyroidectomy Increases Heart Rate Variability and Leptin Levels in Patients with Stage 5 Chronic Kidney Disease

“…Recent studies have revealed that in healthy subjects or police officers, plasma leptin was associated with LF [41,42] . Kurajoh et al [43] proved that in diabetic patients, plasma leptin was significantly associated with SDNN and SDANN being independent of other factors such as age and gender. In our study, leptin could independently predict LF/HF ratio, which indicated that leptin was associated with the function of the cardiac nervous system in CKD patients.…”

Developmental Origins of Cardiometabolic Diseases: Role of the Maternal Diet

“…Since hyperleptinemia, common in overweight and obesity conditions, produce a misbalance in autonomic system, with sympathetic overactivation (Machleidt et al, 2013; Kurajoh et al, 2015; Manna and Jain, 2015), and reduced sensitivity of vagal afferent neurons (de Lartigue, 2016). This disorder of vagal afferent signaling can activate orexigenic pathways in the CNS and drive hyperphagia, obesity, and cardiometabolic diseases at long-term (de Lartigue, 2016).…”