The role of leptin/adiponectin ratio in metabolic syndrome and diabetes

Abstract

Abstract:The metabolic syndrome comprises a cluster of cardiometabolic risk factors, with insulin resistance and adiposity as its central features. Identifying individuals with metabolic syndrome is important due to its association with an increased risk of coronary heart disease and type 2 diabetes mellitus. Attention has focused on the visceral adipose tissue production of cytokines (adipokines) in metabolic syndrome and type 2 diabetes mellitus, as the levels of the anti-inflammatory adipokine adiponectin are decreased, while proinflammatory cytokines are elevated, creating a proinflammatory state associated with insulin resistance and endothelial dysfunction. In this review, we will give special attention to the role of the leptin/adiponectin ratio. We have previously demonstrated that in individuals with severe coronary artery disease, abdominal obesity was uniquely related to decreased plasma concentrations of adiponectin and increased leptin levels. Leptin/adiponectin imbalance was associated with increased waist circumference and a decreased vascular response to acetylcholine and increased vasoconstriction due to angiotensin II. Leptin and adiponectin have opposite effects on subclinical inflammation and insulin resistance. Leptin upregulates proinflammatory cytokines such as tumor necrosis factor-α and interleukin-6; these are associated with insulin resistance and type 2 diabetes mellitus. In contrast, adiponectin has anti-inflammatory properties and downregulates the expression and release of a number of proinflammatory immune mediators. Therefore, it appears that interactions between angiotensin II and leptin/adiponectin imbalance may be important mediators of the elevated risk of developing type 2 diabetes mellitus and cardiovascular diseases associated with abdominal obesity.

Adiponectin: Serum-saliva associations and relations with oral and systemic markers of inflammation

“…The homogeneity of the sample also prohibited us from examining race and ethnicity differences in adiponectin levels. Race and ethnicity differences in adiponectin have been found in prior studies (e.g., Hulver, Saleh, MacDonald, Pories, & Barakat, 2004;Lopez-Jaramillo et al, 2014;OhmanHanson et al, 2016) and future study of these differences may help elucidate mechanisms underlying health disparities in cardiometabolic conditions.…”

“…Adiponectin levels are lower in patients with essential hypertension and type-2 diabetes, and adiponectin is associated with insulin resistance, triglycerides and HDL cholesterol levels (Lihn, Pedersen, & Richelsen, 2005;Nigro et al, 2014;Vaiopoulos, Marinou, Christodoulides, & Koutsilieris, 2012). Given its role in metabolic diseases, adiponectin may be important in tracking and diagnosing some of the most rapidly growing and costly diseases in the United States (e.g., prediabetes/insulin resistance, metabolic syndrome, and vascular disease; Ebrahimi-Mamaeghani, Mohammadi, Arefhosseini, Fallah, & Bazi, 2015;Lopez-Jaramillo et al, 2014;Stojanović, Ilić, Ilić, Petrović, & Djukić, 2015).…”

Prediabetes in Colombia: Expert Consensus

“…In practical terms, these results demonstrate the need for the prediabetic patient to prevent progression to DM2 to undertake a physical activity program that includes strength, as well as cardio-respiratory exercise 88 , particularly in low-income country populations. The environmental and socio-economic factors in these populations predispose them to a greater sensitivity to develop diseases associated with insulin resistance such as DM2, CVD and nonalcoholic fatty liver 89,90 through adaptive epigenetic mechanisms related to the synthesis of substances involved in the regulation of food intake, insulin sensitivity and systemic inflammation [91][92][93][94][95] .…”

Metabolic Syndrome – Myth or Reality in the Endocrinology Clinic

“…Poznato je da je visceralno masno tkivo aktivan organ koji luči brojne proinflamatorne i antiinflamatorne citokine iz adipocita, što je facilitirano infiltracijom masnoga tkiva makrofagima 9 . U metaboličkom je sindromu razina proinflamatornih citokina (leptin, IL-6 i TNF-α) povišena, a antiinflamatornih (adiponektin) smanjena.…”

“…It is known that visceral fat tissue is an active organ secreting numerous proinflammatory and anti-inflammatory cytokines from adipocytes, which is facilitated by the macrophage infiltration of the fat tissue 9 . In metabolic syndrome, the levels of proinflammatory cytokines (leptin, IL-6, and TNF-α) are elevated, while the levels of anti-inflammatory cytokines (adiponectin) are reduced.…”