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Leptin and incident type 2 diabetes: risk or protection?

TitleLeptin and incident type 2 diabetes: risk or protection?
Publication TypeJournal Article
Year of Publication2006
AuthorsSchmidt MI, Duncan BB, Vigo A, Pankow JS, Couper D, Ballantyne CM, Hoogeveen RC, Heiss G
Corporate AuthorsARIC Investigators
JournalDiabetologia
Volume49
Issue9
Pagination2086-96
Date Published2006 Sep
ISSN0012-186X
KeywordsAdiponectin, African Americans, Blood Glucose, Body Mass Index, Case-Control Studies, Cohort Studies, Diabetes Mellitus, Type 2, Enzyme-Linked Immunosorbent Assay, European Continental Ancestry Group, Female, Humans, Incidence, Inflammation, Insulin, Leptin, Linear Models, Male, Middle Aged, Obesity, Risk Factors, Smoking, Triglycerides, United States
Abstract

AIMS/HYPOTHESIS: The aim of this study was to investigate the association of leptin levels with incident diabetes in middle-aged adults, taking into account factors purportedly related to leptin resistance.

SUBJECTS AND METHODS: We conducted a case-cohort study (570 incident diabetes cases and 530 non-cases) representing the 9-year experience of 10,275 participants of the Atherosclerosis Risk in Communities Study. Plasma leptin was measured by direct sandwich ELISA.

RESULTS: In proportional hazards models adjusting for age, study centre, ethnicity and sex, high leptin levels (defined by sex-specific cut-off points) predicted an increased risk of diabetes, with a hazard ratio (HR) comparing the upper with the lower quartile of 3.9 (95% CI 2.6-5.6). However, after further adjusting additionally for obesity indices, fasting insulin, inflammation score, hypertension, triglycerides and adiponectin, high leptin predicted a lower diabetes risk (HR=0.40, 95% CI 0.23-0.67). Additional inclusion of fasting glucose attenuated this protective association (HR=0.59, 95% CI 0.32-1.08, p

CONCLUSIONS/INTERPRETATION: High leptin levels, probably reflecting leptin resistance, predict an increased risk of diabetes. Adjusting for factors purportedly related to leptin resistance unveils a protective association, independent of adiponectin and consistent with some of leptin's described protective effects against diabetes.

DOI10.1007/s00125-006-0351-z
Alternate JournalDiabetologia
PubMed ID16850292
Grant ListN01-HC -55015 / HC / NHLBI NIH HHS / United States
N01-HC-55016 / HC / NHLBI NIH HHS / United States
N01-HC-55018 / HC / NHLBI NIH HHS / United States
N01-HC-55019 / HC / NHLBI NIH HHS / United States
N01-HC-55020 / HC / NHLBI NIH HHS / United States
N01-HC-55021 / HC / NHLBI NIH HHS / United States
N01-HC-55022 / HC / NHLBI NIH HHS / United States
R01-DK056918 / DK / NIDDK NIH HHS / United States