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Predictive value of leptin and adiponectin-to- leptin ratio for hypertension and insulin resistance in subjects with low cardiovascular risk.

Objective: Leptin is an important predictor of cardiovascular (CV) risk. Some studies found that adiponectin-to-leptin ratio (A/L) is a better predictor of hypertension (HT) and insulin resistance (IR) than leptin alone. Our goal was to evaluate whether A/L improves the predictive value of leptin for HT and IR in subjects with low cardiovascular risk. Design and method: Participants (N = 208 ; 135 females ; 171 normotensives (NT) and 37 untreated HT (uHT) were selected from a random sample of 2487 subjects enrolled in cross- sectional study, Subjects with diabetes, chronic kidney disease, pregnancy, terminal illness and treated hypertensives were excluded. BP was measured using Omron M6 device following ESH/ESC guidelines. IR was defined as HOMA- IR>3. Adiponectin and leptin concentrations were determined by ELISA. Results: There were 147 insulin resistant (IR), 61 non-IR subjects. Leptin concentration was lower in NT than in HT (11.05 (5.85-16.75) vs. 8.44 (3.60-14.61), p = 0.05), while there was no difference in A/L (p = 0.56). Leptin was significantly higher in IR than non-IR subjects (12.00 (6.00-17.50) vs. 7.64 (3.25-13.64), p = 0.002) while A/L was lower (0.73 (0.43-1.12) vs. 1.35 (0.59-3.20), p < 0.001). Using receiver operating curves (ROC) to examine the predictive value of leptin and A/L for HT and IR we found that leptin values>5.4 ug/L had a sensitivity of 81% and specificity of 34% for HT (AUC = 0.604, p = 0.04), while A/L was not a significant predictor of HT (AUC = 0.531, p = 0.53). Conclusions: Untreated HT significantly differ from NT in leptin but not in A/L values. However, neither leptin nor A/L are sufficiently significant predictors of HT and IR in subjects with low cardiovascular risk.

Leptin; heart rate; cardiovascular risk

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