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Diabetologia
Erschienen in: Diabetologia 9/2006

01.09.2006 | Article

Leptin and incident type 2 diabetes: risk or protection?

verfasst von: M. I. Schmidt, B. B. Duncan, A. Vigo, J. S. Pankow, D. Couper, C. M. Ballantyne, R. C. Hoogeveen, G. Heiss, For the ARIC Investigators

Erschienen in: Diabetologia | Ausgabe 9/2006

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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<0.03 for linear trend across quartiles). In similar models, protective associations were generally seen across subgroups of sex, race, nutritional status and smoking, though not among those with lower inflammation scores or impaired fasting glucose (interaction p=0.03 for both).

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.
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Metadaten
Titel
Leptin and incident type 2 diabetes: risk or protection?
verfasst von
M. I. Schmidt
B. B. Duncan
A. Vigo
J. S. Pankow
D. Couper
C. M. Ballantyne
R. C. Hoogeveen
G. Heiss
For the ARIC Investigators
Publikationsdatum
01.09.2006
Verlag
Springer-Verlag
Erschienen in
Diabetologia / Ausgabe 9/2006
Print ISSN: 0012-186X
Elektronische ISSN: 1432-0428
DOI
https://doi.org/10.1007/s00125-006-0351-z

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