title: Plasma leptin and insulin levels in weight-reduced obese women with normal body mass index: relationships with body composition and insulin.
abstract: Obesity is a complex disease with multiple features that has confounded efforts to unravel its pathophysiology. As a means of distinguishing primary from secondary characteristics, we compared levels of fasting plasma leptin and insulin in a cohort of weight-reduced obese women who have attained and maintained a normal BMI for more than 1 year with the levels in cohorts of never-obese and currently obese women. Weight-reduced obese women showed decreased plasma concentrations of leptin and insulin compared with obese women, but these levels remained significantly higher than those of never-obese women. Plasma leptin levels were highly correlated with plasma insulin levels (r = 0.60, P < 0.001). To further explore relationships with body composition, total body fat was determined by dual-energy X-ray absorptiometry and body fat distribution by computed tomography in subsets of these groups. Weight-reduced obese women had a significantly greater percent body fat and subcutaneous abdominal fat mass than did the never-obese women, and these were highly correlated with plasma leptin (r = 0.90, P < 0.001, and r = 0.52, P < 0.001, respectively). In these weight-reduced obese women, visceral fat mass was similar to that of the never-obese. The insulin sensitivity index and first-phase insulin response were also comparable. These results demonstrate that higher leptin levels in weight-reduced obese women are related to the higher total fat and particularly the subcutaneous fat masses. Normalization of visceral fat mass in the weight-reduced obese was accompanied by normalization of insulin sensitivity index and first-phase insulin response. This study suggests that increases in plasma leptin and insulin in obesity are secondary features of the obese state.
authors.affiliation: Division of Endocrinology, Metabolism, and Clinical Nutrition and Clinical Research Center, Medical College of Wisconsin, Milwaukee, USA.
authors.forename: S
authors.initials: S
authors.lastname: Guven
authors.forename: A
authors.initials: A
authors.lastname: El-Bershawi
authors.forename: G E
authors.initials: GE
authors.lastname: Sonnenberg
authors.forename: C R
authors.initials: CR
authors.lastname: Wilson
authors.forename: R G
authors.initials: RG
authors.lastname: Hoffmann
authors.forename: G R
authors.initials: GR
authors.lastname: Krakower
authors.forename: A H
authors.initials: AH
authors.lastname: Kissebah
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D001823:Body Composition / Q000502:physiology; D015992:Body Mass Index; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood*; D020738:Leptin; D008875:Middle Aged; D009765:Obesity / Q000097:blood* / Q000000981:diagnostic imaging / Q000473:pathology*; D011506:Proteins / Q000032:analysis*; D012016:Reference Values; D015431:Weight Loss / Q000502:physiology*
chemical_list: D007328:Insulin; D020738:Leptin; D011506:Proteins