Obesity-related hypertension: is there a role for selective leptin resistance?
Obesity is a risk factor for cardiovascular diseases, in particular for hypertension. Serum leptin levels and sympathetic nerve activity are both increased in obesity. Leptin has been demonstrated to increase sympathetic nerve activity. Thus, leptin-dependent sympathoactivation might contribute to obesity-related hypertension. However, leptin resistance occurs in obesity. One possibility is that leptin resistance is selective to the metabolic effects of leptin, sparing its sympathoexcitatory actions. In this article, we review experimental evidence supporting the novel concept of selective leptin resistance. We also discuss the sympathetic actions of leptin that are relevant to blood pressure modulation and potential mechanisms of leptin resistance. Disruption of leptin intracellular signaling pathways and resistance of specific leptin-responsive neural networks provide theoretic models of selective leptin resistance. However, most information about leptin-sympathetic actions and leptin-resistance mechanisms derive from in vitro and animal studies. Future research in humans is widely awaited.
Correia
Marcelo L G
ML
Department of Internal Medicine, University of Iowa, 200 Hawkins Drive, Office E426GH, Iowa City, IA 52242, USA.
Haynes
William G
WG
D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D004351:Drug Resistance / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000503:physiopathology; D020738:Leptin / Q000494:pharmacology / Q000502:physiology; D009415:Nerve Net / Q000187:drug effects; D009434:Neural Pathways / Q000187:drug effects; D009765:Obesity / Q000150:complications* / Q000503:physiopathology; D014481:United States / Q000453:epidemiology
D020738:Leptin