Obesity hypertension: the emerging role of leptin in renal and cardiovascular dyshomeostasis.
OBJECTIVE
Adipose tissue is now considered to be an active physiologic system operating in concert with multiple other organs. Leptin is a peptide hormone that is primarily synthesized and secreted by adipose tissue whose principal action is the control of appetite and energy balance. However, current information suggests that leptin exerts pleiotropic effects on several organ systems. Herein, we review the potential role of leptin in cardiovascular and renal physiological conditions as well as pathophysiological situations including obesity and hypertension.


RESULTS
Increasing evidence suggests that leptin may function as a pressure and volume-regulating factor under conditions of health; however, in situations characterized by chronic hyperleptinemia such as obesity, it may function pathophysiologically for the development of hypertension and possibly also for adverse renal, vascular and cardiac remodeling.


CONCLUSIONS
Adipose tissue should be regarded as a potentially important mediator of cardiorenal physiology. Further research awaits the characterization of additional mechanisms of action of leptin, including its interface with other important endocrine and hemodynamic sodium-volume regulatory systems, in both health and disease, particularly in obesity and related comorbidities. This information could lead to the development of leptin analogues as well as leptin receptor blockers that given specific circumstances could optimize the beneficial actions of the hormone and minimize its deleterious effects.
Department of Internal Medicine, SUNY Upstate Medical University and Veterans Affairs Medical Center, Syracuse, New York, USA.
Shilpa
S
Kshatriya
Garry P
GP
Reams
Robert M
RM
Spear
Ronald H
RH
Freeman
John R
JR
Dietz
Daniel
D
Villarreal
D000273:Adipose Tissue / Q000503:physiopathology; D000818:Animals; D001794:Blood Pressure / Q000502:physiology; D002318:Cardiovascular Diseases / Q000209:etiology / Q000503:physiopathology; D002319:Cardiovascular System / Q000503:physiopathology; D006706:Homeostasis; D006801:Humans; D006973:Hypertension / Q000209:etiology* / Q000503:physiopathology*; D007668:Kidney / Q000503:physiopathology; D020738:Leptin / Q000097:blood / Q000502:physiology*; D008954:Models, Biological; D008955:Models, Cardiovascular; D009765:Obesity / Q000150:complications* / Q000503:physiopathology*; D054411:Receptors, Leptin / Q000502:physiology; D051436:Renal Insufficiency, Chronic / Q000209:etiology / Q000503:physiopathology; D014882:Water-Electrolyte Balance / Q000502:physiology
D020738:Leptin; D054411:Receptors, Leptin