title: Plasma leptin levels and digital pulse volume in obese patients without metabolic syndrome--a pilot study.
abstract: BACKGROUND
  The mechanism of obesity leading to endothelial function is complex, and involves many adipokines and inflammatory cytokines. The data is especially lacking in obese patients without metabolic syndrome. We assessed the relationship among endothelial dysfunction, anthropometric indices, adipokines and inflammatory cytokines in this population.
  
  
  METHODS
  Obese patients without metabolic syndrome were included in this study. The plasma resistin, leptin, retinol-binding-protein 4 and inflammatory cytokines were examined. Endothelial function was assessed by a fingertip peripheral arterial tonometry (PAT) device. Data are expressed as the natural logarithm (ln) of the PAT ratio. Endothelial dysfunction was defined by a ln (PAT ratio) <0.30.
  
  
  RESULTS
  A total of 35 patients were enrolled, 11 of whom were with endothelial dysfunction. There was a significant difference of ln leptin (p=0.007), ln [leptin/visceral fat thickness] (p=0.004) and ln [leptin/subcutaneous fat thickness] (p<0.001) between patients with and without endothelial dysfunction. Multivariate linear regression analyses showed that ln [leptin/subcutaneous fat thickness] was significantly related to the ln (PAT ratio) (p=0.002). Using ln [leptin/subcutaneous fat thickness] to detect endothelial dysfunction, the area of receiver operating characteristic curves was 0.843 (p=0.002). Using 6.10 as a cutoff point, the sensitivity and specificity to determine endothelial dysfunction were 91% and 78%, respectively.
  
  
  CONCLUSIONS
  Abnormal digital vascular function occurs in obese patients without metabolic syndrome. Low plasma leptin/subcutaneous fat ratio is associated with endothelial dysfunction in this population.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Yen Hung
authors.initials: YH
authors.lastname: Lin
authors.forename: Yi-Lwun
authors.initials: YL
authors.lastname: Ho
authors.forename: Jen-Kuang
authors.initials: JK
authors.lastname: Lee
authors.forename: Hsien-Liang
authors.initials: HL
authors.lastname: Huang
authors.forename: Kuo-Chin
authors.initials: KC
authors.lastname: Huang
authors.forename: Ming-Fong
authors.initials: MF
authors.lastname: Chen
mesh_terms: D000273:Adipose Tissue / Q000378:metabolism; D000328:Adult; D000367:Age Factors; D001158:Arteries / Q000503:physiopathology; D015992:Body Mass Index; D016207:Cytokines / Q000378:metabolism; D004730:Endothelium, Vascular / Q000473:pathology; D005260:Female; D006801:Humans; D007249:Inflammation / Q000378:metabolism; D020738:Leptin / Q000097:blood*; D008297:Male; D008365:Manometry; D024821:Metabolic Syndrome; D009765:Obesity / Q000097:blood* / Q000378:metabolism / Q000473:pathology* / Q000503:physiopathology; D010865:Pilot Projects; D012737:Sex Factors
chemical_list: D016207:Cytokines; D020738:Leptin