title: Clinical impact of the leptin to soluble leptin receptor ratio on subclinical carotid atherosclerosis in patients with type 2 diabetes.
abstract: OBJECTIVE
  The adipocyte-derived hormone leptin plays a key role in the regulation of food intake and energy expenditure. Recent studies have suggested that leptin is also involved in the pathogenesis of obesity-associated atherosclerosis and cardiovascular disease. In this study, we investigated the associations of leptin and the soluble leptin receptor (sOb-R) with atherosclerosis in patients with type 2 diabetes.
  
  
  METHODS
  Three hundred seventeen type 2 diabetic subjects were enrolled in this cross-sectional study. Fasting plasma leptin and sOb-R concentrations were measured by enzyme-linked immunosorbent assays. The intima-media thickness (IMT) of the common carotid artery was measured by ultrasound.
  
  
  RESULTS
  The IMT was significantly associated with sOb-R concentrations, age, diabetes duration, serum creatinine (sCre) levels, and systolic blood pressure (SBP), but not with leptin concentrations or the leptin/sOb-R ratio. The concentrations of leptin (r=0.478, p<0.001) and the sOb-R (r= -0.404, p<0.001) and the leptin/sOb-R ratio (r=0.501, p<0.001) were strongly correlated with IMT in subjects treated with insulin for glycemic control, but not in those treated with diet alone or oral hypoglycemic agents. Multiple regression analysis, including age, sex, diabetes duration, body mass index, SBP, HbA1c, triglycerides, LDL-cholesterol, sCre, smoking, and insulin therapy, revealed that plasma leptin and the leptin/sOb-R ratio were independently associated with IMT in subjects treated with insulin.
  
  
  CONCLUSIONS
  Plasma leptin and the leptin/sOb-R ratio are associated with atherosclerosis in patients with type 2 diabetes on insulin therapy, and these associations were independent of obesity and other cardiovascular risk factors.
authors.affiliation: Metabolism, Endocrinology, and Molecular Medicine, Osaka City University Graduate School of Medicine, Asahi-machi, Abeno-ku, Osaka, Japan. memoto@med.osaka-cu.ac.jp
authors.forename: Yuko
authors.initials: Y
authors.lastname: Yamazaki
authors.forename: Masanori
authors.initials: M
authors.lastname: Emoto
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Morioka
authors.forename: Naoya
authors.initials: N
authors.lastname: Kawano
authors.forename: Eiko
authors.initials: E
authors.lastname: Lee
authors.forename: Hiromi
authors.initials: H
authors.lastname: Urata
authors.forename: Shoko
authors.initials: S
authors.lastname: Tsuchikura
authors.forename: Koka
authors.initials: K
authors.lastname: Motoyama
authors.forename: Katsuhito
authors.initials: K
authors.lastname: Mori
authors.forename: Shinya
authors.initials: S
authors.lastname: Fukumoto
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Shoji
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Nishizawa
authors.forename: Masaaki
authors.initials: M
authors.lastname: Inaba
mesh_terms: D017667:Adipocytes / Q000166:cytology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D002340:Carotid Artery Diseases / Q000097:blood*; D059168:Carotid Intima-Media Thickness; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood*; D005260:Female; D006801:Humans; D020738:Leptin / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000503:physiopathology; D054411:Receptors, Leptin / Q000097:blood*
chemical_list: D020738:Leptin; D054411:Receptors, Leptin