Increased cardiovascular risk markers in obesity are associated with body adiposity: Role of leptin
Javier Gómez-Ambrosi 1 , Javier Salvador2 , Camilo Silva2 , Carlos Pastor3 , Fernando Rotellar3 , María J. Gil4 , Javier A. Cienfuegos3 , Gema Frühbeck1,2
1 Metabolic Research Laboratory, 2 Department of Endocrinology, 3 Department of Surgery and 4 Department of Biochemistry; Clínica Universitaria de Navarra, University of Navarra, Pamplona, Spain
Summary
Epidemiological studies have shown that obesity is associated with increased blood concentrations of proinflammatory factors and markers of endothelial dysfunction such as fibrinogen, C-reactive protein (CRP), and vonWillebrand factor (vWF).We analyzed the association of these markers with percentage of body fat (BF), and the influence of leptin in a cross-sectional study of 1,089 subjects (366 men) aged 44 (34–53) [median (interquartile range)] years, who were classified as obese or nonobese according to BF estimated by whole-body air displacement plethysmography. Obesity was defined as BF ≥ 25% in men and ≥ 35% in women.Compared with non-obese subjects (mean ± SD), obese patients had higher concentrations of fibrinogen (312 ± 78 vs.342 ± 81 mg/dl,P < 0.001),CRP (0.41 ± 0.75 vs.0.75 ± 1.04 mg/l, P = 0.014), vWF (107 ± 29 vs. 123 ± 55%, P < 0.001), and leptin (10.4 ± 6.5 vs. 37.5 ± 26.1 ng/ml, P < 0.0001). A positive correlation was observed between BF and fibrinogen (r = 0.266; P < 0.0001), logCRP (r = 0.409; P < 0.0001), and vWF ( r = 206; P < 0.0001). Leptin was correlated with fibrinogen ( r = 0.219, P < 0.0001), logCRP (r = 0.339, P < 0.0001), and vWF ( r = 0.124, P = 0.002), but the statistical significance was lost after including BF in adjusted-correlation and multivariate analysis, suggesting that they are not regulated by leptin per se. In conclusion, the obesity-associated increase in the circulating concentrations of fibrinogen, CRP, and vWF is highly associated to BF and apparently not determined by leptin. Keywords
obesity, inflammation, leptin, adipose tissue, insulin resistance
DOI
http://dx.doi.org/10.1160/TH06-02-0079