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- Title
Leptin mediate central obesity on the severity of cardiovascular autonomic neuropathy in well-controlled type 2 diabetes and prediabetes.
- Authors
Lai, Yun-Ru; Chen, Meng Hsiang; Lin, Wei Che; Chiu, Wen-Chan; Cheng, Ben-Chung; Chen, Jung-Fu; Tsai, Nai-Wen; Huang, Chih-Cheng; Lu, Cheng-Hsien
- Abstract
<bold>Background: </bold>Evidences support the view that central obesity is an independently cardiovascular risk. It is thought that leptin contributes to autonomic dysfunction and cardiovascular risks in type 1 and type 2 diabetes mellitus (T1DM and T2DM). This raises the possibility that leptin might mediate the relationship between central obesity and the severity of cardiovascular autonomic neuropathy (CAN) in patients with well-controlled T2DM and prediabetes.<bold>Methods: </bold>The complete cardiovascular reflex tests and biomarkers were assessed for each patient. The severity of CAN was assessed using composite autonomic scoring scale (CASS). A single-level three-variable mediation model was used to investigate the possible relationships among central obesity [as indicated by waist circumference (WC)], leptin level, and severity of CAN (as indicated by CASS value).<bold>Results: </bold>A total of 107 patients were included in this study: 90 with diabetes and 17 with prediabetes. The results demonstrate that increased WC is associated with increased severity of CAN (r = 0.242, P = 0.017). We further discovered that leptin level is positively correlated with WC (r = 0.504, P < 0.0001) and the CASS value (r = 0.36, P < 0.0001). Further mediation analysis shows that leptin level serves as mediators between higher WC and higher CASS.<bold>Conclusions: </bold>Our results highlighted the relationship among leptin, central obesity, and severity of CAN. As the leptin level serves as mediator between central obesity and severity of CAN, a longitudinal study is needed to confirm that control of WC can decrease leptin levels and can be effective in reducing CAN progression.
- Subjects
LEPTIN; TYPE 2 diabetes; TYPE 1 diabetes; WAIST circumference; OBESITY; OBESITY complications; RESEARCH; RESEARCH methodology; MEDICAL cooperation; EVALUATION research; COMPARATIVE studies; BODY mass index; PREDIABETIC state; LONGITUDINAL method; DISEASE complications
- Publication
Journal of Translational Medicine, 2020, Vol 18, Issue 1, p1
- ISSN
1479-5876
- Publication type
journal article
- DOI
10.1186/s12967-020-02559-7