This article is more than 5 years old. Information may no longer be current.
Leptin to adiponectin ratio may predict metabolic dysfunction in obesity
The ratio of leptin to adiponectin may be a useful surrogate biomarker for early obesity-related metabolic disorders, such as leptin resistance, insulin resistance and delayed postprandial triglyceride clearance, according to a study published in Nutrition, Metabolism & Cardiovascular Diseases.
“We have previously showed a prolonged postprandial clearance of triglycerides in metabolically healthy obese adults, indicating metabolic disturbances in these apparently healthy subjects,” Maria Arlen Larsen, PhD, of the Research Group of Gastroenterology and Nutrition, Arctic University of Norway, and colleagues wrote in the study background. “It is of importance to detect individuals at high risk for further disease development, so that prophylactic actions can be taken. At this point, no clinical screening tools exist that are sensitive enough to detect early metabolic disturbances in [metabolically healthy obesity].”
Larsen and colleagues evaluated 50 adults with obesity (BMI 30 kg/m²) and clinical or biochemical signs of metabolic disease and 17 healthy, normal-weight controls recruited from the Centre of Obesity at University Hospital of North Norway. Among the participants with obesity, 36 adults were considered to have metabolically healthy obesity (meeting no criteria for metabolic syndrome apart from waist circumference measurement) and 14 adults were considered to have metabolically dysregulated obesity (meeting at least two criteria for metabolic syndrome). The researchers used an 8-hour oral fat tolerance test to measure postprandial triglyceride clearance and assessed insulin resistance via homeostatic model assessment of insulin resistance (HOMA-IR; cutoff value, 1.83). Indirect leptin resistance was also calculated as an indirect measure of resting energy expenditure to serum leptin ratio (cutoff value, 114.5). Researchers developed a leptin to adiponectin ratio receiver operating characteristics (ROC) curve to identify delayed triglyceride clearance, defined as less than 88.8% at 6 hours.
Within the cohort, 42 adults with obesity had leptin resistance (including 31 with metabolically healthy obesity), 35 adults had insulin resistance (including 25 with metabolically healthy obesity) and 37 adults had delayed triglyceride clearance.
Additionally, 38.9% of adults with metabolically healthy obesity and 42.9% of adults with metabolically dysregulated obesity had a combination of delayed triglyceride clearance, insulin resistance and leptin resistance, according to researchers.
Youden index revealed two optimal cutoff values for leptin to adiponectin ratio: first at 1.36, and second at 3.65. In logistic regression analyses, researchers found that the cutoff value of 1.36 produced an OR of 8 (95% CI, 2-31) for pathologic triglyceride clearance and accurately identified 79% of cases, whereas the cutoff value of 3.65 produced an OR of 7 (95% CI, 2-28), accurately identifying 76% of cases. In a similar logistic regression analysis, researchers found that a leptin to adiponectin ratio cutoff of 2.2 yielded an OR of 31 (95% CI, 6-166) for pathologic insulin resistance, identifying 81% of cases accurately.
In an ROC analysis combining delayed triglyceride clearance, insulin resistance and leptin resistance, the most appropriate leptin to adiponectin ratio cutoff was greater than 1.88, the researchers wrote. In logistic regression analysis, researchers found that the leptin to adiponectin ratio of 1.88 produced and OR of 48 (95% CI, 8-296) for having at least two metabolic disorders.
“We suggest that [leptin to adiponectin] ratio may be a good surrogate biomarker of early obesity-related metabolic disturbances of either kind,” the researchers wrote. “This may enable early, directed intervention and prevention of developing metabolic disturbances and related diseases.” – by Jennifer Byrne
Disclosures: The authors report no relevant financial disclosures.