Positive correlation of serum leptin levels and peripheral arterial stiffness in patients with type 2 diabetes

Chia‑Wen Lu^a†, Chung‑Jen Lee^b†, Jia‑Sian Hou^a,c, Du‑An Wu^d,e, Bang‑Gee Hsu^c,e,f*

^aDepartment of Nursing, Buddhist Tzu Chi General Hospital, Hualien, Taiwan, ^bDepartment of Nursing, Tzu Chi University of Science and Technology, Hualien, Taiwan, ^cInstitute of Medical Sciences, Tzu Chi University, Hualien, Taiwan, ^dDepartment of Metabolism and Endocrinology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan, ^eSchool of Medicine, Tzu Chi University, Hualien, Taiwan, ^fDepartment of Nephrology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan

†Both authors contributed equally to this work.

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Open Access funded by Buddhist Compassion Relief Tzu Chi Foundation

Abstract

Objective: Leptin plays a pathophysiologic role in the pathogenesis of aortic dysfunction and peripheral arterial stiffness (PAS). Our aim was to evaluate the risk factors for developing PAS and the association of leptin and PAS in patients with type 2 diabetes mellitus (DM). Materials and Methods: Fasting blood samples were obtained for biochemical data and leptin determinations from 105 patients with type 2 DM. In this study, we applied an automatic pulse wave analyzer (VaSera VS‑1000) to measure the brachial‑ankle pulse wave velocity (baPWV); a baPWV value >14.0 m/s on either side was considered high PAS. Results: Seventy‑five patients (71.4%) had high PAS and they included a higher percentage of patients with hypertension (P < 0.001), older age (P < 0.001), and a higher body fat mass (P = 0.043), systolic blood pressure (P < 0.001), diastolic blood pressure (P = 0.016), serum blood urea nitrogen (P = 0.003), and leptin level (P < 0.001), and lower height (P = 0.027) and glomerular filtration rate (P < 0.001) compared with type 2 DM patients with low PAS. After adjusting for factors significantly associated with PAS in these patients by multivariate logistic regression analysis, age (β = 0.470, adjusted R2 change = 0.279; P < 0.001), logarithmically transformed leptin (log‑leptin, β = 0.259, adjusted R2 change = 0.085; P = 0.001), and hypertension (β = 0.197, adjusted R2 change = 0.031; P = 0.011) were significant independent predictors of PAS in type 2 DM patients. Conclusion: The serum leptin level could be a predictor of PAS in type 2 DM patients.

Keywords: Brachial‑ankle pulse wave velocity, Leptin, Peripheral arterial stiffness, Type 2 diabetes mellitusevents