Published in:
01-11-2010 | Original article
Leptin mediates the relationship between abdominal obesity and microalbuminuria in type 2 diabetic patients
Published in: Diabetology International | Issue 1/2010
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Background
Abdominal obesity has been implicated in the pathogenesis of microalbuminuria in patients with diabetes; however, the underlying mechanisms remain unclear. Increased leptin secretion by adipocytes may be one of the factors responsible for the relationship between abdominal obesity and microalbuminuria, because increased leptin secretion has been demonstrated to contribute to renal impairment. We therefore conducted a cross-sectional study to clarify the relationship between increased serum leptin levels associated with abdominal obesity and albuminuria in patients with type 2 diabetes mellitus (T2DM).
Methods
We studied a total of 502 adult patients with T2DM, 220 women and 282 men, with a mean (±SD) age of 60 ± 13 years. Patients with macroalbuminuria and those with an estimated glomerular filtration rate of <15 ml/min/1.73 m2 were excluded. Waist circumference was used as a surrogate marker of abdominal obesity. For statistical analyses, analysis of covariance and multivariate linear regression analysis were conducted.
Results
The geometric mean (95% confidence interval) of serum leptin levels adjusted for conventional risk factors was significantly higher in patients with microalbuminuria than in those with normoalbuminuria [5.6 (5.3–5.9) vs. 6.3 (5.8–6.8) ng/ml, p = 0.030]. In the multiple regression analysis, waist circumference was significantly associated with urinary albumin excretion, though statistical significance disappeared when serum leptin levels were incorporated into this model. Serum leptin levels remained significantly associated with urinary albumin excretion.
Conclusions
Leptin may be a factor mediating the relationship between abdominal obesity and microalbuminuria in patients with T2DM.