Hyperleptinaemia, respiratory drive and hypercapnic response in obese patients (original) (raw)
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Obesity Facts, 2012
Objective: To assess the effects of weight loss on adipokines, asthma-related symptoms, exercise-induced bronchospasm (EIB) and lung function, and to evaluate the role of leptin and adiponectin levels on lung function after treatment in obese adolescents. Methods: 84 postpubertal obese adolescents were enrolled and distributed in quartiles according to weight loss (low (! 2.5 kg), low to moderate (1 2.5 and ! 8 kg), moderate (! 8 and ! 14 kg) and massive (! 14 kg)). Body composition was measured by plethysmography, and visceral and subcutaneous fat were detected by ultrasound. Serum levels of adiponectin and leptin were analyzed. Lung function, asthma and EIB were evaluated according to the American Thoracic Society criteria. Patients were submitted to 1 year of interdisciplinary intervention consisting of physiotherapy, medical, nutritional, exercise, and psychological therapy. Results: After treatment the moderate and massive weight loss promoted an increase in adiponectin and adiponectin/ leptin (A/L) ratio as well as a decrease in leptin levels and a reduction in EIB frequency and asthma-related symptoms. Furthermore, the reduction in leptin levels was a predictor factor to improvement in lung function. Conclusion: Interdisciplinary therapy was able to decrease EIB and asthma-related symptoms and to improve pro/anti-inflammatory adipokines. Additionally, the leptin concentration was a predictor factor to explain changes in lung function.
Leptin: A Potential Link Between Obstructive Sleep Apnea and Obesity
Frontiers in Physiology
Chronic intermittent hypoxia (CIH), a pathophysiological manifestation of obstructive sleep apnea (OSA), is strongly correlated with obesity, as patients with the disease experience weight gain while exhibiting elevated plasma levels of leptin. This study was done to determine whether a relationship may exist between CIH and obesity, and body energy balance and leptin signaling during CIH. Sprague-Dawley rats were exposed to 96 days of CIH or normoxic control conditions, and were assessed for measures of body weight, food and water intake, and food conversion efficiency. At the completion of the study leptin sensitivity, locomotor activity, fat pad mass and plasma leptin levels were determined within each group. Additionally, the hypothalamic arcuate nucleus (ARC) was isolated and assessed for changes in the expression of proteins associated with leptin receptor signaling. CIH animals were found to have reduced locomotor activity and food conversion efficiency. Additionally, the CIH...
Respiratory Medicine, 2007
Background: Long-term nocturnal non-invasive mechanical ventilation (NIMV) is an effective treatment for obesity-hypoventilation syndrome (OHS), improving central carbon dioxide (CO 2 ) sensitivity. Leptin might contribute to sustain adequate ventilation in obesity. The aim of the study was to investigate the role of leptin in the OHS pathogenesis looking at its relationship to CO 2 sensitivity before and after NIMV in OHS patients. Methods: In six obese patients (3F/3M; aged 6379 yr; BMI 47.074.5 kg/m 2 ) with OHS and without obstructive sleep apnoea-hypopnoea (OSAH) diurnal arterial blood gases, fasting plasma leptin concentration and CO 2 chemosensitivity were determined before and after 10.375.6 (range 6-20) months of NIMV. Results: After NIMV improvements were observed in gas exchange (PaO 2 from 51.376.7 to 75.0710.3 mmHg, po0.01; PaCO 2 from 55.574.8 to 43.771.2 mmHg, po0.01; [HCO 3 À ] from 33.373.8 to 29.871.7 mmol/l, po0.05) and CO 2 chemosensitivity, measured as P 0.1 / PetCO 2 slope (from 0.0970.07 to 0.1870.07 cmH 2 O/mmHg, po0.05) and V E /PetCO 2 slope (from 0.470.3 to 0.970.5 l/min/mmHg, p ¼ 0:07). Plasma leptin increased from 34.5721.1 ng/ml to 50.2722.9 ng/ml (po0.01) after NIMV and changes of the P 0.1 / PetCO 2 slope correlated with percent changes of plasma leptin (r 2 ¼ 0:79, po0.05). Conclusions: These findings suggest a possible role of leptin in the recovery of neuromuscular response to hypercapnia obtained during long-term nocturnal NIMV in OHS patients without OSAH.
Treatment of Obesity Hypoventilation Syndrome and Serum Leptin
Respiration, 2006
2.2 kg/m 2 , PaCO 2 6.7 8 0.2 kPa, PaO 2 8.9 8 0.4 kPa and total respiratory disturbance index 44 8 35 events/hour. Subjects were clinically reviewed after a median of 2.3 years (range 1.6-3) with repeat investigations. Nine patients were regular NIV users and 5 were non-users. NIV users had a signifi cant reduction in serum leptin levels (p = 0.001), without a change in BMI. In these patients, there was a trend towards an improved daytime hypercapnia and hypoxemia, while in the 5 non-users, no changes in serum leptin, BMI or arterial blood gases occurred. Conclusion: Regular NIV use reduces serum leptin in OHS. Leptin may be a modulator of respiratory drive in patients with OHS.
Indian Journal of Tuberculosis, 2015
Background: Leptin takes part in regulation of energy balance, neuronal functions, pain and mood. It may act as intermediary marker for various components of HRQOL in patients of obstructive sleep apnea syndrome. Aims: To document the correlation among leptin levels, obesity and HRQoL in OSAS patients. Methods: A tertiary care hospital based cross-sectional study was done in 224 subjects aged 18e65 years, after taking informed consent. Subjects with previous history of smoking, Liver disease, COPD, CHD, T2 DM, asthma, cancer, end stage renal disease, heart failure, any endocrine disorder including Cushing syndrome, thyroid, on systemic steroid or any continuous medication for last 6 months, on dieting or suffering from any disability condition (other than obesity and OSAS) affecting their HRQoL were excluded from the study. All subjects underwent Polysomnography. Leptin assay was done by ELISA method. Hindi version of HRQoL tool SF-36 was used to evaluate HRQoL. Results: SPSS 20 was used to analyse data. Three groups (AHI <5, 5 to 15 and >15) were compared. Significant differences were observed in BMI, NC, WC, WHR and ESS. Differences were not significant in sleep architecture and Leptin level. SF-36 HRQoL, scores were observed decreased with increase in severity of disease. Leptin level was found significantly correlated with "Role limitations due to physical health problems", "Social functioning", Hypopnea and obesity indices. Conclusions: In these subjects Obesity indices are the most important correlates of Leptin level. Oxygen desaturation indices with exception of Hypopnea and HRQoL may not be exclusively correlated to leptin levels.
Objective: The aim of this study was to assess the level of serum leptin hormone in chronic obstructive pulmonary disease patients during acute exacerbation and in stable conditions and also, to determine if these changes correlate with changes in the ventilatory functions. Methods: Sixty cases were included in this prospective study (40 COPD patients and 20 age related smokers without symptoms or signs of COPD and within normal pulmonary functions as a control). Patients and control were divided according to their BMI into obese (BMI P 30) and non-obese (BMI = 18.5–25). Subjects were submitted to full history taking, thorough physical examination, plain chest X-ray, complete blood count, erythrocyte sedimentation rate, liver and kidney functions, fasting and post prandial blood sugar, ventilatory functions, and serum leptin level measurement. Results: Serum leptin level (ng/ml) was significantly higher (P < 0.001) in stable obese COPD (mean ±SD = 23.85± 4.47) patients than obese controls (mean ± SD= 20.9 ± 2.7) and stable non-obese COPD (mean ± SD= 5.63 ± 1.05) and stable non-obese COPD cases had significantly higher (P <0.05) serum leptin level than non-obese controls (mean ± SD= 6.53 ± 1.19). Serum leptin level was significantly higher (P< 0.001) in obese COPD cases during exacerbation (mean ±SD = 67.59± 9.8) than in non-obese COPD cases during exacerbation(mean±SD=18.14±4.15). Significant positive correlation between serum leptin and BMI (kg/m2) of different groups (P <0.01) [obese control (r = 0.945), non-obese control (r =0.970), obese COPD in exacerbation (r = 0.812), obese COPD in stable state (r = 0.774), non-obese COPD exacerbation (r =0.876) and non-obese COPD in stable state (r = 0.799)]. Conclusion: Serum leptin hormone level (ng/ml) was significantly higher in obese COPD cases than in controls and non-obese cases and during exacerbation than in stability which indicates that leptin plays a role in the systemic inflammatory process. Serum leptin hormone level positively correlated with BMI (kg/m2).
Circulation, 1999
Background—Obstructive sleep apnea syndrome (OSAS) is a common disorder in obese subjects. Visceral fat accumulation (VFA) is a better predictor of coronary heart disease than body mass index. Leptin is a hormone involved in the control of body weight and fat distribution. The effect of nasal continuous positive airway pressure (NCPAP) treatment on VFA and serum leptin levels in OSAS patients has not been known.Methods and Results—VFA and subcutaneous fat accumulation (SFA) were assessed by CT before and after NCPAP treatment in 22 OSAS patients (mean apnea and hypopnea index >50 episodes/h). Serum leptin levels of another 21 OSAS patients were measured before and after 3 to 4 days of NCPAP to gain insight into the mechanism by which NCPAP affects fat distribution. VFA and SFA decreased significantly after 6 months of NCPAP treatment (236±16 to 182±14cm2,P=0.0003 and 215±21 to 189±18 cm2,P=0.003, respectively). VFA decreased significantly in the body weight reduction group (n=9,P...
Intranasal Leptin Relieves Sleep-disordered Breathing in Mice with Diet-induced Obesity
American Journal of Respiratory and Critical Care Medicine
Rationale: Leptin treats upper airway obstruction and alveolar hypoventilation in leptin-deficient ob/ob mice. However, obese humans and mice with diet-induced obesity (DIO) are resistant to leptin because of poor permeability of the blood-brain barrier. We propose that intranasal leptin will bypass leptin resistance and treat sleep-disordered breathing in obesity. Objectives: To assess if intranasal leptin can treat obesity hypoventilation and upper airway obstruction during sleep in mice with DIO. Methods: Male C57BL/6J mice were fed with a high-fat diet for 16 weeks. A single dose of leptin (0.4 mg/kg) or BSA (vehicle) were administered intranasally or intraperitoneally, followed by either sleep studies (n = 10) or energy expenditure measurements (n = 10). A subset of mice was treated with leptin daily for 14 days for metabolic outcomes (n = 20). In a separate experiment, retrograde viral tracers were used to examine connections between leptin receptors and respiratory motoneurons. Measurements and Main Results: Acute intranasal, but not intraperitoneal, leptin decreased the number of oxygen desaturation events in REM sleep, and increased ventilation in non-REM and REM sleep, independently of metabolic effects. Chronic intranasal leptin decreased food intake and body weight, whereas intraperitoneal leptin had no effect. Intranasal leptin induced signal transducer and activator of transcription 3 phosphorylation in hypothalamic and medullary centers, whereas intraperitoneal leptin had no effect. Leptin receptor-positive cells were synaptically connected to respiratory motoneurons. Conclusions: In mice with DIO, intranasal leptin bypassed leptin resistance and significantly attenuated sleep-disordered breathing independently of body weight.
Leptin and ventilatory function response to exercise in obese boys and girls: A comparative study
This study was an attempt to determine and compare difference in response of serum leptin and ventilatory function (including forced vital capacity "FVC" and forced expiratory volume in the first second "FEV1") in obese boys and obese girls to aerobic exercise. Subjects: 40 obese child (body mass index (BMI)) in the 95 th percentile or greater) with age range of 10 to 13 years were into the study. They were divided into two groups of equal number, 20 obese boys (Group A) and 20 obese girls (Group B). Methods: Both groups received moderate intensity aerobic exercise training on a stationary bicycle ergometer for 3 months; 5 days per week. Serum leptin level and ventilatory function (FVC and FEV 1) were assessed in all children before beginning and after finishing the study. Results: After 3 months of aerobic exercise training; There were significant reduction in serum leptin and significant increase in ventilatory function in both obese boys and obese girls groups. Furthermore; there was significant difference between both groups in serum leptin in favor of group B. In the contrary; there was significant difference between both groups in ventilatory function in favor of group A. Conclusion: after aerobic training; ventilatory functions respond in obese boys more favorably than in obese girls. In the contrary; serum leptin respond in obese girls more favorably than in obese boys. [Mohamed A A., Abd El-Kafy EM, Mohamed SM. Leptin and ventilatory function response to exercise in obese boys and girls: A comparative study. J Am Sci 2012;8(9):857-863]. (ISSN: 1545-1003). http://www.jofamericanscience.org. 117