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Serum leptin levels in patients with primary hyperaldosteronism before and after treatment: relationships to insulin sensitivity

Abstract

Background: Leptin is a protein hormone produced predominantly by adipocytes that plays a role in food intake regulation and a series of other physiological processes including blood pressure regulation.

Objectives: The aim of our study was to compare serum leptin levels in patients with primary hyperaldosteronism (PA) with those of healthy subjects and to explore the relationship of serum leptin levels and the parameters of insulin action in these patients before and after surgical or pharmacological treatment.

Methods: Serum potassium, leptin, aldosterone, insulin levels and plasma renin activity were measured and hyperinsulinaemic euglycaemic clamp was performed in 11 patients with PA and 11 healthy age-, gender- and body mass index (BMI)-matched subjects. In eight of 11 patients the same measurements were repeated at least 6 months after surgical or pharmacological treatment.

Results: The basal serum leptin levels in PA patients did not significantly differ from those of healthy subjects (mean ± s.e.m. 8.4 ± 1.9 vs 11.2 ± 1.8 ng/ml, P = 0.30), although their insulin sensitivity was significantly impaired (PA patients vs control subjects: glucose disposal rate in the last 20 min of clamp (M) 18.7 ± 1.8 vs30.6 ± 3.3 μmol/kg/min, metabolic clearance rate of glucose (MCRg) 3.9 ± 0.5 vs7.2 ± 1.1 ml/kg/min, P < 0.05). The surgical or pharmacological treatment of PA patients increased significantly their serum leptin levels (10.9 ± 3.7 vs 8.4 ± 1.9 ng/ml, P < 0.05) and simultaneously improved their insulin sensitivity. Basal serum leptin levels in both groups correlated positively with BMI and serum insulin levels. The inverse relationship between serum leptin levels and the insulin sensitivity parameters was found in both PA patients before treatment and healthy subjects. These relationships disappeared after treatment of PA patients except for those between serum leptin levels and MCRg.

Conclusion: Basal serum leptin levels in untreated patients with PA do not significantly differ from those of healthy subjects, but increase significantly after surgical or pharmacological treatment. The increase in serum leptin levels is paradoxically accompanied by the improvement of insulin sensitivity in these patients.

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References

  1. Zhang Y et al. Positional cloning of the mouse obese gene and its human homologue Nature 1994 372: 425–432

    Article  CAS  PubMed  Google Scholar 

  2. Haluzik M et al. Lower serum leptin concentrations in rugby players in comparison with healthy non sporting controls, relationships to anthropometric and biochemical parameters Eur J Appl Physiol 1998 79: 58–61

    Article  CAS  Google Scholar 

  3. Haluzík M, Papežová H, Nedvídková J, Kábrt J . Serum leptin levels inpatients with anorexia nervosa before and after partial refeeding, relationships to serum lipids and biochemical nutritional parameters Phys Res 1999 48: 197–202

    Google Scholar 

  4. Dagogo-Jack S . Regulation and possible significance of leptin in humans: leptin in health and disease Diab Rev 1999 7: 23–38

    Google Scholar 

  5. Sierra-Honigmann MR et al. Biological action of leptin as an angiogenic factor Science 1998 281: 1683–1686

    Article  CAS  PubMed  Google Scholar 

  6. Hardie L, Trayhurn P, Abramovich D, Fowler P . Circulating leptin in women: a longitudinal study in the menstrual cycle and during pregnancy Clin Endocrinol 1997 47: 101–106

    Article  CAS  Google Scholar 

  7. Cioffi JA et al. Novel B219/OB receptor isoforms: Possible role of leptin in hematopoiesis and reproduction Nat Med 1996 2: 585–589

    Article  CAS  PubMed  Google Scholar 

  8. Zemel MB . Insulin resistance, obesity and hypertension: an overview J Nutr 1995 125: 1715–1717

    Google Scholar 

  9. Haynes WG et al. Receptor-mediated regional sympathetic nerve activation by leptin J Clin Invest 1997 100: 270–278

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Shek EW, Brands MW, Hall JE . Chronic leptin infusion increases arterial pressure Hypertension 1998 31: 409–414

    Article  CAS  PubMed  Google Scholar 

  11. Kokot F, Adamczak M, Wiecek A, Cieplok J . Does leptin play a role in the pathogenesis of essential hypertension? Kidney Blood Press Res 1999 22: 154–160

    Article  CAS  PubMed  Google Scholar 

  12. Sheu WH, Lee WJ, Chen YT . High plasma leptin concentrations in hypertensive men but not in hypertensive women J Hypertens 1999 17: 1289–1295

    Article  CAS  PubMed  Google Scholar 

  13. Uckaya G et al. Plasma leptin levels strongly correlate with plasma renin activity inpatients with essential hypertension Horm Metab Res 1999 31: 435–438

    Article  CAS  PubMed  Google Scholar 

  14. Shamiss A, Caroll J, Rosenthal T . Insulin resistance in secondary hypertension Am J Hypertens 1992 5: 26–28

    Article  CAS  PubMed  Google Scholar 

  15. Shimamoto K et al. Does insulin resistance participate in an impaired glucose tolerance in primary aldosteronism? J Hum Hypertens 1994 8: 755–759

    CAS  PubMed  Google Scholar 

  16. Ishimori M et al. Increased insulin sensitivity inpatients with aldosterone-producing adenoma Clin Endocrinol 1994 41: 433–438

    Article  CAS  Google Scholar 

  17. Šindelka G et al. Insulin action in primary hyperaldosteronism before and after surgical or pharamacological treatment Exp Clin Endocrinol Diab 2000 108: 21–25

    Google Scholar 

  18. Torpy DJ et al. Leptin levels are supressed in primary hyperaldosteronism Horm Metab Res 1999 31: 533–536

    Article  CAS  PubMed  Google Scholar 

  19. Fogt EJ, Dodd LM, Jenning EM, Clemerns AH . Development and evaluation of a glucose analyser for a glucose-controlled insulin infusion system Clin Chem 1978 24: 1366–1372

    CAS  PubMed  Google Scholar 

  20. Coleman RA, Herrmann TS . Nutritional regulation of leptin in humans Diabetologia 1999 42: 639–646

    Article  CAS  PubMed  Google Scholar 

  21. Frühbeck G, Salvador J . Relation between leptin and the regulation of glucose metabolism Diabetologia 2000 43: 3–12

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

This study is supported by grants from IGA MH No. 5455-3, 5031-3, 6663-3, 6669-3 and Research Project of Ministry of Education No. J13/98:111100002-1. We thank Bio Vendor company for kindly providing ELISA kits for leptin measurements.

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Correspondence to M Haluzík.

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Haluzík, M., Šindelka, G., Widimský Jr, J. et al. Serum leptin levels in patients with primary hyperaldosteronism before and after treatment: relationships to insulin sensitivity. J Hum Hypertens 16, 41–45 (2002). https://doi.org/10.1038/sj.jhh.1001292

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