2
|
Saber H, Himali JJ, Shoamanesh A, Beiser A, Pikula A, Harris TB, Roubenoff R, Romero JR, Kase CS, Vasan RS, Seshadri S. Serum Leptin Levels and the Risk of Stroke: The Framingham Study. Stroke 2015; 46:2881-5. [PMID: 26337973 DOI: 10.1161/strokeaha.115.009463] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Accepted: 08/05/2015] [Indexed: 01/14/2023]
Abstract
BACKGROUND AND PURPOSE Leptin is a major adipokine that regulates weight balance and energy homeostasis. There is inconsistent evidence linking circulating leptin levels to risk of stroke. We tested the hypothesis that leptin levels are associated with risk of incident stroke in an elderly community based sample. METHODS Serum leptin levels were assayed in 757 stroke free individuals (mean age, 79 years; 62% women) from the Framingham Original Cohort at the 22nd examination cycle (1990-1994). Incidence of all -stroke and ischemic stroke were prospectively ascertained. RESULTS During a mean follow up of 10 years, 119 individuals developed stroke (99 ischemic strokes). In multivariable Cox regression models, log leptin levels were not associated with incidence of all -stroke or ischemic stroke (hazard ratios per SD increment in log leptin 0.90 [0.73-1.09] and 0.89 [0.72-1.11], respectively). The results were suggestive for potential effect modification by waist/hip ratio for the association between leptin and stroke (P=0.03). Adjusting for age, sex, and established stroke risk factors, analysis stratified by waist/hip ratio quartiles revealed a lower incidence of first-ever all-stroke and ischemic stroke associated with higher leptin levels among only subjects in the top waist/hip ratio quartile (hazard ratio, 0.64 [0.43, 0.95] versus 0.98 [0.77, 1.25] for incident all-stroke and 0.61 [0.39, 0.95] versus 0.96 [0.74, 1.26] for ischemic stroke). CONCLUSIONS Leptin levels were not directly related to the risk of incident stroke overall but there was an inverse association with stroke in the top waist/hip ratio quartile. Further investigations are required to confirm these findings and explore possible mechanisms for the observed association.
Collapse
Affiliation(s)
- Hamidreza Saber
- From the Framingham Heart Study, MA (H.S., A.B., J.R.R., C.S.K., R.S.V., S.S.); Department of Biostatistics, Boston University School of Public Health, MA (A.B.); Division of Neurology, Department of Medicine, McMaster University/Population Health Research Institute, Hamilton, ON, Canada (A.S.); Department of Neurology, University of Toronto, Toronto, ON, Canada (A.P.); Geriatric Epidemiology section, National Institute on Aging, National Institute of Health, Bethesda, MD (T.B.H.); Friedman School of Nutrition Science and Policy, Tufts University School of Medicine, Boston, MA (R.R.); and Department of Neurology, Boston University School of Medicine, MA (H.S., J.J.H., A.B., J.R.R., C.S.K., R.S.V., S.S.).
| | - Jayandra J Himali
- From the Framingham Heart Study, MA (H.S., A.B., J.R.R., C.S.K., R.S.V., S.S.); Department of Biostatistics, Boston University School of Public Health, MA (A.B.); Division of Neurology, Department of Medicine, McMaster University/Population Health Research Institute, Hamilton, ON, Canada (A.S.); Department of Neurology, University of Toronto, Toronto, ON, Canada (A.P.); Geriatric Epidemiology section, National Institute on Aging, National Institute of Health, Bethesda, MD (T.B.H.); Friedman School of Nutrition Science and Policy, Tufts University School of Medicine, Boston, MA (R.R.); and Department of Neurology, Boston University School of Medicine, MA (H.S., J.J.H., A.B., J.R.R., C.S.K., R.S.V., S.S.)
| | - Ashkan Shoamanesh
- From the Framingham Heart Study, MA (H.S., A.B., J.R.R., C.S.K., R.S.V., S.S.); Department of Biostatistics, Boston University School of Public Health, MA (A.B.); Division of Neurology, Department of Medicine, McMaster University/Population Health Research Institute, Hamilton, ON, Canada (A.S.); Department of Neurology, University of Toronto, Toronto, ON, Canada (A.P.); Geriatric Epidemiology section, National Institute on Aging, National Institute of Health, Bethesda, MD (T.B.H.); Friedman School of Nutrition Science and Policy, Tufts University School of Medicine, Boston, MA (R.R.); and Department of Neurology, Boston University School of Medicine, MA (H.S., J.J.H., A.B., J.R.R., C.S.K., R.S.V., S.S.)
| | - Alexa Beiser
- From the Framingham Heart Study, MA (H.S., A.B., J.R.R., C.S.K., R.S.V., S.S.); Department of Biostatistics, Boston University School of Public Health, MA (A.B.); Division of Neurology, Department of Medicine, McMaster University/Population Health Research Institute, Hamilton, ON, Canada (A.S.); Department of Neurology, University of Toronto, Toronto, ON, Canada (A.P.); Geriatric Epidemiology section, National Institute on Aging, National Institute of Health, Bethesda, MD (T.B.H.); Friedman School of Nutrition Science and Policy, Tufts University School of Medicine, Boston, MA (R.R.); and Department of Neurology, Boston University School of Medicine, MA (H.S., J.J.H., A.B., J.R.R., C.S.K., R.S.V., S.S.)
| | - Aleksandra Pikula
- From the Framingham Heart Study, MA (H.S., A.B., J.R.R., C.S.K., R.S.V., S.S.); Department of Biostatistics, Boston University School of Public Health, MA (A.B.); Division of Neurology, Department of Medicine, McMaster University/Population Health Research Institute, Hamilton, ON, Canada (A.S.); Department of Neurology, University of Toronto, Toronto, ON, Canada (A.P.); Geriatric Epidemiology section, National Institute on Aging, National Institute of Health, Bethesda, MD (T.B.H.); Friedman School of Nutrition Science and Policy, Tufts University School of Medicine, Boston, MA (R.R.); and Department of Neurology, Boston University School of Medicine, MA (H.S., J.J.H., A.B., J.R.R., C.S.K., R.S.V., S.S.)
| | - Tamara B Harris
- From the Framingham Heart Study, MA (H.S., A.B., J.R.R., C.S.K., R.S.V., S.S.); Department of Biostatistics, Boston University School of Public Health, MA (A.B.); Division of Neurology, Department of Medicine, McMaster University/Population Health Research Institute, Hamilton, ON, Canada (A.S.); Department of Neurology, University of Toronto, Toronto, ON, Canada (A.P.); Geriatric Epidemiology section, National Institute on Aging, National Institute of Health, Bethesda, MD (T.B.H.); Friedman School of Nutrition Science and Policy, Tufts University School of Medicine, Boston, MA (R.R.); and Department of Neurology, Boston University School of Medicine, MA (H.S., J.J.H., A.B., J.R.R., C.S.K., R.S.V., S.S.)
| | - Ronenn Roubenoff
- From the Framingham Heart Study, MA (H.S., A.B., J.R.R., C.S.K., R.S.V., S.S.); Department of Biostatistics, Boston University School of Public Health, MA (A.B.); Division of Neurology, Department of Medicine, McMaster University/Population Health Research Institute, Hamilton, ON, Canada (A.S.); Department of Neurology, University of Toronto, Toronto, ON, Canada (A.P.); Geriatric Epidemiology section, National Institute on Aging, National Institute of Health, Bethesda, MD (T.B.H.); Friedman School of Nutrition Science and Policy, Tufts University School of Medicine, Boston, MA (R.R.); and Department of Neurology, Boston University School of Medicine, MA (H.S., J.J.H., A.B., J.R.R., C.S.K., R.S.V., S.S.)
| | - Jose Rafael Romero
- From the Framingham Heart Study, MA (H.S., A.B., J.R.R., C.S.K., R.S.V., S.S.); Department of Biostatistics, Boston University School of Public Health, MA (A.B.); Division of Neurology, Department of Medicine, McMaster University/Population Health Research Institute, Hamilton, ON, Canada (A.S.); Department of Neurology, University of Toronto, Toronto, ON, Canada (A.P.); Geriatric Epidemiology section, National Institute on Aging, National Institute of Health, Bethesda, MD (T.B.H.); Friedman School of Nutrition Science and Policy, Tufts University School of Medicine, Boston, MA (R.R.); and Department of Neurology, Boston University School of Medicine, MA (H.S., J.J.H., A.B., J.R.R., C.S.K., R.S.V., S.S.)
| | - Carlos S Kase
- From the Framingham Heart Study, MA (H.S., A.B., J.R.R., C.S.K., R.S.V., S.S.); Department of Biostatistics, Boston University School of Public Health, MA (A.B.); Division of Neurology, Department of Medicine, McMaster University/Population Health Research Institute, Hamilton, ON, Canada (A.S.); Department of Neurology, University of Toronto, Toronto, ON, Canada (A.P.); Geriatric Epidemiology section, National Institute on Aging, National Institute of Health, Bethesda, MD (T.B.H.); Friedman School of Nutrition Science and Policy, Tufts University School of Medicine, Boston, MA (R.R.); and Department of Neurology, Boston University School of Medicine, MA (H.S., J.J.H., A.B., J.R.R., C.S.K., R.S.V., S.S.)
| | - Ramachandran S Vasan
- From the Framingham Heart Study, MA (H.S., A.B., J.R.R., C.S.K., R.S.V., S.S.); Department of Biostatistics, Boston University School of Public Health, MA (A.B.); Division of Neurology, Department of Medicine, McMaster University/Population Health Research Institute, Hamilton, ON, Canada (A.S.); Department of Neurology, University of Toronto, Toronto, ON, Canada (A.P.); Geriatric Epidemiology section, National Institute on Aging, National Institute of Health, Bethesda, MD (T.B.H.); Friedman School of Nutrition Science and Policy, Tufts University School of Medicine, Boston, MA (R.R.); and Department of Neurology, Boston University School of Medicine, MA (H.S., J.J.H., A.B., J.R.R., C.S.K., R.S.V., S.S.)
| | - Sudha Seshadri
- From the Framingham Heart Study, MA (H.S., A.B., J.R.R., C.S.K., R.S.V., S.S.); Department of Biostatistics, Boston University School of Public Health, MA (A.B.); Division of Neurology, Department of Medicine, McMaster University/Population Health Research Institute, Hamilton, ON, Canada (A.S.); Department of Neurology, University of Toronto, Toronto, ON, Canada (A.P.); Geriatric Epidemiology section, National Institute on Aging, National Institute of Health, Bethesda, MD (T.B.H.); Friedman School of Nutrition Science and Policy, Tufts University School of Medicine, Boston, MA (R.R.); and Department of Neurology, Boston University School of Medicine, MA (H.S., J.J.H., A.B., J.R.R., C.S.K., R.S.V., S.S.)
| |
Collapse
|
4
|
Sakai T, Kusakabe T, Ebihara K, Aotani D, Yamamoto-Kataoka S, Zhao M, Gumbilai VMJ, Ebihara C, Aizawa-Abe M, Yamamoto Y, Noguchi M, Fujikura J, Hosoda K, Inagaki N, Nakao K. Leptin restores the insulinotropic effect of exenatide in a mouse model of type 2 diabetes with increased adiposity induced by streptozotocin and high-fat diet. Am J Physiol Endocrinol Metab 2014; 307:E712-9. [PMID: 25159327 DOI: 10.1152/ajpendo.00272.2014] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Leptin may reduce pancreatic lipid deposition, which increases with progression of obesity and can impair β-cell function. The insulinotropic effect of glucagon-like peptide-1 (GLP-1) and the efficacy of GLP-1 receptor agonist are reduced associated with impaired β-cell function. In this study, we examined whether leptin could restore the efficacy of exenatide, a GLP-1 receptor agonist, in type 2 diabetes with increased adiposity. We chronically administered leptin (500 μg·kg⁻¹·day⁻¹) and/or exenatide (20 μg·kg⁻¹·day⁻¹) for 2 wk in a mouse model of type 2 diabetes with increased adiposity induced by streptozotocin and high-fat diet (STZ/HFD mice). The STZ/HFD mice exhibited hyperglycemia, overweight, increased pancreatic triglyceride level, and reduced glucose-stimulated insulin secretion (GSIS); moreover, the insulinotropic effect of exenatide was reduced. However, leptin significantly reduced pancreatic triglyceride level, and adding leptin to exenatide (LEP/EX) remarkably enhanced GSIS. These results suggested that the leptin treatment restored the insulinotropic effect of exenatide in the mice. In addition, LEP/EX reduced food intake, body weight, and triglyceride levels in the skeletal muscle and liver, and corrected hyperglycemia to a greater extent than either monotherapy. The pair-feeding experiment indicated that the marked reduction of pancreatic triglyceride level and enhancement of GSIS by LEP/EX occurred via mechanisms other than calorie restriction. These results suggest that leptin treatment may restore the insulinotropic effect of exenatide associated with the reduction of pancreatic lipid deposition in type 2 diabetes with increased adiposity. Combination therapy with leptin and exenatide could be an effective treatment for patients with type 2 diabetes with increased adiposity.
Collapse
Affiliation(s)
- Takeru Sakai
- Department of Diabetes, Endocrinology, and Nutrition, Kyoto University Graduate School of Medicine, Kyoto, Japan; Medical Innovation Center, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Toru Kusakabe
- Medical Innovation Center, Kyoto University Graduate School of Medicine, Kyoto, Japan;
| | - Ken Ebihara
- Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital, Kyoto, Japan; and
| | - Daisuke Aotani
- Medical Innovation Center, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Sachiko Yamamoto-Kataoka
- Department of Diabetes, Endocrinology, and Nutrition, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Mingming Zhao
- Department of Diabetes, Endocrinology, and Nutrition, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | | | - Chihiro Ebihara
- Department of Diabetes, Endocrinology, and Nutrition, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Megumi Aizawa-Abe
- Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital, Kyoto, Japan; and
| | - Yuji Yamamoto
- Department of Diabetes, Endocrinology, and Nutrition, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Michio Noguchi
- Medical Innovation Center, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Junji Fujikura
- Department of Diabetes, Endocrinology, and Nutrition, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kiminori Hosoda
- Medical Innovation Center, Kyoto University Graduate School of Medicine, Kyoto, Japan; Department of Human Health Science, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Nobuya Inagaki
- Department of Diabetes, Endocrinology, and Nutrition, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kazuwa Nakao
- Medical Innovation Center, Kyoto University Graduate School of Medicine, Kyoto, Japan
| |
Collapse
|