Title:What Fans the Fire: Insights into Mechanisms of Leptin in Metabolic Syndrome- Associated Heart Diseases
Volume: 20
Issue: 4
Author(s): Maolong Dong and Jun Ren
Affiliation:
Keywords:
Leptin, leptin resistance, cardiovascular disease, metabolic syndrome.
Abstract: Obesity and metabolic syndrome are one of the most devastating risk factors for cardiovascular diseases. The obesity gene
product leptin plays a central role in the regulation of food intake and energy expenditure. The physiological and pathophysiological roles
of leptin in cardiovascular system have been investigated extensively since its discovery in 1994. In addition to its well-established metabolic
effects, more recent evidence have depicted a rather pivotal role of leptin in inflammation, oxidative stress, endoplasmic reticulum
stress, apoptosis and tissue remodeling en route to the pathogenesis of type 2 diabetes mellitus, hypertension, atherosclerosis, and insulin
resistance. Under physiological condition, leptin is known to reduce appetite, promote energy expenditure, increase sympathetic activity,
facilitate glucose utilization and improve insulin sensitivity. In addition, leptin may regulate cardiac and vascular function through a nitric
oxide-dependent mechanism. However, hyperleptinemia usually occurs with progressively increased body weight and metabolic syndrome
development, leading to a state of global or selective leptin resistance. Both central and peripheral leptin resistance may be present
under pathophysiological conditions such as inflammation, insulin resistance, hyperlipidemia and a cadre of other cardiovascular diseases
including hypertension, atherosclerosis, obesity, ischemic heart disease and heart failure. In this review, we will discuss cardiovascular
actions of leptin related to various components of metabolic syndrome. Particular emphasis will be given to insights derived from therapeutic
interventions with lifestyle modification, cardiovascular drugs, anti-diabetic and anti-obesity drugs.
