This Article Full Text Full Text (PDF) Submit a related Letter to the Editor Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Perego, L. Articles by Pontiroli, A. E. Search for Related Content PubMed PubMed Citation Articles by Perego, L. Articles by Pontiroli, A. E. Related Collections Cardiovascular Endocrinology Obesity

Circulating Leptin Correlates with Left Ventricular Mass in Morbid (Grade III) Obesity before and after Weight Loss Induced by Bariatric Surgery: A Potential Role for Leptin in Mediating Human Left Ventricular Hypertrophy

Divisione di Medicina Interna (L.P., F.F., P.F.), Chirurgia Generale (M.P.), and Cardiochirurgia (F.M.), Istituto Scientifico San Raffaele, 20132 Milan, Italy; Cattedra di Medicina Interna, H. San Paolo, Università degli Studi di Milano (A.E.P., P.P.), 20142 Milan, Italy; Dipartimento di Patologia e Medicina di Laboratorio, Università degli Studi di Parma (D.C.), 43100 Parma, Italy; Istituto di Statistica Medica (A.M.), H San Paolo, Università degli Studi di Milano, Milan, Italy; and Dipartimento di Gerontologia, Geriatria e Malattie del Metabolismo, Seconda Università di Napoli (M.B., G.P.), 80138 Naples, Italy

Address all correspondence and requests for reprints to: Dr. Franco Folli, Department of Medicine, Istituto Scientifico San Raffaele, Via Olgettina 60, 20132 Milan, Italy. E-mail: franco.folli{at}hsr.it.

Context: Obesity is frequently associated with left ventricular hypertrophy, even when uncomplicated by hypertension or diabetes mellitus. Left ventricular hypertrophy is an important risk factor for congestive heart failure.

Objective: The objective of this study was to evaluate the relationship between leptin and left ventricular mass in uncomplicated, morbid (grade 3) obesity and the existence of leptin receptors and intracellular signaling proteins in the human heart.

Design: Left ventricular mass (LVM) was calculated through electrocardiogram reading in normotensive grade III obese patients (World Health Organization classification) undergoing bariatric surgery [laparoscopic adjustable gastric banding (LAGB)] at baseline and 1 yr later. The control group was composed of healthy lean normotensive subjects. Leptin receptors were detected by PCR and immunocytochemistry in human heart biopsies.

Setting: This study was performed at university hospitals.

Patients: Thirty-one grade 3 obese patients and 30 healthy nonobese normotensive, age- and sex-matched control subjects were studied.

Intervention: Obese subjects underwent LAGB to induce weight loss and were evaluated at baseline and after 1 yr.

Results: LVM, plasma leptin, glucose, insulin levels, and homeostasis model assessment index were higher in obese than in lean controls (P < 0.01); at univariate regression analysis, LVM correlated with body mass index, leptin, and homeostasis model assessment index; at multiple regression analysis, LVM only correlated with leptin levels (P = 0.001). Obese subjects were reevaluated 1 yr after LAGB, when their body mass index changed from 46.2 ± 1.24 to 36.6 ± 1.05 kg/m² (P < 0.01); the decrease in LVM correlated only with the decrease in leptin levels (P < 0.01). We demonstrated that long and short isoforms of the leptin receptor and intracellular proteins mediating leptin signaling were expressed in human heart by RT-PCR, immunocytochemistry, or both methods.

Conclusions: These data suggest that leptin could contribute to the left ventricular hypertrophy in humans.

This article has been cited by other articles:

				H. Ashrafian, C. W. le Roux, A. Darzi, and T. Athanasiou Effects of Bariatric Surgery on Cardiovascular Function Circulation, November 11, 2008; 118(20): 2091 - 2102. [Full Text] [PDF]

				Y. Abe, K. Ono, T. Kawamura, H. Wada, T. Kita, A. Shimatsu, and K. Hasegawa Leptin induces elongation of cardiac myocytes and causes eccentric left ventricular dilatation with compensation Am J Physiol Heart Circ Physiol, May 1, 2007; 292(5): H2387 - H2396. [Abstract] [Full Text] [PDF]

				A. E. Pontiroli, P. Pizzocri, R. Paroni, and F. Folli Sympathetic Overactivity, Endothelial Dysfunction, Inflammation, and Metabolic Abnormalities Cluster in Grade III (World Health Organization) Obesity: Reversal through sustained weight loss obtained with laparoscopic adjustable gastric banding Diabetes Care, December 1, 2006; 29(12): 2735 - 2738. [Full Text] [PDF]