Published: 2016-12-18

Hyperleptinemia - an independent predictor of metabolic syndromein the adult population in Kerala, India

Manju K. Sudharmadevi, Vijayalekshmi Lekshminarayan, Leena K. Balakumaran, Shenoy K. Trivikrama


Background: Hyperleptinemia, associated with obesity which is a major risk factor for metabolic syndrome. Kerala has the highest prevalence of most of the cardio metabolic disorders and risk factors. So we analysed the ability of serum leptin level to predict the risk of developing metabolic syndrome among the adult population in Kerala, India.

Methods: The study included 149 men and 155 women in the age group of 20-60years. Anthropometric measurements and Blood pressure were recorded. BMI and WHR were calculated. Fasting blood sample was used to measure serum leptin, insulin, lipid profile and glucose. HOMA-IR and HOMA-β were calculated. Baseline characterestics (means ± SEM) of men and women were examined by quartiles of serum leptin levels using ANOVA. The strength of association between leptin and components of metabolic syndrome was expressed as Odds Ratio (OR) using logistic regression analysis. p values <0.05 were considered significant.

Results: In men and women, participants in the upper leptin quartiles were more likely to have factors associated with metabolic syndrome including waist circumference, systolic BP, decreased HDL cholesterol etc. Furthermore, those with metabolic syndrome were more likely to be in the upper leptin quartiles. On multivariate binary logistic regression analysis of leptin, the OR was: BMI (OR=3.51), waist circumference (OR=3.14), insulin (OR=4.43), and HOMA-IR (OR=2.4) in men, while in women the association of leptin was strong with abdominal obesity (OR=7.6), insulin (OR=2.8) and Insulin resistance (OR=4.1).

Conclusions: Serum leptin levels had a strong association with components of metabolic syndrome, especially abdominal obesity and insulin resistance. Elevated leptin level should be taken as a warning sign of metabolic syndrome.


Metabolic syndrome, Leptin, Kerala, Abdominal obesity, Insulin resistance

Full Text:



Monica Mars, De Graaf C, CPGM De Groot, CTM Van Rossum, Kok FJ. Fasting leptin and appetite responses induced by a 4-day 65%-energy-restricted diet. International Journal of Obesity. 2006;30(1):122-8.

Zhang Y, Proenca R, Maffei M, Barone M, Leoplod L, Friedman JM. Positional cloning of the mouse obese gene and its human homologue. Nature. 1994;372(6505):425-32.

Considine RV, Sinha MK, Heiman ML, Kriauciunas A, Stephens TW, Nyce MR, et al. Serum immunoreactive leptin concentrations in normal-weight and obese humans. New England Journal of Medicine. 1996;334:292-95.

Reilly MP, Rader DJ. The metabolic syndrome: More than the sum of its parts? Circulation. 2003;108:1546-51.

Deurenberg Yap M, Chew SK, Deurenberg P. Elevated body fat percentage and cardiovascular risks at low body mass index levels among Singaporean, Chinese, Malays and Indians. Obes Rev. 2002;3:209-15.

Rush E, Plank L, Chandu V, Laulu M, Simmons D, Swinburn B, Yajnik C. Body size, body composition and fat distribution : a comparison of young New Zealand men of European, Pacific Island and Asian Indian ethnicities. N Z Med J 2004;117(1207):U1203.

Kim B, Feldman EL. Insulin resistance as a key link for the increased risk of cognitive impairment in the metabolic syndrome. Exp Mol Med. 2015;47:e167.

Ajay KT, Vatsala AR, Suresh Y Bondade, Sonam D, Sangam. Effect of obesity in cardiovascular Functions in Adolescent Male. J Pharm Sci & Res. 2014;6(3):164-66.

Klop B, Elte J W, Cabezas M C. Dyslipidemia in obesity: mechanisms and potential targets. Nutrients. 2013;5(4):1218-40.

Yadav A, Jyoti P, Jain SK, Bhattacharjee J. Correlation of adiponectin and leotin with insulin resistance: A pilot study in healthy North Indian population. Indian J Clin Biochem. 2011;26(2):193-6.

Eckle RH, Grundy SM, Zimmet PZ. The metabolic syndrome. Lancet. 2005;365(9468):1415-28.

Galassi A, Reynolds K, He J. Metabolic syndrome and risk of cardiovascular disease : a meta-analysis. Am J Med. 2006;119(10):812-19.

Friedwald WT, Levy RJ, Fredrickson DS. Estimation of the concentration of LDL-cholesterol in plasma without use of preparative ultracentrifuge. Clin Chem. 1972;18:499-502.

Flier JS, Kahn CR, Roth J. Receptors, antireceptor antibodies and mechanisms of insulin resistance . N Eng J Med. 1979;300(8):413-9.

Matthews DR, Hosker JP, Rudensky AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28:412-9.

National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Third report of the National Cholesterol Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation. 2002;106:3143-421.

Misra A, Misra R, Wijesuriya M, Banerjee D. The metabolic syndrome in South Asians: Continuing escalation and possible solution.Ind J Med Res 2007;125:345-54.

Sreekumar B, Sam Jacob, Allena Elza Varghese, Sharlet George. A study of Metabolic Syndrome in obese patients in a teaching hospital in Kerala. J Evolution of Med and Dental Sci. 2014;3(20):5534-40.

Ramachandran A, Snehalatha C, Vijay V, Satyavani K, Latha E, Haffner SM. Plasma leptin in non-diabetic Asian Indians: Association with abdominal adiposity. Diabet Med. 1997;14:937-41.

Ahima RS, Prabakaran D, Flier JS. Leptin. Annu Res Physiol. 2000;62:413-37.

Myers MG, Michael A. Cowley and Heike Munzberg. Mechanisms of leptin action and leptin resistance. Annual Review of Physiology 2008;70:537-56.

Leon-Cabrera S, Solis-Lozano L, Suarez-Alvarez K, Gonzalez-Chavez A, Bejar YL, Robles-Diaz G et al. Hyperleptinemia is associated with parameters of low-grade systemic inflammation and metabolic dysfunction in obese human beings. Frontiers in Integrative Neuroscience. 2013;7:62.

Wang T, Chang W, Chiu Y, Lee C, Lin K, Cheng YY, et al. Relationships between changes in leptin and insulin resistance levels in obese individuals following weight loss. The Kaohsiung J of Medical Sciences. 2013;29(8):436-43.

Muller G, Ertl J, Gerl M, Preibisch G. Leptin impairs metabolic action of insulin in isolated rat adipocytes. J Biol Chem. 1997;272(16):10585-93.

Rhao AZ, Shinohara MM, Huang D, Shimizu M, Eldar-Finketman H, Krebs EG, et al. Leptin induces insulin-like signalling that antagonizes cAMP elevation by glucagon in hepatocytes. J Biol Chem 2000;275(15):11348-54.