Vol 9, No 4 (2020)
Research paper
Published online: 2020-07-21

open access

Page views 958
Article views/downloads 594
Get Citation

Connect on Social Media

Connect on Social Media

Serum leptin level and microvascular complications in type 2 diabetes

Talaat A Abdel Aaty1, Mohamed M Rezk2, Magdy H Megallaa1, Maha E Yousseif1, Heba S Kassab1
Clin Diabetol 2020;9(4):239-244.


Background. Type 2 diabetes (T2DM) and its complications are highly prevalent in Egypt and are considered a major health problem. Insulin resistance arising from visceral obesity is the main pathological mechanism of T2DM. Leptin is an adipokine secreted from visceral adipose tissue and its level is proved to be higher in patients with T2DM, but its association with microvascular complications is not yet well-established, for this aim the present study was conducted. Methods. This cross-sectional study was conducted among 120 participants with T2DM recruited from the diabetes outpatient clinic of Alexandria Main Uni­versity Hospital, Alexandria, Egypt. Each participant was subjected to full history taking, complete physical examination and laboratory investigations. Results. Serum leptin level was significantly positively correlated with diabetes duration, BMI, WC, systolic and diastolic blood pressure, FPG, HbA1c, serum insu­lin level, HOMA-IR, total cholesterol, triglycerides and LDL-C. Regarding microvascular complications, serum leptin level was highly significantly positively correlated with UACR, peripheral neuropathy and retinopathy (P < 0.001) and significantly negatively correlated with e-GFR (P = 0.003). Conclusions. Serum leptin level is significantly correlated with microvascular complications in patients with T2DM in Alexandria, Egypt.

Article available in PDF format

View PDF Download PDF file


  1. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes—2020. Diabetes Care. 2019; 43(Suppl. 1): S14–S31.
  2. Khalil SH, Megallaa MH, Rohoma KH, et al. Prevalence of type 2 diabetes mellitus in a sample of the adult population of Alexandria, Egypt. Diabetes Res Clin Pract. 2018; 144: 63–73.
  3. Lin Yi, Sun Z. Current views on type 2 diabetes. J Endocrinol. 2010; 204(1): 1–11.
  4. Kahn SE, Hull RL, Utzschneider KM. Mechanisms linking obesity to insulin resistance and type 2 diabetes. Nature. 2006; 444(7121): 840–846.
  5. Abel ED, Peroni O, Kim JK, et al. Adipose-selective targeting of the GLUT4 gene impairs insulin action in muscle and liver. Nature. 2001; 409(6821): 729–733.
  6. Kintscher U, Law RE. PPARgamma-mediated insulin sensitization: the importance of fat versus muscle. Am J Physiol Endocrinol Metab. 2005; 288(2): E287–E291.
  7. Liu J, Fox CS, Hickson DA, et al. Impact of abdominal visceral and subcutaneous adipose tissue on cardiometabolic risk factors: the Jackson Heart Study. J Clin Endocrinol Metab. 2010; 95(12): 5419–5426.
  8. MacDougald OA, Hwang CS, Fan H, et al. Regulated expression of the obese gene product (leptin) in white adipose tissue and 3T3-L1 adipocytes. Proc Natl Acad Sci U S A. 1995; 92(20): 9034–9037.
  9. Bado A, Levasseur S, Attoub S, et al. The stomach is a source of leptin. Nature. 1998; 394(6695): 790–793.
  10. Friedman JM, Halaas JL. Leptin and the regulation of body weight in mammals. Nature. 1998; 395(6704): 763–770.
  11. Moonishaa TM, Nanda SK, Shamraj M, et al. Evaluation of Leptin as a Marker of Insulin Resistance in Type 2 Diabetes Mellitus. Int J Appl Basic Med Res. 2017; 7(3): 176–180.
  12. Guzik TJ, Marvar PJ, Czesnikiewicz-Guzik M, et al. Perivascular adipose tissue as a messenger of the brain-vessel axis: role in vascular inflammation and dysfunction. J Physiol Pharmacol. 2007; 58(4): 591–610.
  13. Bakker W, Eringa EC, Sipkema P, et al. Endothelial dysfunction and diabetes: roles of hyperglycemia, impaired insulin signaling and obesity. Cell Tissue Res. 2009; 335(1): 165–189.
  14. Tritos NA, Mantzoros CS. Leptin: its role in obesity and beyond. Diabetologia. 1997; 40(12): 1371–1379.
  15. Margetic S, Gazzola C, Pegg GG, et al. Leptin: a review of its peripheral actions and interactions. Int J Obes Relat Metab Disord. 2002; 26(11): 1407–1433.
  16. Paz-Filho G, Mastronardi C, Franco CB, et al. Leptin: molecular mechanisms, systemic pro-inflammatory effects, and clinical implications. Arq Bras Endocrinol Metabol. 2012; 56(9): 597–607.
  17. Khalil SA, Megallaa MH, Rohoma KH, et al. Prevalence of chronic diabetic complications in newly diagnosed versus known type 2 diabetic subjects in a sample of Alexandria population, Egypt. Curr Diabetes Rev. 2019; 15(1): 74–83.
  18. Alberti KG, Zimmet P, Shaw J. Metabolic syndrome--a new world-wide definition. A Consensus Statement from the International Diabetes Federation. Diabet Med. 2006; 23(5): 469–480.
  19. Pham H, Armstrong DG, Harvey C, et al. Screening techniques to identify people at high risk for diabetic foot ulceration: a prospective multicenter trial. Diabetes Care. 2000; 23(5): 606–611.
  20. Sacks DB. Carbohydrates. In: Burtis CA, Ashwood ER, editors. Tietz textbook of clinical chemistry. 2nd ed. Philadelphia: WB Saunders. 1994: 935–949.
  21. Ray Bio. Human leptin Elisa Kit https://www.raybiotech.com/files/manual/ELISA/ELH-Leptin.pdf [accessed 18th January 2020].
  22. Shaikh A, Seegmiller JC, Borland TM, et al. Comparison between immunoturbidimetry, size-exclusion chromatography, and LC-MS to quantify urinary albumin. Clin Chem. 2008; 54(9): 1504–1510.
  23. Stevens LA, Schmid CH, Zhang YL, et al. Development and validation of GFR-estimating equations using diabetes, transplant and weight. Nephrol Dial Transplant. 2010; 25(2): 449–457.
  24. Cha JJ, Hyun YY, Jee YiH, et al. Plasma leptin concentrations are greater in type II diabetic patients and stimulate monocyte chemotactic peptide-1 synthesis via the mitogen-activated protein kinase/extracellular signal-regulated kinase pathway. Kidney Res Clin Pract. 2012; 31(3): 177–185.
  25. Yassin MM, AbuMustafa AM, Yassin MM. Serum leptin in diabetic nephropathy male patients from Gaza Strip. Diabetes Metab Syndr. 2019; 13(2): 1245–1250.
  26. Khan A, Ghaffar T, Kainat A, et al. Zulfania . Correlation between serum leptin level and body mass index (BMI) in patients with type 2 diabetes mellitus. J Pak Med Assoc. 2020; 70(1): 3–6.
  27. Rodríguez AJ, Nunes Vd, Mastronardi CA, et al. Association between circulating adipocytokine concentrations and microvascular complications in patients with type 2 diabetes mellitus: A systematic review and meta-analysis of controlled cross-sectional studies. J Diabetes Complications. 2016; 30(2): 357–367.
  28. Sari R, Balci MK, Apaydin C. The relationship between plasma leptin levels and chronic complication in patients with type 2 diabetes mellitus. Metab Syndr Relat Disord. 2010; 8(6): 499–503.
  29. Jung CH, Kim BY, Mok JO, et al. Association between serum adipocytokine levels and microangiopathies in patients with type 2 diabetes mellitus. J Diabetes Investig. 2014; 5(3): 333–339.
  30. Uckaya G, Ozata M, Bayraktar Z, et al. Is leptin associated with diabetic retinopathy? Diabetes Care. 2000; 23(3): 371–376.