Leptin mediate central obesity on the severity of cardiovascular autonomic neuropathy in well-controlled type 2 diabetes
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Journal of Translational Medicine Open Access
RESEARCH
Leptin mediate central obesity on the severity of cardiovascular autonomic neuropathy in well‑controlled type 2 diabetes and prediabetes Yun‑Ru Lai1,2, Meng Hsiang Chen3, Wei Che Lin3, Wen‑Chan Chiu4, Ben‑Chung Cheng1,4, Jung‑Fu Chen4, Nai‑Wen Tsai2, Chih‑Cheng Huang2* and Cheng‑Hsien Lu1,2,5,6*
Abstract Background: Evidences support the view that central obesity is an independently cardiovascular risk. It is thought that leptin contributes to autonomic dysfunction and cardiovascular risks in type 1 and type 2 diabetes mellitus (T1DM and T2DM). This raises the possibility that leptin might mediate the relationship between central obesity and the severity of cardiovascular autonomic neuropathy (CAN) in patients with well-controlled T2DM and prediabetes. Methods: The complete cardiovascular reflex tests and biomarkers were assessed for each patient. The severity of CAN was assessed using composite autonomic scoring scale (CASS). A single-level three-variable mediation model was used to investigate the possible relationships among central obesity [as indicated by waist circumference (WC)], leptin level, and severity of CAN (as indicated by CASS value). Results: A total of 107 patients were included in this study: 90 with diabetes and 17 with prediabetes. The results demonstrate that increased WC is associated with increased severity of CAN (r = 0.242, P = 0.017). We further discov‑ ered that leptin level is positively correlated with WC (r = 0.504, P
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