The obese gene product, leptin: Possible role in obesity-related hypertension in adolescents

Objective. The mechanism of the association between obesity and hypertension is not clear. The recently discovered obese gene product, leptin, the levels of which increase in obese subjects, has been shown to reduce food intake and increase sympathetic nervous system activity in animal studies. The present study was undertaken to elucidate the relationship between blood pressure and factors related to obesity, including leptin, in different age groups. Methods. The subjects were 348 Japanese male adolescents (15-17 years old) and 165 men (40-59 years old) not taking medication for hypertension, diabetes mellitus or hyperlipidaemia. Height, weight, blood pressure, heart rate, plasma glucose, lipid profiles, serum insulin and leptin levels were measured in the morning after an overnight fast. Results. Body mass index (BMI), serum leptin level and the homeostasis model insulin resistance index increased in the order of blood-pressure category (i.e. normotensive < high normal < hypertensive) in both the male adolescents and the middle-aged men. In addition, simple linear regressions revealed that both systolic and diastolic blood pressure correlated significantly with serum leptin and the insulin resistance index in both groups. Even after adjustment for age and BMI, the correlation of mean blood pressure with leptin remained in the obese adolescents (r² = 0.390, P = 0.02). The heart rate also correlated with leptin in the adolescents (r = 0.18, P < 0.001), but not in the middle-aged subjects (r= 0.04). Even after adjustment for age and BMI in adolescents, serum leptin correlated significantly with heart rate. Conclusion. These results suggest a role for leptin in obesity-related hypertension, especially in adolescents.