Original Article

Leptin and Adiponectin in Relation to Body Mass Index and Anemia

Abstract

Obesity/its comorbidities occasionally exist alone, but actually, this is a dynamic network of cross morbidities that are often regarded as separable entities. Obesity is nowadays viewed as an escalating risk factor for iron deficiency, and various theories have been proposed since then explaining their relation. We aimed to determine the relationship of increased body mass index (BMI) with adiponectin, leptin, and iron profile in a sample of middle-aged and older adults with and without iron deficiency anemia. An observational study was performed among 90 participants classified into three groups. Group І included healthy subjects with normal BMI; as a control. Group II included subjects with increased BMI, and group III included subjects with increased BMI and iron deficiency anemia. After overnight fasting, fasting blood glucose, triglycerides, total cholesterol, iron, total iron-binding capacity, complete blood count, serum leptin, and adiponectin were measured. There were significantly higher mean values of BMI among those with anemia, higher mean values of serum leptin, and significantly lower mean values of adiponectin. A significant positive correlation of serum leptin with BMI and a significant negative correlation of serum leptin with iron in Group III were reported. The adiponectin/leptin ratio of (0.8) was correlated with iron and homeostatic model assessment in Group III, and a ratio of (1.1) was significantly correlated with BMI and hemoglobin level in Group II. This could suggest that interventions aimed at increasing the adiponectin/leptin ratio may help in resolving anemia among obese populations by increasing their serum iron and hemoglobin.

1. Low S, Chin MC, Deurenberg-Yap M. Review on epidemic of obesity. Ann Acad Med Singap. 2009; 38(1):57-59.
2. Ellulu M, Abed Y, Rahmat A, Ranneh Y and Ali F. Epidemiology of obesity in developing countries: challenges and prevention. Glob Epidemi Obes. 2014; 2:2.
3. Bhurosy T, Jeewon R. Overweight and Obesity Epidemic in Developing Countries: A Problem with Diet, Physical Activity, or Socioeconomic Status? The Scientific World Journal. 2014; 201: 1–7.
4. Swinburn BA, Sacks G, Hall KD, McPherson K, Finegood DT, Moodie ML, Gortmaker SL. The global obesity pandemic: shaped by global drivers and local environments. The Lancet. 2011; 804–14.
5. WHO- Obesity and overweight fact sheet. Available from: https://www.who.int/en/news-room/fact-sheets/detail/obesity-and-overweight
6. Przybyszewska J, Zekanowska E, Kedziora-Kornatowska K, Boinska J, Cichon R, Porzych K, et al. Prohepcidin and iron metabolism parameters in the obese elderly patients with anemia. J Nutr Health Aging. 2011; 15: 259–64.
7. Cheng HL, Bryant C, Cook R, O'Connor H, Rooney K, Steinbeck K. The relationship between obesity and hypoferraemia in adults: a systematic review. Obes Rev. 2012; 13(2):150-161.
8. Gartner A, Berger J, Bour A, El Ati J, Traissac P, Landais E, El Kabbaj S, Delpeuch F. Assessment of iron deficiency in the context of the obesity epidemic: importance of correcting serum ferritin concentrations for inflammation. The American Journal of Clinical Nutrition. 2013; 98: 821–826.
9. Mujica-Coopman MF, Brito A, López de Romaña D, Pizarro F, Olivares M. Body mass index, iron absorption and iron status in childbearing age women. J Trace Elem Med Biol. 2015; 30: 215-219.
10. Sal E, Yenicesu I, Celik N, et al. Relationship between obesity and iron deficiency anemia: is there a role of hepcidin? Hematology. 2018; 23(8):542-548.
11. Aigner E, Feldman A, Datz C. Obesity as an emerging risk factor for iron deficiency. Nutrients. 2014; 6(9):3587-3600.
12. Frühbeck, G.Catalán, V.Rodríguez, A.Ramírez, B.Becerril, S.Portincasa, P. Gómez-Ambrosi, J. Normalization of adiponectin concentrations by leptin replacement in ob/ob mice is accompanied by reductions in systemic oxidative stress and inflammation. Sci. Rep. 2017; 7: 2752
13. Blüher M, Mantzoros CS. From leptin to other adipokines in health and disease: facts and expectations at the beginning of the 21st century. Metabolism. 2015; 64(1):131-145.
14. Friedman JM. Leptin and the endocrine control of energy balance. Nat Metab. 2019; 1:754–64
15. Achari AE, Jain SK. Adiponectin, a Therapeutic Target for Obesity, Diabetes, and Endothelial Dysfunction. Int J Mol Sci. 2017; 18(6):1321.
16. Gabrielsen JS, Gao Y, Simcox JA, Huang J, Thorup D, Jones D, et al. Adipocyte iron regulates adiponectin and insulin sensitivity.J Clin Invest. 2012; 122(10):3529-3540.
17. Mather, K.J.; Goldberg, R.B. Clinical use of adiponectin as a marker of metabolic dysregulation. Best Pract. Res. Clin. Endocrinol. Metab. 2014; 28:107–117
18. Lewerin C, Johansson H, Lerner UH, M. K. KarlssoM.K.,Lorentzon M. High serum adiponectin is associated with low blood hemoglobin in elderly men. Journal of Int Med.2015; 278:68-76.
19. Gao Y, Li Z, Gabrielsen JS, et al. Adipocyte iron regulates leptin and food intake. J Clin Invest. 2015; 125(9):3681-3691.
20. Ghantous, C.M.; Azrak, Z.; Hanache, S.; Abou-Kheir,W.; Zeidan, A. Differential role of leptin and adiponectin in cardiovascular system. Int. J. Endocrinol. 2015: 534320.
21. Frühbeck, G.; Catalán, V.; Rodríguez, A.; Gómez-Ambrosi, J. Adiponectin-leptin ratio: A promising index to estimate adipose tissue dysfunction. Relation with obesity-associated cardiometabolic risk. Adipocyte 2018:7:57–62.
22. Defining Adult Overweight and Obesity. https://www.cdc.gov/obesity/adult/defining.html (Accessed at August 2019)
23. World Health Organization Media Centre; Obesity and Overweight Geneva, Switzerland, 2013.
24. WHO and ARE-Ministry of Health & Population: Egypt National STEPwise Survey of Non Communicable Diseases Risk Factors 2017 Fact Sheet. (Accessed at August 2019) https://www.who.int/ncds/surveillance/steps/Egypt_STEPS_Survey_2017_Fact_Sheet.pdf?ua=1
25. Ministry of Health and Population- 2015 Egypt Health Issues Survey (EHIS), October 2015. In collaboration with: El Zanaty and Associates, USAID, UNFPA and UNICEF.
26. Żekanowska E, Boinska J, Giemza-Kucharska P, Kwapisz J. REVIEW PAPER: Obesity and iron metabolism. BioTechnologia. 2011; 92(2):147-152.
27. DePaoli, A. Leptin in common obesity and associated disorders of metabolism. J. Endocrinol. 2014.
28. Axelsson, J. et al. Body fat mass and serum leptin levels influence epoetin sensitivity in patients with ESRD. Am J Kidney Dis 2005; 46:628–34.
29. Rafieian-Kopaei M, et al. Correlation of serum leptin with levels of hemoglobin in hemodialy. J Nephropharmacol. 2012; 1(2): 23–6.
30. Park SH. Use of erythropoiesis-stimulating agents in obese hemodialysis patients. Kidney Res Clin Pract. 2018; 37(3):308-309.
31. Jiang Y, Zhang J, Yuan Y, et al. Association of Increased Serum Leptin with Ameliorated Anemia and Malnutrition in Stage 5 Chronic Kidney Disease Patients after Parathyroidectomy. Sci Rep. 2016;6:27918.
32. Honda M, Tsuboic A, Minatoc S, Kitaokac K, Takeuchi M. Association of Age and Anemia with Adiponectin Serum Levels in Normal-Weight Japanese Women. J Clin Med Res. 2019;11(5):367-74
33. Iwabu M, Okada-Iwabu M,Yamauchi T and Kadowaki T. Adiponectin/Adipo R Research and Its Implications for Lifestyle-Related Diseases. Front. Cardiovasc. Med. 2016; 6:116.
Files
IssueVol 60, No 6 (2022) QRcode
SectionOriginal Article(s)
DOI https://doi.org/10.18502/acta.v60i6.10040
Keywords
: Obesity iron deficiency adiponectin leptin adiponectin/leptin ratio

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Hanna H, Salama A. Leptin and Adiponectin in Relation to Body Mass Index and Anemia. Acta Med Iran. 2022;60(6):350-357.