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Increased circulating leptin concentrations in insulin-resistant first-degree relatives of patients with non-insulin-dependent diabetes mellitus: relationship to body composition and insulin sensitivity but not to family history of non-insulin-dependent diabetes mellitus

Objective: To explore a possible association between serum concentration of leptin, insulin sensitivity and non-insulin-dependent diabetes mellitus (NIDDM).

Design: Forty first-degree relatives of NIDDM patients and 35 control subjects matched for age, gender and body mass index underwent a hyperinsulinaemic (insulin infusion rate 0·6 mU/kg per min) euglycaemic clamp combined with indirect calorimetry. Serum leptin was measured in fasting blood samples obtained before the clamp.

Results: All subjects had a normal oral glucose tolerance test. Insulin-stimulated glucose uptake (M) was decreased in the relatives compared with the control subjects (4·58 ± 0·27 versus 606 ± 0·25 mg/kg per min, P < 0·001). Conversely, serum leptin was increased in the relatives (9·6·/÷ 1·1 versus 6·1·/÷ 1·2 ng/ml (geometric mean·/÷ antilog S.E.M.). P < 0·05). A positive correlation was observed between circulating levels of leptin and percentage body fat (P < 0·001) and inverse correlations were found between leptin, M (P < 0·01), maximal aerobic capacity (VO₂ max) (P < 0·01), and energy expenditure (P 0·01) in both groups. In multiple linear regression analysis, percentage body fat, gender and M significantly determined the level of leptin (r² = 0·71, P < 0·001) whereas family history of NIDDM and VO₂ max did not.

Conclusion: Serum leptin is increased in insulin-resistant offspring of NIDDM patients. The association between leptin, anthropometric measures and insulin sensitivity is, however, comparable with that of a control group. The increased concentrations of serum leptin in the relatives appear to be associated with the insulin resistance, but not with a family history of NIDDM.

European Journal of Endocrinology 136 173–179