Zimmet, Paul, Hodge, Allison M ORCID: 0000-0001-5464-2197, Nicolson, Margery, Staten, Myrlene, de Courten, Maximilian, Moore, Jason, Morawiecki, Andrew, Lubina, John, Collier, Greg R, Alberti, K. G. M. M and Dowse, Gary (1996) Serum leptin concentration, obesity, and insulin resistance in Western Samoans: cross sectional study. BMJ, 313 (7063). pp. 965-969. ISSN 0959-8138 (print) 1756-1833 (online)

Abstract

Objective: To measure serum leptin concentrations in the Polynesian population of Western Samoa and to examine epidemiological associations of leptin with anthropometric, demographic, behavioural, and metabolic factors in this population with a high prevalence of obesity and non-insulin dependent diabetes mellitus. Design: Cross sectional study, leptin concentration being measured in a subgroup of a population based sample. Subjects: 240 Polynesian men and women aged 28–74 years were selected to cover the full range of age, body mass index, and glucose tolerance. Main outcome measurements: Serum leptin, insulin, and glucose concentrations; anthropometric measures; physical activity; and area of residence. Results: Leptin concentrations were correlated with body mass index (r = 0.80 in men, 0.79 in women) and waist circumference (r = 0.82 in men, 0.78 in women) but less so with waist to hip ratio. At any body mass index, leptin concentration was higher in women than men (geometric mean adjusted for body mass index 15.3 v 3.6 pg/1, P<0.001). Leptin concentration also correlated with fasting insulin concentration (r = 0.63 in men, 0.64 in women) and insulin concentration 2 hours after a glucose load (r = 0.58 in men, 0.52 in women). These associations remained significant after controlling for body mass index; effects of physical activity and of rural or urban living on leptin concentration were eliminated after adjusting for obesity, except values remained high in urban men. 78% of variance in leptin was explained by a model including fasting insulin concentration, sex, body mass index, and a body mass index by sex interaction term. Similar results were obtained if waist circumference replaced body mass index. Conclusions: The strong relation of leptin with obesity is consistent with leptin production being proportional to mass of adipose tissue. The relation with insulin independent of body mass index suggests a possible role for leptin in insulin resistance or hyperinsulinaemia.

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