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Global Translational Medicine Effect of leptin on aortic dissection

reduce leptin-induced neointima formation . Overall, and heart failure. Statins and other drugs may reduce
[43]
hyperleptinemia is associated with increased cIMT and leptin concentration. Therefore, in patients with CHD and
carotid plaque instability. heart failure, the choice of leptin-lowering therapy may

Elevated leptin level is related to the development help reduce their cardiovascular risk.
of insulin resistance and type 2 diabetes mellitus Leptin can stimulate atherosclerosis, inflammatory
(T2DM) . In T2DM, the relationship between high responses, oxidative stress, and thrombosis, thereby
[44]
leptin concentration and increased cardiovascular risk, promoting endothelial dysfunction, arterial stiffness,
microvascular complications, and cardiac autonomic and the development of atherosclerotic plaques [75-77] . In
dysfunction has been reported [45-48] . Other studies have addition, leptin regulates bone homeostasis, reproduction,
also reported that the concentration of leptin is associated and angiogenesis . At present, there are many ongoing
[78]
with the occurrence and severity of asymptomatic studies based on the physiological effects of leptin.
myocardial infarction (MI) and carotid atherosclerosis Research has shown that leptin can regulate vascular
(assessed by cIMT) in T2DM patients [49,50] . In addition, remodeling in vivo and that the increase in leptin levels
[79]
obesity, hypertension, MetS, and endothelial dysfunction can significantly promote the growth of lesions after
have been found to be more common in T2DM patients experimental vascular injury in mice [67,80] . Leptin can
with elevated leptin levels [51-53] . In both T2DM patients also enhance platelet aggregation and stabilize arterial
and healthy individuals, leptin decreases following an oral thrombosis, thereby increasing the possibility that
fat-tolerance meal . Other than that, certain leptin gene elevated leptin levels in obese people may directly lead
[54]
polymorphisms have been found to be associated with the to an increased risk of cardiovascular disease associated
presence of T2DM [55-58] . It has been reported that leptin with obesity [81-86] . However, the evidence for any potential
replacement therapy can improve muscle and liver insulin association between leptin and AD is limited, thus
resistance in patients with lipodystrophy as well as inhibit requiring further studies.
liver gluconeogenesis, fat decomposition, and fasting In our study, two pre-clinical studies were conducted on
hyperglycemia in animal diabetes models . 88 animals that met the inclusion criteria. The results showed
[59]
Leptin may affect cardiac remodeling, metabolism, and that leptin had a significant effect on the enlargement of
systolic function . According to a study, the soluble leptin aortic diameter and the increase in aortic wall compliance at
[60]
receptor (LepR) and leptin content in epicardial adipocytes the animal level. In animal models, the local application of
are 56.9% and 28.6% higher, respectively, than those in leptin is sufficient to induce regional degeneration of ECM,
[61]
subcutaneous adipocytes . In patients with coronary thus increasing the risk of dissection. The local inhibition
heart disease (CHD), leptin levels have been found to be of leptin activity on the aorta may weaken the progression
positively correlated with myeloperoxidase and C-reactive of AD and its related heart diseases to some extent. Based
protein (an inflammatory marker) concentrations as well on its protective properties, we expect a positive response
as the increase in factor VII activity [62-64] . There is also in local aneurysms when local LepA is used in various
increased expression of leptin gene in the epicardium, aneurysms (i.e., aortic, peripheral, and visceral lesions). It is
pericardium, and subcutaneous adipose tissue of CHD evident that there is obvious heterogeneity in the research.
patients with MetS . It has been previously reported Through sensitivity analysis, we found that the combined
[65]
that leptin enhances platelet activation in CHD patients effect value reversed after excluding the study conducted
by promoting bone differentiation and calcification of by Ying et al. , suggesting that this study is the reason
[66]
[17]
vascular cells in vitro . In addition, leptin may directly for the heterogeneity in the meta-analysis. According to
[67]
affect coronary artery endothelial cells by increasing the the study conducted by Ying et al. , the reason for the
[17]
[68]
expression of tissue factors and cell adhesion molecules . contrasting experimental results may be related to the
Leptin can also increase insulin resistance in patients difference in drug dosage and the mechanism of action.
with CHD [69,70] . Statins, on the other hand, can reduce the Through meta-regression, we found that the mode of
concentration of leptin in patients with CHD [71,72] . Future administration (local sustained-release and intraperitoneal
research should clarify if this induction is related to the injection), reagent dosage, and mouse type were not the
atherosclerotic protective properties of statins. In addition reasons for heterogeneity. Leptin is known to play a key role
to statins, several other drugs, including hypoglycemic, in regulating energy balance and controlling body weight.
antihypertensive, and anti-obesity drugs, have also shown Once it is released into the circulation, it may exert central
effects on leptin levels [73,74] . Leptin may be a target drug and peripheral effects by combining with LepR, found in
candidate for therapeutic intervention. Hyperleptinemia, many tissues, thus leading to the activation of several main
in general, is related to the existence and severity of CHD signal transduction pathways [7,8,12,87] . We speculate that

Volume 1 Issue 2 (2022) 7 https://doi.org/10.36922/gtm.v1i2.85