Leptin in acute myocardial infarction and period of convalescence in patients with type 2 diabetes mellitus.

Background: Leptin is a protein produced in adipose tissue and takes part in angiogenesis and atherogenesis. Leptin is associated with development of type 2 diabetes and cardiovascular disease.

Aim: To evaluate leptin concentrations in acute myocardial infarction and in the period of convalescence in patients with type 2 diabetes mellitus.

Methods: Coronary angiography was performed in 58 patients with acute myocardial infarction. The study group comprised 35 patients with type 2 diabetes mellitus (DM) (25 men, 10 women, mean age 63.8 + or - 11.5 years) and 23 non-diabetic subjects (17 men, 6 women, mean age 58.6 + or - 9.9 years) - the control group. All patients underwent medical examination and body mass indices (BMI) as well as waist/hip ratios (WHR) were calculated. Venous blood was collected after 24 hours of admission (second day), on day 5 and three weeks after admission.

Results: Leptin level was significantly associated with BMI (DM: r = 0.46, p = 0.005; control group: r = 0.67, p < 0.01), and hip circumference (DM: r = 0.28, p = 0.09; control group: r = 0.41, p = 0.04). Plasma leptin levels in women with type 2 diabetes were higher than in men (32.1 + or - 11.7 microg/mL vs 12.7 + or - 11.2 microg/mL, p < 0.01). Plasma leptin levels were significantly lower in non-diabetics compared to diabetic patients. Plasma leptin levels in diabetic patients were significantly higher in the acute phase of myocardial infarction than in the period of convalescence (18.3 + or - 14.3 microg/mL, 16.1 + or - 12.8 microg/mL, 14.8 + or - + or - 11.2 microg/mL, p = 0.02) but not in the control group (10.6 + or - 8.2 microg/mL, 10.0 + or - 7.3 microg/mL, 9.6 + or - 7.0 microg/mL, NS).

Conclusions: Plasma leptin levels in diabetic patients were significantly higher in the acute myocardial infarction than in the period of convalescence. These findings suggests that leptin may play an important role in the metabolic changes taking place during the first days of myocardial infarction.