The leptin to adiponectin ratio is a good biomarker for the prevalence of metabolic syndrome, dependent on visceral fat accumulation and endurance fitness in obese patients with diabetes mellitus

Background: We investigated the contribution of adiponectin or leptin on the prevalence of metabolic syndrome (MS), while also taking cardiorespiratory fitness and visceral fat accumulation into account regarding diabetes patients. Methods: Japanese male patients (n = 77) with either impaired glucose tolerance (IGT) or type 2 diabetes mellitus were divided into three tertiles according to their adipocytokine levels. A logistic regression analysis was performed after adjusting for age to investigate the association between the adipocytokine levels and the prevalence of MS based on World Health Organization (WHO) criteria. Results: The visceral fat area (VFA) and maximal oxygen uptake (V̇O₂max) were found to be significantly different within the tertiles regarding the leptin and adiponectin levels and the adiponectin-to-leptin (A/L) ratio. The low tertile of leptin showed a significantly lower odds ratio (OR) for prevalence of MS than that in the high group. Both the low and the medium tertiles of adiponectin showed a significantly higher OR for prevalence of SM than that of the high group. Especially, the low tertile of A/L ratio had about an eight times higher prevalence of MS than the high tertile, and the difference was significant. However, when both the VFA and/or V̇O₂max were added to the logistic regression model as adjusting factors, all of these significant differences disappeared. Conclusion: The A/L ratio is suggested to be a good biomarker for the prevalence of MS in comparison to the adiponectin and leptin levels alone. However, these relationships are dependent on abdominal fat accumulation and/or cardiorespiratory fitness levels.