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P53 Background: Leptin, a protein secreted by adipose tissue, has  actions that may affect blood pressure via energy balance, insulin  sensitivity and/ or the central nervous system. Purpose: The purpose of  this abstract is to evaluate the association between leptin level and  blood pressure in the multi-center, tri-ethnic Insulin Resistance  Atherosclerosis Study (IRAS) population. Methods: IRAS participants  (n=1507) were age 40-69 years; 56% female; mean body mass index (BMI)=  29 kg/m2; and 39% hypertensive. Main exposure: multi species leptin  radioimmunoassay was used to quantify leptin concentrations (Linco  Research Inc., St. Louis, MO; range 0-122.19ng/ml). Main outcome: Main  outcome was hypertension (Yes/No), defined as a systolic &gt;=140mm Hg  and/ or a diastolic reading of &gt;=90mm Hg or taking antihypertensive  medication. Analysis: Logistic regression was used to analyze the  relationship between leptin and hypertension, while adjusting for age,  dietary fat, gender, activity, ethnicity and clinic. Final models  evaluated the role of obesity. Results: The proportion of individuals  that were hypertensive by quartile was 28%, 40%, 40% and 49%,  respectively. The odds of being hypertensive was 1.60 (p=0.0001) times  higher for every 16ng/ml (1 SD) change in leptin after adjusting for  age, gender, dietary fat, ethnicity and clinic site, and energy  expended (n=1507). The role of BMI (leptin*BMI) was considered,  resulting in a reduction of leptin’s effect on hypertension (p=0.02  for the interaction term). The overall odds ratio for being  hypertensive per 16ng/ml (1 SD) change was 1.80 (p=0.04) with an  attenuation of the effect as BMI increased (estimated OR for BMI of 22,  27 and 32 was 1.23, 1.14, and 1.05 respectively). Analysis were  repeated excluding those with diabetes (n=999) and results were  essentially unchanged. Conclusion: Increased leptin is associated with  increased occurrence of hypertension and its effect is attenuated by  increasing BMI. Future work is necessary to confirm and explain these  results.

Leptin in Relation to Hypertension: The Role of Obesity in the Insulin Resistance Atherosclerosis Study (IRAS)