Unravelling the adipokine paradox: When the classic proatherogenic adipokine leptin is deemed the beneficial one

Adipokines released by adipose tissue have been recognised as important players in the development of cardiovascular disease. Leptin is a well-studied adipokine with an important role in body metabolism and energy expenditure and leptin-deficiency or deficient leptin signalling results in excessive obesity and type 2 diabetes. Studies in cells and animal models support that leptin has a pro-atherogenic potential and exerts pro-hypertrophic effects on the heart. However, recent basic and clinical evidence suggests that leptin may also have a beneficial role in cardiovascular physiology. Notably, clinical studies have failed to convincingly link leptin with increased cardiovascular disease risk. We herein summarise the role of leptin in cardiovascular disease as another example of the 'adipokine paradox' and discuss the complexity in using serum adipokine levels as biomarkers in cardiovascular disease. (C) 2015 Elsevier Ireland Ltd. All rights reserved.