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Aim: The evaluation of the influence of testosterone and fat tissue distribution on the serum leptin levels in perimenopausal women., Patients: 93 perimenopausal women without HRT (age: 51.0 +/- 8.8 yrs, FSH: 68.0 +/- 49.4 IU/l, estradiol: 38.3 +/- 37.0 ng/1) were divided into group A - 63 women with serum testosterone level < 0.6 ng/ml and group B--30 women with serum testosterone > or = 0.6 ng/ml. Each group was later divided according to WHR into subgroup I (AI and BI) (WHR < 0.8) and II (AII and BII) (WHR > or = 0.8)., Methods: Basic fasting serum levels of LH, FSH, PRL, estradiol, insulin, hGH, IGF-I, IGFBP-1, IGFBP-3, leptin, testosterone, DHEAS TNF-alpha and SHBG were measured by RIA kits. Total cholesterol, HDL and LDL cholesterol, as well as triglycerides plasma levels were measured. Statistical evaluation was carried out by ANOVA and linear regression., Results: BMI, WHR and plasma DHEAS level were higher in group B vs. group A. The lowest hGH, HDL-cholesterol and the highest TNF-alpha levels were found in group BII. The relations leptin/BMI and leptin/body mass were found in each group. The inverse relation between leptin and IGFBP-1 was found in groups A and B. In group A the inverse relations leptin/HDL-cholesterol and leptin/ DHEAS were observed. In group B the direct leptin/testosterone and inverse leptin/IGF-I relations were found. In group AI the inverse leptin/DHEAS relation remained, while in group AII inverse leptin/HDL-cholesterol relation remained and reverse leptin/IGFBP-1 relation was significant. The direct leptin/testosterone, leptin/WHR and inverse leptin/TNF-alpha links were observed in group BII., Conclusion: The serum leptin level was linked to WHR, serum testosterone, insulin, TNF-alpha levels only in groups of perimenopausal women with such cardiovascular risk factors as high WHR, overweight, high serum TNF-alpha and testosterone levels.

Aim: As the link between body fat and leptin is well known, the aim of the study was to seek for secondary regulators of plasma leptin level., Patients: 86 women (mean: age 47.0+/-14.3 years; estradiol 50.0+/-60.6 ng/l; FSH 52.4+/-42.9 IU/l; BMI 26.9+/-5.9) divided into three groups according to their BMI. Group A: 39 normal weight women (mean: age 44.4+/-16.0 years; estradiol 69.6+/-79.8 ng/l; FSH 50.4+/-47.7 IU/l; BMI 22.9+/-1.3). Group B: 27 overweighted women (mean: age 55.0+/-6.4 years; estradiol 25.1+/-17.2 ng/l; FSH 75.6+/-26.3 IU/l; BMI 27.7+/-1.6). Group C: 21 obese women with mean: age 48.7+/-12.2 years; estradiol 36.9+/-44.0 ng/l; FSH 42.3+/-36.6 IU/l and BMI 34.6+/-4.9., Methods: Standard clinical evaluation and hormone evaluation (LH, FSH, prolactin, estradiol, leptin, insulin-like growth factor-I (IGF-I), human growth hormone (hGH), insulin-like growth factor binding protein-3 (IGFBP-3), insulin, dihydroepiandrosterone sulphate (DHEAS), sex hormone binding globin (SHBG) and testosterone were done in basic condition which levels of were measured by RIA kits. Statistical analysis. Shapiro-Wilk test, Mann-Whitney-Wilcoxon u test, Spearman rank correlation coefficient and stepwise multiple regression: p values of 0.05 or less were considered as significant., Results: Taking all women into account (n=86) the plasma leptin level correlated directly with age (r=0.32; p<0.02), body mass (r=0.60; p<0.001), BMI (r=0.71; p<0.001) as well as inversely with estradiol (r=-0.21; p<0.05), IGF-I (r=-0.24; p<0.05), SHBG (r=-0.34; p<0.01) and DHEAS (r=-0.30; p<0.01). However only in the group B leptin/age relation remained (r=0.40; p<0.05) after the division according to BMI. In the group B the leptin /DHEAS (r=-0.40; p<0.05) and leptin/PRL (r=0.51; p<0.05) links were also present. In the group C the leptin/SHGB relation (r=-0.56; p<0.02) only remained and an association between insulin and leptin was found (r=0.48; p<0.05). The body mass and BMI relation to age were again present only in all 86 women (r=0.30; p<0.002: r=0.36; p<0.001 resp.). Having split the women into groups, these links either disappeared or became inverse (rC=-0.39; p<0.05). Taking into consideration age/leptin relation in all women, the division according to the menopausal status revealed the direct relation in premenopausal women (n=29; r=0.43; p<0.02) and a reverse one in postmenopausal women (n=38; r=-0.32; p<0.05). The plasma leptin level was the highest (p<0.001) in group C (23.2+/-10.4 microg/l) and the lowest was found in the group A (8.9+/-4.1 microg/l). That corresponded with the differences in mean body mass index and mean body mass. The stepwise multiple regression revealed that body mass index accounted for 31% (p<0.001) and plasma SHBG level accounted for 17.7% (p<0.02) of plasma leptin variance in all women. In the group A body mass and age together accounted for 61% (p<0.01) and estradiol alone accounted for 44% (p<0.02) of plasma leptin variance. In the group B insulin alone accounted for 39% (p<0.05) and together with testosterone accounted for 46% (p<0.05) of plasma leptin variance. Finally in obese women none of the evaluated parameters significantly accounted for leptin variance., Conclusion: The results presented in this paper confirmed the strong influence of body fat mass on serum leptin concentration. However insulin, SHBG, sex steroids as well as age may also exert secondary influence on plasma leptin level in certain groups of women.