Higher Serum Leptin Levels are Associated with a Reduced Risk of Sarcopenia but a Higher Risk of Dynapenia Among Older Adults

Tung-Wei Kao,1,2 Tao-Chun Peng,1 Wei-Liang Chen,1 Yu-Chiao Chi,2 Chi-Ling Chen,2 Wei-Shiung Yang2– 4 1Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; 2Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan; 3Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; 4Center for Obesity, Life Style and Metabolic Surgery, National Taiwan University Hospital, Taipei, TaiwanCorrespondence: Wei-Shiung Yang Email wsyang@ntu.edu.twBackground: Leptin plays an important role in regulating the energy homeostasis of fat and muscle. Paradoxical findings existed between serum leptin levels and muscle health conditions. Here, we aimed to investigate the relationship between serum leptin levels and the risk of sarcopenia or dynapenia among older adults.Methods: Adults aged 65 and older living in the community were recruited at annual health checkups. Body composition, gait speed, and handgrip strength were examined. The cutoff values of muscle mass and strength to define sarcopenia and dynapenia were based on the consensus by the Asia Working Group of Sarcopenia in 2019. Serum leptin level was measured by an immunoassay.Results: Four hundred sixty participants (55.65% females) were enrolled. There were 16.08% and 23.91% with sarcopenia and dynapenia, respectively. Higher serum leptin levels were positively associated with muscle and fat mass but negatively associated with handgrip strength and gait speed for both sexes. In the logistic regression models adjusted for various confounders, a higher serum leptin level was associated with an increased risk of dynapenia with dose-response effects among both male and female participants (odds ratio [OR]=3.74, 95% confidence interval [CI]= 0.99– 14.17; OR= 3.32, 95% CI=1.03– 10.74, respectively), and a positive trend existed in both genders (p for trend=0.040 and 0.042, respectively). In contrast, a higher leptin level was associated with a reduced risk of sarcopenia with dose-response trends for both sexes (OR= 0.06, 95% CI=0.01– 0.48; OR= 0.26, 95% CI=0.06– 1.17, respectively) in models of multivariate logistic regression analyses, and a negative trend existed in both genders (p for trend = 0.002 and 0.023, respectively).Conclusion: A positive trend existed between the serum leptin level and the dynapenia risk, whereas it revealed a negative trend in the serum leptin level and sarcopenia risk in both male and female elderly individuals. The biological mechanisms underlying its negative association with muscle strength but its positive association with muscle mass warrants further investigation.Keywords: leptin, dynapenia, sarcopenia, elderly, muscle, strength, mass