Loss of leptin actions in obesity: two concepts with cardiovascular implications.

Obesity is associated with increased risk of hypertension and heart disease. Leptin has recently been linked to increased risk of cardiovascular disease. We review briefly here two concepts regarding loss of leptin actions that have potential implications for cardiovascular disease. These are: 1. the concept of selective leptin resistance; and 2. the concept that loss of leptin action results in lipid accumulation and lipotoxicity of skeletal muscle, pancreatic islet cells, and heart and, thereby, promotes insulin resistance, insulin deficiency and cardiac dysfunction, respectively.