[Role of leptin in the regulation of lipid and carbohydrate metabolism].

Leptin is a hormone secreted primarily by adipose tissue and its blood levels depend on the amount of fat stored in adipocytes. Leptin has a wide range of physiological effects. Acting directly or through the sympathetic nervous system it participates in the regulation of energy metabolism. Leptin inhibits synthesis of triacylglycerols in the liver, adipose tissue and skeletal muscles, thus reducing the intracellular lipid content in these tissues. In adipocytes, leptin down-regulates the expression of genes encoding fatty acid synthase (FAS) and acetyl-CoA carboxylase (ACC), the major enzymes of fatty acid synthesis, while it up-regulates the expression of the hormone-sensitive lipase (HSL) encoding gene, thus stimulating hydrolysis of triacylglycerols in adipose tissue. Moreover, leptin enhances fatty acid oxidation in adipocytes, and skeletal and cardiac muscle by increasing the expression of genes encoding key enzymes involved in this process, carnitine palmitoyltransferase 1 (CPT1) and medium chain acyl-CoA dehydrogenase (MCAD). It has also been demonstrated that this hormone improves insulin sensitivity and glucose tolerance by stimulating glucose transport and metabolism in many tissues. It is known that leptin is involved in the long-term regulation of food intake. However, increasing evidence suggests that it may also influence energy substrate utilization in peripheral tissues. Therefore, leptin can effectively control whole-body energy homeostasis by altering lipid and carbohydrate metabolism, especially in adipose tissue and muscles.