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What vitamins are good for leptin resistance?

Vitamin A was positively associated with leptin (p < 0.05). When stratifying by BMI, % body fat and waist circumference, high leptin concentrations were associated with lower zinc and lower vitamin C concentrations in women with obesity (p < 0.05) and higher vitamin A concentrations in women without obesity (p < 0.01).

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In the present study, low vitamin C concentrations were associated with obesity and with higher leptin concentrations. In contrast, high vitamin A concentrations were associated with high leptin concentrations. When stratifying, high leptin concentrations were associated with lower zinc and vitamin C concentrations in women with obesity and with high body fat percent, and were also associated with higher vitamin A concentrations in women without obesity. Thus, zinc, and vitamins A, and C are associated with obesity, adiposity and leptin concentrations in women from a rural population in Mexico. Zinc, vitamin A, vitamin C and vitamin E status of overweight and obese women were very similar to women with adequate BMI. These results agree to what has been previously reported, and results from these studies vary depending on the micronutrient studied. It has been observed, for example, that obese individuals have lower vitamin C concentrations, while vitamin E concentrations were normal compared with lean individuals [31]. Adult obese women were found to have significantly higher gamma-tocopherol concentrations compared with normal weight women, but alpha-tocopherol concentrations did not differ between groups [32]. Obese hypertensive patients in Poland had lower levels of hair zinc, but had similar serum zinc concentrations, compared with healthy adults [33]. Similarly, no differences were observed in zinc concentrations between obese and non-obese Turkish children [34]. Other studies have found differences in micronutrient status between obese and non-obese individuals. Low vitamins A and E concentrations, for example, have been found in morbidly obese Spanish patients [7], and low vitamin E and C concentrations in morbidly obese patients in Norway [6]. Thus, several factors might be involved that make the association between micronutrient status and obesity, inconsistent. In the population studied, no differences were observed in the concentrations of vitamins A, C, E and zinc in the women according to their BMI, and this could be explained by their dietary habits. Overweight and obese women in this population had significantly higher intakes of energy and lipids compared with normal weight women. However, intake of micronutrients was similar in overweight, obese and normal weight women. This could be explained because obese individuals included several foods which are energy dense. Low vitamin C concentrations were associated with higher BMI and higher waist-to-height ratio. Our results are similar to Johnston et al. [35] who found an inverse relationship between vitamin C and BMI and waist circumference in adults. The relationship observed between vitamin C and obesity in the women that participated in the study could have been caused by the effect that vitamin C has on leptin expression. Lower vitamin C concentrations were found to be associated with higher leptin concentrations in all women, and in obese women after stratifying by BMI. It has been observed that vitamin C dose-dependently inhibits leptin secretion in primary rat adipocytes [9]. In addition, vitamin C supplementation reduces the gene expression of apelin, an adipokine associated with insulin resistance, obesity and increased inflammation in animal models [36]. Higher concentrations of apelin are related to high concentrations of leptin and proinflammatory cytokines. Also, vitamin C has been shown to modify the response from rat adipocytes to high glucose levels, and to modulate the interaction between adipocytes and macrophages, protecting the adipocyte from a high glucose environment and from the inflammatory response associated with obesity [37, 38].

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Vitamin A is known to actively participate in the adipocyte metabolism. One of its metabolites, all-trans retinoic acid, has been known to stimulate lipolysis by activating the peroxisome proliferation-activated receptor delta and retinoic acid receptor [39, 40]. Retinoic acid has been found in vitro to decrease preadipocyte survival time and to inhibit or promote adipose cell differentiation [41]. In addition, retinoic acid has been shown to inhibit the expression of leptin, resistin and uncoupling proteins (UCP) in mice and human cell culture tissues [10, 11, 41]. In our study, vitamin A concentrations were associated with high concentrations of leptin in the overall population, and the same was observed in women that had low BMI, low body fat percent and low waist circumference. These results suggest that vitamin A and its metabolites have different effects on leptin expression among individuals that differ in adipose tissue and total body fat content. The association of zinc with obesity and body composition is not consistent. In obese Chilean children, for example, no association was found between zinc status and body composition [42]. In adults living in urban India, low concentrations of zinc were associated with higher abdominal fat [8]. In our study, zinc was not associated with obesity or leptin concentrations in the overall population. However, when stratifying by BMI and percent body fat, a negative association was found between zinc and leptin concentrations in women with obesity, with a body fat content of 36-40% and high waist circumference. This association could be explained by the effect of zinc-alpha2-glycoprotein (ZAG) on leptin concentrations. ZAG is an adipokine involved in the metabolism of lipids in the adipocyte that is down-regulated in obesity, probably due to the inflammation process associated with obesity. In obese individuals, low ZAG gene expression is associated with low serum adiponectin and high plasma leptin levels, and may play an important role in the development of obesity [43, 44]. The influence zinc has on the adipocyte through the expression of leptin, by promoting free fatty acid release and glucose uptake, may also be controlled through the expression of a number of zinc-transporters in the adipocyte, that may be altered in obesity [45, 46]. This is the first study to evaluate the relationship between zinc and vitamins A, C, and E, with leptin in women. Our findings suggest that the effects of vitamins and zinc concentrations in the adipocyte are complex and change depending on BMI, total body fat, and abdominal fat.

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A major limitation of this study is that cross-sectional studies cannot establish causality. More studies are needed to understand the causes and consequences of micronutrient status on obesity and comorbidities. In addition, no vitamin A deficiency was found, and the prevalence of zinc, vitamin C and vitamin E deficiency was low. Thus, the relationship of vitamins A, C, E, and zinc with leptin could be different in populations with a high prevalence of these micronutrients deficiencies.

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