Hormonal
Leptin resistance in obesity reverses its protective vascular effects, contributing to a pro-oxidative state, endothelial dysfunction, and accelerated biological senescence.
In obesity, high leptin levels do not protect the heart because the body becomes resistant to them. This resistance allows leptin to promote oxidative stress and endothelial dysfunction, increasing cardiovascular risk. Restoring leptin sensitivity (e.g., through weight loss or bariatric surgery) may help restore these protective vascular effects.
Obesity-induced leptin resistance can reverse this balance toward an atherogenic phenotype... hyperleptinemia in obesity may arise as a compensatory mechanism to overcome leptin resistance. Despite higher circulating-levels, the previously mentioned vascular effects are attenuated.
Why this rating
The paper cites multiple studies ([36-38]) linking leptin resistance to oxidative stress and endothelial dysfunction.
Source
Relevance of Leptin and Other Adipokines in Obesity-Associated Cardiovascular Risk
Manuel F. Landecho et al. · Nutrients · 2019
DOI 10.3390/nu11112664
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