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July 17, 2002

Effects of Leptin on Platelet Function in Obese Patients—Reply

Author Affiliations

Stephen J.LurieMD, PhD, Senior EditorIndividualAuthor

JAMA. 2002;288(3):313-314. doi:10.1001/jama.288.3.311

In Reply: Dr Corica and colleagues question the appropriateness of our speculation about potential therapeutic interventions targeting elevated leptin in obese patients. Our results and those of others13 indicate that leptin may promote platelet aggregation by interacting with the leptin receptor on platelets. Furthermore, a recent clinical study identified plasma leptin as an independent risk factor for cardiovascular events,4 although mechanisms other than increased platelet aggregation may relate to this increased risk. Currently, the best treatment for reducing the potential adverse effects of leptin is probably weight reduction, which is admittedly difficult. Because of the well-known consequences of leptin deficiency on weight gain and metabolism,5 we agree that drug-induced leptin reduction or antagonism might cause more harm than good. Therefore, targeting the platelet seems to be a more reasonable approach. However, we certainly agree that there is much to be learned about the mechanism of leptin-induced platelet aggregation and whether chronically elevated leptin levels have an effect on thrombosis.

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