DIET, EXERCISEREGIMENS AND MEDICATIONSTHAT ALTER BLOOD LEPTIN, ADIPONECTIN LEVELS AND ADIPONECTIN/LEPTIN RATIO TO PREVENT AND CONTROL CARDIO METABOLIC DISEASES DEVELOPMENT AND PROGRESSION

Objectives: High adiponectin and low leptin levels in serum are associated with less risk of insulin resistance, hypertension, atherosclerosis and a favorable lipid profile. In this systematic review, our objective was to determine effective diet changes, exercise and medications to achieve a favorable adiponectin/leptin ratio that decrease the risk of cardio metabolic conditions. Methods: After searching the literature in PubMed, MEDLINE, Google scholar and Cochrane library, we included randomized controlled trials and observational studies done on human participants regardless of age, BMI, sex and co-morbid conditions and studies that compared or assessed effects of interventions like diet, exercise or medications for more than two weeks on blood leptin and adiponectin levels. Follow up studies, animal studies and the studies in which adiponectin and leptin levels were not specified were excluded from the review. We screened 118 studies, data was retrieved from 70 studies out of which 36 studies were eligible for quality assessment. We used Cochrane risk of bias tool for randomized controlled trials and new castle Ottawa scale for observational studies for their quality assessment. Finally, we included 22 randomized controlled trials and 2 observational studies. Findings: The supplements, diet and exercise regimens and medications that were studied, many of them showed desirable changes in adipokine levels. Some of these regimens have not shown changes from baseline. Conclusions: Exercise, diet modifications and medications like Orlistat, Resveratrol, Pioglitazone should be used to target the adipokine levels to reduce cardiometabolic disease risk and progression.