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Objective: Smoking is a well-known cardio­vascular risk factor associated with weight loss. We aimed to evaluate the association between smoking, serum leptin levels, and abdominal fat.Design: Cross-sectionalSetting: Data from examinations 2 or 3 (2002-2005) of the Multi-Ethnic Study of Atherosclerosis (MESA)Participants: 1,875 asymptomatic, commu­nity-dwelling adultsMain Outcomes Measures: We used multivariable linear regression models to assess the race/ethnicity-specific associations between smoking, serum loge-leptin levels, and computed tomography ascertained abdominal fat. Results were adjusted for de­mographic and relevant clinical covariates.Results: Participants (mean age 64.5±9.6 years; 50.6% women; 42.2% former, 11.4% current smokers) were White (40.1%), His­panic (25.8%), African American (21.1%), and Chinese (13.0%). Overall, median (25th – 75th percentile) leptin levels were signifi­cantly lower among current (11.14 ng/mL; 4.13 – 26.18) and former smokers (11.68 ng/mL; 4.72 – 27.57), as compared with never smokers (15.61 ng/mL; 3.05 – 30.12) (P<.001). The difference in median leptin levels between current and never smok­ers were significantly higher for Hispan­ics (Δ9.64 ng/mL) and African Americans (Δ8.81 ng/mL) than Whites (Δ2.10 ng/mL) and Chinese (Δ4.70 ng/mL) (P<.001). After adjustment for total abdominal fat, loge- leptin levels remained lower for former (-.14 [-.22 – -.07]) and current (-.17 [-.28 – -.05]) smokers, compared with never smokers. Results differed by race/ethnicity, with signif­icantly lower loge-leptin levels observed only among current and former African Ameri­cans and Hispanic smokers, compared with their never smoker counterparts. (Ps for interaction <.05)Conclusions: Among smokers, leptin levels significantly vary by race/ethnicity. Former and current smoking are associ­ated with lower leptin levels, although this may be restricted to Hispanics and African Americans. Ethn Dis. 2018;28(4):531-538; doi:10.18865/ed.28.4.531

BACKGROUND AND AIMS: Inflammatory biomarkers and adipocytokines (IBA) may contribute to atherosclerosis by promoting vascular inflammation. The association between IBA and coronary artery calcium (CAC), a marker of subclinical atherosclerosis, is not well defined in South Asians (SA). We hypothesized that IBA (high sensitivity C-reactive protein [hsCRP], tumor necrosis factor alpha [TNF-α], adiponectin, and leptin) were independently associated with and improved discrimination of CAC among SA. METHODS: We analyzed IBA and CAC among participants in the prospective Mediators of Atherosclerosis in South Asians Living in America (MASALA) study. We used logistic regression models to examine cross-sectional associations of IBA with CAC presence (CAC >0) and severity (CAC >100), and C-statistics to assess the incremental contribution of each IBA to traditional risk factors (TRF) from the AHA/ACC Pooled Cohort Equations (PCE) for discrimination of CAC. RESULTS: Among 906 participants of the MASALA study, women (n=420) had significantly higher levels of hsCRP, adiponectin, and leptin but lower levels of TNF-α than men (p<0.01 for all). There was no significant association between any of the four IBA and either CAC category in multivariable-adjusted models, respectively. Lastly, none of the four IBA improved discrimination of CAC presence or severity when added to elements of the PCE. CONCLUSIONS: IBA were not associated with CAC presence or severity in the MASALA population. IBA did not help identify SA at risk of subclinical atherosclerosis, although associations with ASCVD events remain unclear. In SA, CAC may have a distinct pathophysiology independent of inflammation as measured by IBA.