Association of Serum Leptin and Adiponectin Levels with Blood Pressure and Insulin Resistance in Obese Adults: A Cross-Sectional Study

Background: Obesity is widely recognized as a serious worldwide health issue, with a clear relationship to metabolic abnormalities including insulin resistance and high blood pressure. Leptin and adiponectin, two adipose-derived hormones, serve conflicting roles in regulating vascular and metabolic activities. However, few studies have looked at their link with cardiometabolic risk in South Asian populations. The purpose of this research was to look at how serum leptin and adiponectin affect blood pressure and insulin resistance in obese Pakistani adults. Methods: A cross-sectional research was carried out at three tertiary care facilities from January 2024 to June 2025. A total of 120 obese people (BMI ≥30 kg/m²; ages 25-60) were recruited. Demographic, anthropometric, and clinical data were gathered. Blood pressure was assessed using established methods, and fasting blood samples were tested for glucose, insulin, leptin, and adiponectin. Insulin resistance was evaluated using the homeostasis model assessment (HOMA-IR). Correlation tests and multivariate regression were used in the statistical analysis, which controlled for age, gender, and BMI. Results: The study population's mean BMI was 33.8 ± 3.9 kg/m2, and its mean age was 44.5 ± 9.8 years, with 57.5% of the participants being female. The mean values of leptin and adiponectin were 21.5 ± 9.3 ng/mL and 6.2 ± 2.1 µg/mL, respectively. When compared to those with normotension, hypertensive participants showed considerably greater levels of leptin (25.2 ± 8.7 vs. 18.3 ± 7.2 ng/mL, p<0.01) and significantly lower levels of adiponectin (5.1 ± 1.8 vs. 7.2 ± 2.3 µg/mL, p<0.01). Systolic pressure and HOMA-IR were favorably connected with leptin (r=0.38 and r=0.42, p<0.001), but adiponectin was inversely correlated (r=–0.32 and r=–0.39, p<0.01). Both adiponectin and leptin were validated by regression models as independent predictors of insulin resistance and hypertension. Conclusion: Obese Adults from Pakistan show a clear imbalance between leptin and adiponectin, with greater levels of leptin and lower levels of adiponectin being independently associated with insulin resistance and high blood pressure. These adipokines might guide preventative and intervention plans and act as early markers of cardiometabolic risk.