LEP and metabolic syndrome: Moreover, since leptin and adiponectin are associated with opposite metabolic and vascular effects and contribute, usually in an opposite manner, to several components of the metabolic syndrome, the leptin to adiponectin ratio has been shown to reflect compromised adipose tissue function and to be a better predictor of insulin resistance and adverse outcomes, including CVD and mortality, than either leptin or adiponectin alone [52–54].