The comorbid course of arterial hypertension in combination with type 2 diabetes mellitus and obesity was one of the pressing issues of modern medicine due to the high risk of cardiovascular complications and metabolic maladaptation. The aim of the study: to determine the characteristics of leptin levels in patients with hypertension depending on the presence of comorbid conditions and to establish its associations with metabolic profile indicators. Object and methods of research. A total of 250 patients with varying comorbidity were examined and divided into four groups according to the presence of associated conditions. Leptin, insulin, 25(OH)D, and HbA1c levels were determined using the enzyme-linked immunosorbent assay method. Statistical analysis included correlation and intergroup comparisons (p<0.05). Results. As the study results showed, leptin levels significantly increased in patients with all three comorbid diagnoses (28.85±14.22 ng/mL) compared to the group with isolated arterial hypertension (23.83±12.52 ng/mL; p<0.05). A positive correlation was recorded between leptin and body mass index (r=0.627; p<0.0001), glycated haemoglobin (r=0.393; p=0.041), and a negative correlation with insulin level (r=–0.418; p=0.036) and 25(OH)D (r=–0.411; p=0.06). In patients with elevated HbA1c (above 8.5%), a slight decrease in leptin levels was observed compared to those with HbA1c between 7–8.5%. It was also established that 25(OH)D deficiency was associated with increased leptin levels, which could indicate a pathogenic relationship between these factors. Conclusion. An increase in leptin levels could be considered a marker of metabolic disorders, leptin resistance, and vitamin D deficiency in patients with arterial hypertension and comorbid conditions. The results of the presented study could contribute to the improvement of risk stratification strategies and individualisation of therapy.