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Higher leptin concentrations associated with metabolic syndrome in children
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European children with higher levels of serum leptin are more likely to have metabolic syndrome, regardless of BMI, according to published findings.
“The pathophysiology of [metabolic syndrome] is not completely clear, and the several pathogenic mechanisms proposed are still under investigation,” Alfonso Siani, MD, head of the unit of epidemiology and population genetics at the Institute of Food Sciences in Avellino, Italy, and colleagues wrote. “Among the involved factors, the adipokines profile seems to be crucial for the development of the adverse metabolic phenotype typical of individuals who develop the syndrome.”
Siani and colleagues analyzed data from 1,253 children aged 2 to 9 years participating in the Identification and Prevention of Dietary- and Lifestyle-Induced Health Effects in Children and Infants (IDEFICS) cohort, including children from Belgium, Cyprus, Estonia, Germany, Hungary, Italy, Spain and Sweden, recruited from schools and kindergartens (47.9% boys; mean age, 7 years). Researchers assessed waist circumference, triglycerides, HDL cholesterol, glucose, insulin, blood pressure, leptin and adiponectin levels. Children were classified as normal weight, overweight or obese and grouped into two categories: non-overweight and overweight or obese. Children were classified as having metabolic syndrome if they had at least three of the following criteria: increased waist circumference, high BP, dyslipidemia and elevated blood glucose and/or fasting glucose.
Among children with overweight or obesity, 24.8% of boys and 27.1% of girls had metabolic syndrome; among normal-weight children, less than 2% of children had metabolic syndrome. Researchers found that serum leptin and the leptin-to-adiponectin ratio were higher in children with overweight or obesity compared with children without obesity, whereas serum adiponectin was lower in children with obesity vs. normal-weight children. Additionally, children with overweight or obesity and metabolic syndrome had higher serum leptin levels and a higher leptin-to-adiponectin ratio compared with children with overweight or obesity who did not have metabolic syndrome. For each 1 standard deviation increase in serum leptin z score, boys with overweight or obesity had a 2.74 times greater odds of developing metabolic syndrome (95% CI, 1.73-4.35) compared with children of normal weight; results persisted after adjustment for BMI z score and body fat mass z score. Among girls with overweight and obesity, each 1 standard deviation increase in leptin z score was associated with a 1.67 times greater odds of developing metabolic syndrome compared with girls without overweight or obesity (95% CI, 1.16-2.4); results persisted after adjustment for BMI and body fat mass.
The researchers noted that, although most participants were likely prepubertal, no information was collected on pubertal status, which may affect any association between adipokines and metabolic syndrome.
“Our results showed for the first time that in the European children participating to the IDEFICS study, higher leptin concentration is associated with [metabolic syndrome], even after adjusting for BMI or [body fat mass], confirming an early role of leptin in [metabolic syndrome], and suggesting that other possible pathways beyond obesity may be involved in the leptin–[metabolic syndrome] relationship,” the researchers wrote. “Conversely, the association of adiponectin with [metabolic syndrome] seems to be mediated by body fat in the age range under investigation. The [leptin-to-adiponectin] ratio as a biomarker of [metabolic syndrome] did not offer further advantages in comparison with the measurement of leptin alone.” – by Regina Schaffer
Disclosure: The researchers report no relevant financial disclosures.
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