Is the Leptin/Adiponectin Ratio a Better Diagnostic Biomarker for Insulin Resistance than Leptin or Adiponectin Alone in Adolescents?

Abstract

Background: Recently, the leptin/adiponectin (L/A) ratio has been suggested as a novel predictor of cardio-metabolic and other chronic diseases. Aim: To evaluate the ability of leptin (L), adiponectin (A), and the L/A ratio in identifying high risk of insulin resistance IR in adolescents, adjusted by cardiorespiratory fitness, adherence to the Mediterranean diet, and body fat percentage. Subjects and methods: This is a cross-sectional analysis with 529 adolescents aged 12–18 years-old. Blood samples were taken to analyze glucose, insulin, leptin, and adiponectin levels. IR (homeostasis model assessment of insulin resistance (HOMA-IR) was estimated from fasting serum insulin and glucose). Results: Adiponectin, leptin, and L/A ratio were accurate to predict IR among adolescents. The optimal L/A cut-off value to indicate risk of IR development was >0.35 in boys and >0.97 in girls. Logistic analyses showed that the suggested cut-off points for adiponectin (girls: OR: 2.87 (1.26–6.53); p = 0.012); leptin (boys: OR: 5.23 (1.16–7.14) p = 0.006; girls: OR: 2.99 (1.10–8.09) p = 0.031), and the L/A ratio (boys: OR: 8.38 (2.6–26.8) p < 0.001; girls: OR: 6.1 (2.1–17.0) p < 0.001), were significant predictors of IR, after adjustments for age, pubertal stage, adherence to the Mediterranean diet, cardiorespiratory fitness, and body fat percentage. Conclusion: Leptin and L/A ratio were associated with IR risk, after adjustments for confounders in both sexes and adiponectin in girls. The L/A ratio seems to have a higher diagnostic accuracy to identify IR risk than adiponectin or leptin, in both sexes.

Association between plasma leptin/adiponectin ratio and insulin resistance indexes in prepubertal children

“…The association between LAR and insulin resistance was mainly driven by leptin over adiponectin in the present study, given that we found a weak association between plasma adiponectin and insulin resistance. In this context, increased leptin level, a common finding in obesity, is strongly associated with insulin resistance partially through increased adiposity, which suggests an overall decrease in sensitivity to leptin and insulin in obesity ( 38 ). Notably, the children in our study were prepubertal (Tanner 1) and had approximately 7 years of age (before the known rise in plasma insulin of adolescence), which may explain the nonsignificant results for the association between plasma adiponectin and insulin resistance.…”

“…It has been proposed that, in adolescents, leptin and LAR are associated with high insulin resistance independent of potential confounders (age, sex, pubertal stage, adherence to the Mediterranean diet, cardiorespiratory fitness, and body fat percentage) ( 47 ). These results are consistent with those of the present study, where we found a high risk of insulin resistance associated with leptin and LAR.…”

Corchorus olitorius extract exhibit anti-hyperglycemic and anti-inflammatory properties in rodent models of obesity and diabetes mellitus

“…These inflammatory cytokines induce insulin resistance by activating the suppressors of cytokine signaling proteins in insulin-target tissues ( 73 ). Both leptin and adiponectin are important in obesity through indirect regulation of food intake and body weight ( 74 ). In fact, leptin reduces body weight by decreasing food intake.…”

Complex Analysis of Endothelial Markers as Potential Prognostic Indicators in Luminal Invasive Breast Carcinoma Patients: Outcomes of a Six-Year Observational Study

“…Thus, adipocytes are regarded as a significant source of chronic low-grade inflammation. Endothelial cells release excessive amounts of cell adhesion molecules (CAMs), such as vascular cell adhesion molecule-1 (VCAM-1), intercellular adhesion molecule-1 (ICAM-1), and E-selectin in response to subclinical inflammation, resulting in leukocyte mobilization and adherence to the endothelium [ 7 ].…”

“…Numerous hormone-dependent cancers are associated with a lower adiponectin concentration, i.e., breast, endometrial, and prostate [ 22 , 23 , 24 ]. Thus, the leptin-to-adiponectin ratio (LAR) was established as a sensitive systemic inflammatory marker and predictor of cardiometabolic and neoplastic disease outcomes [ 7 ]. Since, Słomian et al observed that lower LAR was associated with a longer survival rate and better therapy response.…”