Leptin as a predictor of metabolic syndrome in prepubertal children

Abstract

Objective: Leptin has been suggested as a potential biomarker of cardiovascular risk. This paper aims to ascertain, based on a sample of prepubertal children, which serum leptin value best suited to identify metabolic syndrome (MS). Subjects and methods: This observational, cross-sectional study recruited children from the outpatient pediatrics clinic, with the purpose of validating serum leptin level cutoffs to identify MS. All obese and overweight children who met eligibility criteria were included in the study, as was a sample of normal-weight children. The sample underwent clinical assessment and blood fasting glucose, lipid profile, insulin, and leptin were measured. Sensitivity and specificity were estimated for each leptin measurement, using MS as the outcome. These values were used to construct a receiver operating characteristic (ROC) curve. The association between MS and leptin was assessed using logistic models to predict MS. Results: A total of 65 normal weight, 46 overweight, and 164 obese children were analyzed (160 boys, 115 girls; age: 93.7 ± 17.8 months). The most appropriate leptin cutoff was 13.4 ng/mL (sensitivity 67.6%; specificity 68.9%; accuracy 72.1%). The logistic model indicated that leptin levels above 13.4 ng/dL were significantly associated with MS and that, for every 1 ng/dL increase in leptin levels, the odds of MS increase by 3% (p = 0.002; OR 1.03; 95% CI 1.01-1.05). Conclusions: Leptin may be a useful biomarker of cardiovascular risk in prepubertal children, with an optimal cutoff of 13.4 ng/mL. Identification of potential new risk markers for cardiovascular disease in children could contribute to the development of preventive strategies.Arch Endocrinol Metab. 2017;61(1):7-13

Does treatment of short or stunted children aged 6–59 months for severe acute malnutrition using ready to use therapeutic food make them overweight? Data from Malawi

“…If all children, irrespective of height or stuntedness are able to reach the discharge criteria satisfactorily and not develop obesity then this study suggests that, for children with SAM and recruited by MUAC, treatment with RUTF does not contribute towards obesity as a risk factor for metabolic syndrome. Studies using other markers of metabolic syndrome such as leptin have demonstrated that after 4–10 weeks of treatment with RUTF, leptin levels are lower than those of normally nourished children and approximately 7 times lower than the threshold for predicting metabolic syndrome [29, 30].…”

Obesidade: fatores de risco para doença cardiovascular na infância

“…Não há um consenso na literatura a respeito do ponto de corte em crianças. No entanto, um estudo do presente grupo de pesquisadores, realizado na mesma população, 26 mostrou que se for adotado o ponto de corte de 13,4 ng/ ml existe uma sensibilidade e uma especificidade de 68% e 69%, respectivamente, para a SM. Assim, usando esse ponto de corte, observa-se que todas as crianças de ambos os grupos estão acima, apesar de não haver diferença estaticamente significativa entre tais grupos.…”

Metabolic determinants of lupus pathogenesis

“…Adipokines are a group of peptides including leptin and adiponectin synthesized by white adipose tissue (WAT) that regulate energy homeostasis, but are also involved in inflammation . Altered levels of adipokines have been reported in patients with MetS and with SLE, as detailed below. Leptin regulates energy homeostasis in the neuroendocrine system by increasing satiety to simultaneously limit food intake and promote energy utilization.…”