Leptin, adiponectin, and their ratio as markers of insulin resistance and cardiometabolic risk in childhood obesity

Abstract

Background: It is imperative to develop markers for risk stratification and detection of cardiometabolic comorbidities in children with obesity. The adipokines leptin and adiponectin are both involved in fat mass regulation and the development of obesityrelated disorders; furthermore, their ratio (leptin/adiponectin ratio) is suggested to be associated with insulin resistance and cardiometabolic risk.Objective: To evaluate associations between fasting serum concentrations of the adipokines (total leptin and adiponectin as well as the L/A ratio) and cardiometabolic comorbidities in children with overweight/obesity.Methods: A total of 2258 children with overweight/obesity or normal weight aged 6 to 18 years were studied. Differences in anthropometrics and adipokine concentrations were tested using Wilcoxon rank-sum test. Associations between the adipokines and cardiometabolic risk were tested using Spearman's correlation and logistic regression, adjusted for age and body mass index SD score (BMI-SDS).Results: Compared to normal weight children; children with overweight/obesity exhibited higher leptin concentrations, lower adiponectin concentrations, and higher L/A ratios. After adjusting for age and degree of obesity, girls with overweight/obesity in the upper quartile range for the L/A ratio, when compared with girls in the lower quartile range, were more likely to have insulin resistance (odds ratio [OR]: ABBREVIATIONS: BMI, Body mass index; DXA, Dual-energy X-ray absorptiometry; HOMA-IR, Homeostasis model of assessment -insulin resistance; L/A ratio, Leptin/adiponectin ratio; SDS, SD score.Christine Frithioff-Bøjsøe and Morten A.V. Lund shared first authorship.

Plasma Adipokines Profile in Prepubertal Children with a History of Prematurity or Extrauterine Growth Restriction

“…These biological mediators have pro-and anti-inflammatory properties and modulate several physiological functions, such as energy balance, insulin sensibility, inflammatory and immune responses, appetite, and vascular homeostasis [30]. Balance between adipokines is crucial to integrate metabolism with several physiologic functions [13], and proinflammatory adipokines may play a critical role in the progression of chronic inflammation and the development of MS, hypertension, T2D, obesity and CVD [12,13,[31][32][33], even at early ages [15,34].…”

“…Reviews focused on the impact of adipose tissue disturbance in the adipokine profile have demonstrated that balance shifts to favor proinflammatory adipokines may play a critical role in the development of cardiometabolic pathologies [12][13][14]. It is known that abnormal adipokine profile may be observed in obese children [15]. Moreover, it was suggested that impaired growth during critical periods, such as in the third trimester of pregnancy can lead the programming of adipose tissue, conferring a high subsequent cardiometabolic risk later in life [16].…”

Elevated Serum Level of Cytokeratin 18 M65ED Is an Independent Indicator of Cardiometabolic Disorders

“…TG : HDL-C ratio and triglyceride-glucose index are all reported to be associated with the cardiometabolic disorders [45,46]. Leptin, adiponectin, and their ratio were associated with insulin resistance and other cardiometabolic comorbidities [47]. In the latest researches, branched chain amino acids were found to be passive biomarkers or the key to the pathogenesis of cardiometabolic diseases [48].…”

Serum concentration of asprosin in new-onset type 2 diabetes

“…Adipokines are cytokines secreted from adipose tissue, which affect a broad spectrum of biological processes (4)(5)(6)(7). Some of these adipokines, such as resistin and leptin, antagonize insulin function in peripheral tissues, especially in the liver and skeletal muscles, which leads to insulin resistance (7)(8)(9)(10). In contrast, adiponectin increases insulin sensitivity (11,12).…”