Stein Katja, Vasquez-Garibay Edgar, Kratzsch Juergen, Romero-Velarde Enrique, Jahreis Gerhard
Institute of Nutrition, Friedrich Schiller University, Dornburger Strasse 24, D-07743 Jena, Germany.
J Clin Endocrinol Metab. 2006 Mar;91(3):1021-6. doi: 10.1210/jc.2005-1394. Epub 2005 Dec 13.
Leptin might be more important as a starvation hormone than as a satiety signal. The role of the soluble leptin receptor (sOB-R) and its regulation in children with protein energy malnutrition (PEM) is poorly understood.
We elucidated the effect of intensive nutritional support on the leptin axis in 26 severely malnourished toddlers who received infant milk-based formula for 2 wk via continuous enteral tube feeding followed by 2 wk ad libitum feeding. Serum levels of leptin, sOB-R, IGF-I, and IGF-binding protein-3 as well as anthropometric measurements were determined at the beginning of the study and at 2-wk intervals. The control group consisted of 13 well-nourished children.
The following were changes in the PEM toddlers after the nutritional support. Leptin increased significantly (P < 0.001), reaching 166% of levels observed in control group. sOB-R decreased significantly (P < 0.001), and a 142-fold molar excess of sOB-R over leptin was found. There were significant correlations between leptin and IGF-I after 2 wk and IGF-binding protein-3 during the whole study. sOB-R was not correlated with any anthropometric data, whereas IGF-I was a predictor of sOB-R variance in the PEM toddlers (19.9%, P = 0.022).
It can be concluded that sOB-R has a modulatory effect on leptin in PEM children during nutritional recovery and participates in their adaptive survival mechanisms. Leptin and the molar excess of sOB-R over leptin are better biomarkers of nutritional status than IGF-I in PEM children during nutritional recovery.
瘦素作为一种饥饿激素可能比作为一种饱腹感信号更为重要。可溶性瘦素受体（sOB-R）在蛋白质能量营养不良（PEM）儿童中的作用及其调节机制尚不清楚。
我们阐明了强化营养支持对26名重度营养不良幼儿瘦素轴的影响，这些幼儿通过持续肠内管饲接受基于婴儿配方奶的营养支持2周，随后自由进食2周。在研究开始时以及每隔2周测定血清瘦素、sOB-R、胰岛素样生长因子-I（IGF-I）和IGF结合蛋白-3水平以及人体测量数据。对照组由13名营养良好的儿童组成。
营养支持后PEM幼儿出现以下变化。瘦素显著增加（P<0.001），达到对照组观察水平的166%。sOB-R显著降低（P<0.001），发现sOB-R与瘦素的摩尔过量为142倍。2周后瘦素与IGF-I之间以及整个研究期间瘦素与IGF结合蛋白-3之间存在显著相关性。sOB-R与任何人体测量数据均无相关性，而IGF-I是PEM幼儿sOB-R变异的预测因子（19.9%，P=0.022）。
可以得出结论，在营养恢复过程中，sOB-R对PEM儿童的瘦素有调节作用，并参与其适应性生存机制。在营养恢复过程中，对于PEM儿童，瘦素以及sOB-R相对于瘦素的摩尔过量比IGF-I是更好的营养状况生物标志物。
