Gajewska Joanna, Weker Halina, Ambroszkiewicz Jadwiga, Chełchowska Magdalena, Dylag Hanna, Ołtarzewski Mariusz, Laskowska-Klita Teresa
Department of Newborn Screening, Institute of Mother and Child in Warsaw, 01-211 Warszawa.
Med Wieku Rozwoj. 2009 Oct-Dec;13(4):237-43.
Children's simple obesity and its adverse health effects need efficient dietary treatment and physical activity recommendations. Anthropometric parameters may not identify all positive changes associated with lifestyle modifications.
The aim of this study was to investigate if leptin and soluble leptin receptor concentration can be clinically useful markers for the monitoring of therapy efficacy in prepubertal obese children.
Changes in clinical, anthropometric and metabolic parameters including leptin and soluble leptin receptor in 26 patients aged 4-10 years, before and after a 3-months lifestyle intervention programme, were determined. This programme consisted of dietary and physical activity modifications and behaviour therapy, including individual psychological care of the child and its family. The recommended daily intake from a low-energy diet was 1200-1400 kcal/day. The reference group consisted of 30 healthy normal-weight children. Concentration of serum leptin and soluble leptin receptor were measured by ELISA kits.
After a 3-months therapy in the obese children we observed decreased leptin concentration by about 50% (p<0.001) and increased leptin receptor concentration by about 20% (p<0.05), in comparison to the baseline. Significant negative correlation was obtained between both markers before (r= -0.506, p<0.001) and after therapy (r= -0.572, p<0.001). In children with lifestyle intervention programme lower body mass index, by about 10% (p<0.05) was found.
The presented results suggest that leptin, as well as soluble leptin receptor, may identify positive changes in metabolism associated with weight reduction. Further studies with longer term therapy of the study group are continued, in order to confirm the value of these biochemical markers in the management of prepubertal obese children.