Gonzaga Nathalia C, Medeiros Carla C M, de Carvalho Danielle F, Alves João G B
Master's Program in Public Health, State University of Paraiba, Campina Grande, Pernambuco, Brazil.
J Paediatr Child Health. 2014 Sep;50(9):707-12. doi: 10.1111/jpc.12610. Epub 2014 Jun 13.
To verify the relationship between leptin and cardiometabolic risk factors in obese children and adolescents.
A cross-sectional study evaluated 200 children and adolescents treated in Campina Grande, Brazil, from April 2009 to March 2010. Leptin, fasting glucose, insulin, homeostasis model assessment of insulin resistance (HOMA-IR), total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and triglycerides were determined. The t-test was used to compare leptin means of two groups and analysis of variance to compare means of three groups. Multiple comparisons of pairs of group means were performed with Tukey's test. In all tests, a significance level of 0.05 was adopted.
The leptin sample mean was 22.7 ± 10.0 μg/L (95% confidence interval: 21.3 μg/L to 24.1 μg/L). Leptin was significantly higher in the following groups: female, teenager, increased waist circumference, high systolic blood pressure, elevated triglycerides hyperinsulinemia, insulin resistance and metabolic syndrome. Most cardiometabolic risk factors had higher means in the last quartile of leptin, except total-cholesterol, LDL-C and triglycerides levels. HDL-C was reduced in the last quartile of leptin. Simple linear regression analysis showed a significant negative correlation between leptin and HDL-C and a positive correlation between leptin and triglycerides, insulin, HOMA-IR, body mass index, waist circumference, and systolic and diastolic blood pressure. Multiple linear regression models showed an independent association between leptin and HDL-C, triglycerides, insulin, HOMA-IR, body mass index, waist circumference, systolic and diastolic blood pressure, after age and gender control.
Leptin may be a useful marker of metabolic syndrome and insulin resistance in obese adolescents.
验证肥胖儿童及青少年体内瘦素与心脏代谢风险因素之间的关系。
一项横断面研究对200名于2009年4月至2010年3月在巴西坎皮纳格兰德接受治疗的儿童及青少年进行了评估。测定了瘦素、空腹血糖、胰岛素、胰岛素抵抗稳态模型评估（HOMA-IR）、总胆固醇、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）及甘油三酯水平。采用t检验比较两组的瘦素均值，采用方差分析比较三组的均值。采用Tukey检验对各组均值进行多重比较。所有检验均采用0.05的显著性水平。
瘦素样本均值为22.7±10.0μg/L（95%置信区间：21.3μg/L至24.1μg/L）。在以下几组中瘦素水平显著更高：女性、青少年、腰围增加、收缩压升高、甘油三酯升高、高胰岛素血症、胰岛素抵抗及代谢综合征。除总胆固醇、LDL-C及甘油三酯水平外，大多数心脏代谢风险因素在瘦素水平的最后四分位数中均值更高。瘦素水平的最后四分位数中HDL-C降低。简单线性回归分析显示瘦素与HDL-C之间存在显著负相关，瘦素与甘油三酯、胰岛素、HOMA-IR、体重指数、腰围以及收缩压和舒张压之间存在正相关。多元线性回归模型显示，在控制年龄和性别后，瘦素与HDL-C、甘油三酯、胰岛素、HOMA-IR、体重指数、腰围、收缩压和舒张压之间存在独立关联。
瘦素可能是肥胖青少年代谢综合征和胰岛素抵抗的有用标志物。
