Madeira Isabel, Bordallo Maria Alice, Rodrigues Nádia Cristina, Carvalho Cecilia, Gazolla Fernanda, Collett-Solberg Paulo, Medeiros Clarice, Bordallo Ana Paula, Borges Marcos, Monteiro Claudia, Ribeiro Rebeca
Faculdade de Ciências Médicas, Departamento de Pediatria, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brasil.
Faculdade de Ciências Médicas, Departamento de Medicina Interna, UERJ, Rio de Janeiro, RJ, Brasil.
Arch Endocrinol Metab. 2017 Jan-Feb;61(1):7-13. doi: 10.1590/2359-3997000000199. Epub 2016 Sep 5.
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).
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.
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).
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.
瘦素被认为是心血管疾病风险的潜在生物标志物。本文旨在基于青春期前儿童样本，确定最适合识别代谢综合征（MS）的血清瘦素值。
这项观察性横断面研究从儿科门诊招募儿童，目的是验证用于识别MS的血清瘦素水平临界值。所有符合入选标准的肥胖和超重儿童以及正常体重儿童样本均纳入研究。对样本进行临床评估，并测量空腹血糖、血脂、胰岛素和瘦素。以MS为结果，估计每次瘦素测量的敏感性和特异性。这些值用于构建受试者工作特征（ROC）曲线。使用逻辑模型预测MS，评估MS与瘦素之间的关联。
共分析了65名正常体重、46名超重和164名肥胖儿童（160名男孩，115名女孩；年龄：93.7±17.8个月）。最合适的瘦素临界值为13.4 ng/mL（敏感性67.6%；特异性68.9%；准确性72.1%）。逻辑模型表明，瘦素水平高于13.4 ng/dL与MS显著相关，瘦素水平每增加1 ng/dL，MS的几率增加3%（p = 0.002；OR 1.03；95% CI 1.01 - 1.05）。
瘦素可能是青春期前儿童心血管疾病风险的有用生物标志物，最佳临界值为13.4 ng/mL。识别儿童心血管疾病潜在的新风险标志物有助于制定预防策略。
