1 Department of Epidemiology, Capital Institute of Paediatrics , Beijing, P.R. China .
2 Centre de Recherche de l'Institut Universitaire de Cardiologie & Pneumologie de Québec (CRIUCPQ), Université Laval , Québec, Canada .
Child Obes. 2017 Jun;13(3):213-221. doi: 10.1089/chi.2016.0273. Epub 2017 Jan 27.
Previous longitudinal studies have shown inconsistent results regarding the influence of adipokines on changes in weight and body fat. We aimed to determine the predictive value of serum leptin, adiponectin, and their ratio on subsequent changes in obesity measures in children.
Two hundred forty-six obese and 532 nonobese children aged 6-11 years were remeasured for BMI and waist circumference after 6.4 ± 0.2 years. Z-score of BMI was used to standardize for age and sex. Obesity was defined using the international BMI cutoffs. Waist-to-height ratio (WHtR) was calculated to define central obesity using a boundary value of 0.5. Fasting serum leptin and adiponectin levels were measured at baseline.
Newly identified obese children had significantly higher levels of leptin and leptin-to-adiponectin ratio than nonobese children. There were lower adiponectin levels in boys with persistent obesity versus those with transient obesity. After adjusting for age, Tanner stage, and corresponding adiposity measures at baseline, leptin levels and leptin-to-adiponectin ratio were positively associated with BMI Z-score gain in girls and WHtR gain in boys. An inverse association between leptin and BMI Z-score gain was detected in boys. Stratified analyses revealed significant associations only in the nonobese and prepubertal group. There were no significant associations between adiponectin and changes in obesity measures.
High leptin levels and leptin-to-adiponectin ratio are sex-specific predictors of obesity measures gain in nonobese and prepubertal children. Body composition measurement is necessary to assess fat mass growth and distribution during childhood and adolescence.
先前的纵向研究表明，脂肪因子对体重和体脂肪变化的影响结果不一致。我们旨在确定血清瘦素、脂联素及其比值对儿童肥胖指标后续变化的预测价值。
对 246 名肥胖和 532 名非肥胖的 6-11 岁儿童进行 6.4±0.2 年后再次测量 BMI 和腰围。BMI 的 Z 分数用于按年龄和性别标准化。肥胖采用国际 BMI 切点定义。腰围身高比（WHtR）用于定义中心性肥胖，采用 0.5 的边界值。在基线时测量空腹血清瘦素和脂联素水平。
新诊断为肥胖的儿童的瘦素和瘦素与脂联素比值明显高于非肥胖儿童。持续性肥胖的男孩的脂联素水平低于一过性肥胖的男孩。在调整了年龄、性成熟度和基线时相应的肥胖指标后，瘦素水平和瘦素与脂联素比值与女孩 BMI Z 评分增加和男孩 WHtR 增加呈正相关。在男孩中，瘦素与 BMI Z 评分增加呈负相关。分层分析显示，仅在非肥胖和青春期前组中存在显著相关性。脂联素与肥胖指标的变化之间无显著相关性。
高瘦素水平和瘦素与脂联素比值是肥胖指标在非肥胖和青春期前儿童中增加的性别特异性预测指标。在儿童和青少年时期，需要进行身体成分测量来评估脂肪量的增长和分布。
