Division of Health Sciences, Department of Population Evidence and Technologies, Warwick Medical School, University of Warwick, Coventry CV7 7HL, UK.
Department of Endocrinology and Diabetes, University Hospital of Ioannina, 45500 Ioannina, Greece.
Int J Environ Res Public Health. 2021 Feb 16;18(4):1897. doi: 10.3390/ijerph18041897.
Childhood obesity is a growing epidemic. Early identification of high-risk groups will allow for the development of prevention strategies. Cord blood adipocytokines have been previously examined as biomarkers predicting future obesity. We conducted a systematic review looking at the association between cord blood leptin and adiponectin with adiposity up to 5 years of age. A literature review was performed between January 1994 and August 2020 using two bibliographic databases (Medline/Pubmed and EMBASE) and was registered on PROSPERO (CRD42017069024). Studies using skinfold thickness and direct methods of assessing body composition in full term neonates were considered. Partial correlation and multiple regression models were used to present the results. Meta-analysis was performed, were possible, using a random effects model. Cochran's Q test was used to assess heterogeneity and I statistics to calculate the percentage of variation across studies. The potential for publication bias was assessed using funnel plots. Data from 22 studies were retrieved and reviewed by two independent reviewers. Cord blood leptin was positively associated with adiposity at birth ( = 0.487; 95% CI: 0.444, 0.531) but was inversely related to adiposity up to 3 years of age. The association was not sustained at 5 years. There was a weak positive association between adiponectin in cord blood and adiposity at birth ( = 0.201; 95% CI: 0.125, 0.277). No correlation was found between cord blood adiponectin in young children, but data were limited. This review supports that cord blood leptin and adiponectin are associated with adiposity at birth. The results of this study provide insight into the role of adipocytokines at birth on future metabolic health and their potential use as risk stratification tools.
儿童肥胖是一个日益严重的问题。早期识别高危人群将有助于制定预防策略。脐带血脂肪细胞因子已被作为预测未来肥胖的生物标志物进行了研究。我们进行了一项系统评价，研究了脐带血瘦素和脂联素与 5 岁以下肥胖的相关性。1994 年 1 月至 2020 年 8 月期间，我们在两个文献数据库（Medline/Pubmed 和 EMBASE）中进行了文献回顾，并在 PROSPERO（CRD42017069024）上进行了注册。考虑了使用皮褶厚度和直接方法评估足月新生儿身体成分的研究。使用偏相关和多元回归模型来呈现结果。如有可能，使用随机效应模型进行荟萃分析。使用 Cochran's Q 检验评估异质性，使用 I 统计量计算研究之间的变异百分比。使用漏斗图评估发表偏倚的可能性。从 22 项研究中检索并由两名独立评审员审查数据。脐带血瘦素与出生时的肥胖呈正相关（ = 0.487；95%CI：0.444，0.531），但与 3 岁时的肥胖呈负相关。这种关联在 5 岁时并不持续。脐带血脂联素与出生时的肥胖呈弱正相关（ = 0.201；95%CI：0.125，0.277）。在幼儿中未发现脐带血脂联素与肥胖之间存在相关性，但数据有限。本综述支持脐带血瘦素和脂联素与出生时的肥胖有关。该研究结果提供了关于脂肪细胞因子在出生时对未来代谢健康的作用及其作为风险分层工具的潜在用途的见解。
