Center for Rare Endocrine Diseases, Division of Paediatric Endocrinology and Diabetes, Department of Paediatrics and Adolescent Medicine, University Medical Center Ulm, Ulm, Germany.
Department of Internal Medicine I, University Hospital Ulm, Ulm, Germany.
Front Endocrinol (Lausanne). 2022 May 23;13:881982. doi: 10.3389/fendo.2022.881982. eCollection 2022.
While for individuals with obesity an association between hyperleptinemia and an increased risk of non-alcoholic fatty liver disease (NAFLD) is assumed, a leptin deficiency is also related to the development of NAFLD early in life in mice, in patients with leptin deficiency due to biallelic likely pathogenic variants in the leptin gene, and in patients with lipodystrophy.
To investigate the association of circulating leptin levels in pre-pubertal children with obesity and steatosis hepatis.
The cross-sectional study consisted data of n=97 (n=76) pre-pubertal children (11.8 ± 1.5 years) with obesity (BMIz: 2.4 ± 0.4). Fasting concentrations of cardiometabolic parameters were measured: insulin, c-peptide, glucose, triglyceride, cholesterol, HDL, LDL, AST, ALT, GGT, leptin. Steatosis hepatis was diagnosed by an ultrasound examination (mild, moderate or severe). Patients were categorized into two groups: low z-score of circulating leptin levels (≤25th percentile) vs. normal z-score of circulating leptin levels.
One-third of the children with obesity were diagnosed with steatosis hepatis (I°: 63.6%, II°/III°: 36.4%). Children with steatosis hepatis had significantly lower z-scores of circulating leptin levels compared to children with an unremarkable liver ultrasonography (-2.1 ± 0.8 vs. -0.7 ± 0.6). Z-scores of circulating leptin levels correlate negatively with degree of steatosis hepatis. Children with low z-scores of circulating leptin levels had significantly higher triglyceride, fasting insulin and c-peptide levels compared to children with normal z-scores of circulating leptin levels.
Prepubertal children with NAFLD and obesity and partial leptin deficiency might be defined as a clinical subgroup.
虽然人们认为肥胖个体的高瘦素血症与非酒精性脂肪性肝病 (NAFLD) 风险增加有关，但在生命早期的小鼠中，瘦素缺乏也与 NAFLD 的发生有关，在因瘦素基因双等位体可能致病性变异而导致瘦素缺乏的患者中，以及在脂肪营养不良患者中也是如此。
研究肥胖和肝脂肪变性的青春期前儿童循环瘦素水平与非酒精性脂肪性肝病的相关性。
这项横断面研究纳入了 n=97（n=76）名肥胖（BMIz：2.4±0.4）的青春期前儿童（11.8±1.5 岁）的数据。空腹测量了心血管代谢参数的浓度：胰岛素、C 肽、葡萄糖、甘油三酯、胆固醇、HDL、LDL、AST、ALT、GGT、瘦素。通过超声检查诊断肝脂肪变性（轻度、中度或重度）。将患者分为两组：循环瘦素水平低 z 评分（≤第 25 百分位）与正常循环瘦素水平 z 评分。
三分之一的肥胖儿童被诊断为肝脂肪变性（I°：63.6%，II°/III°：36.4%）。与肝脏超声检查正常的儿童相比，患有肝脂肪变性的儿童的循环瘦素水平 z 评分显著降低（-2.1±0.8 与-0.7±0.6）。循环瘦素水平 z 评分与肝脂肪变性程度呈负相关。与循环瘦素水平正常的儿童相比，循环瘦素水平低 z 评分的儿童的甘油三酯、空腹胰岛素和 C 肽水平显著升高。
患有非酒精性脂肪性肝病和肥胖症以及部分瘦素缺乏的青春期前儿童可能被定义为一个临床亚组。
