Agostinis-Sobrinho César, Vicente Sofia E de Castro Ferreira, Norkiene Sigute, Rauckienė-Michaelsson Alona, Kievisienė Justina, Dubey Viney Prakash, Razbadauskas Arturas, Lopes Luís, Santos Rute
Faculty of Health and Sciences, Klaipeda University, 92294 Klaipeda, Lithuania.
Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, 4200-450 Porto, Portugal.
Children (Basel). 2022 Aug 9;9(8):1193. doi: 10.3390/children9081193.
Background: Recently, the leptin/adiponectin (L/A) ratio has been suggested as a novel predictor of cardio-metabolic and other chronic diseases. Aim: To evaluate the ability of leptin (L), adiponectin (A), and the L/A ratio in identifying high risk of insulin resistance IR in adolescents, adjusted by cardiorespiratory fitness, adherence to the Mediterranean diet, and body fat percentage. Subjects and methods: This is a cross-sectional analysis with 529 adolescents aged 12−18 years-old. Blood samples were taken to analyze glucose, insulin, leptin, and adiponectin levels. IR (homeostasis model assessment of insulin resistance (HOMA-IR) was estimated from fasting serum insulin and glucose). Results: Adiponectin, leptin, and L/A ratio were accurate to predict IR among adolescents. The optimal L/A cut-off value to indicate risk of IR development was >0.35 in boys and >0.97 in girls. Logistic analyses showed that the suggested cut-off points for adiponectin (girls: OR: 2.87 (1.26−6.53); p = 0.012); leptin (boys: OR: 5.23 (1.16−7.14) p = 0.006; girls: OR: 2.99 (1.10−8.09) p = 0.031), and the L/A ratio (boys: OR: 8.38 (2.6−26.8) p < 0.001; girls: OR: 6.1 (2.1−17.0) p < 0.001), were significant predictors of IR, after adjustments for age, pubertal stage, adherence to the Mediterranean diet, cardiorespiratory fitness, and body fat percentage. Conclusion: Leptin and L/A ratio were associated with IR risk, after adjustments for confounders in both sexes and adiponectin in girls. The L/A ratio seems to have a higher diagnostic accuracy to identify IR risk than adiponectin or leptin, in both sexes.
最近，瘦素/脂联素（L/A）比值被认为是心血管代谢疾病和其他慢性疾病的一种新型预测指标。目的：评估瘦素（L）、脂联素（A）以及L/A比值在识别青少年胰岛素抵抗（IR）高风险方面的能力，并根据心肺适能、对地中海饮食的依从性和体脂百分比进行调整。对象与方法：这是一项对529名12至18岁青少年的横断面分析。采集血样以分析血糖、胰岛素、瘦素和脂联素水平。通过空腹血清胰岛素和血糖估算胰岛素抵抗（采用胰岛素抵抗稳态模型评估（HOMA-IR））。结果：脂联素、瘦素和L/A比值在预测青少年IR方面具有准确性。提示IR发生风险的最佳L/A临界值在男孩中>0.35，在女孩中>0.97。逻辑分析表明，脂联素（女孩：比值比（OR）：2.87（1.26 - 6.53）；p = 0.012）、瘦素（男孩：OR：5.23（1.16 - 7.14）p = 0.006；女孩：OR：2.99（1.10 - 8.09）p = 0.031）以及L/A比值（男孩：OR：8.38（2.6 - 26.8）p < 0.001；女孩：OR：6.1（2.1 - 17.0）p < 0.001），在对年龄、青春期阶段、对地中海饮食的依从性、心肺适能和体脂百分比进行调整后，均为IR的显著预测指标。结论：在对男女混杂因素以及女孩中的脂联素进行调整后，瘦素和L/A比值与IR风险相关。在男女中，L/A比值在识别IR风险方面似乎比脂联素或瘦素具有更高的诊断准确性。
