Pediatric Endocrinology Division, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia.
Department of Molecular Biology, Prodia Widyahusada Laboratory, Jakarta, Indonesia.
Clin Obes. 2023 Jun;13(3):e12586. doi: 10.1111/cob.12586. Epub 2023 Feb 21.
Identifying the risk factors is critical in preventing childhood obesity. Leptin concentration is elevated in obesity. High serum leptin levels are believed to reduce soluble leptin receptor (sOB-R) concentrations and are associated with leptin resistance. The free leptin index (FLI) is a biomarker of leptin resistance and the status of leptin action. This study aims to investigate the association between leptin, sOB-R, and FLI with measurements to diagnose obesity in children, such as BMI, waist circumference and waist-to-height ratio (WHtR). We conducted a case-control study in 10 elementary schools in Medan, Indonesia. The case group was children with obesity, while the control group was children with normal BMI. Leptin and sOB-R levels were measured from all the subjects using the ELISA method. Logistic regression analysis was employed to determine which factors were predictor variables of obesity. A total of 202 children between 6 and 12 years old were recruited for this study. Children with obesity showed significantly higher leptin levels and FLI and lower SOB-R levels FLI (p < .05) than control. The cut-off for WHtR in this study was 0.499 (sensitivity 90% and specificity 92.5%). Children with higher leptin levels had a higher risk of obesity based on BMI, waist circumference, and WHtR values.
确定风险因素对于预防儿童肥胖至关重要。肥胖患者的瘦素浓度升高。人们认为，高血清瘦素水平会降低可溶性瘦素受体（sOB-R）的浓度，并与瘦素抵抗有关。游离瘦素指数（FLI）是瘦素抵抗和瘦素作用状态的生物标志物。本研究旨在探讨瘦素、sOB-R 和 FLI 与用于诊断儿童肥胖的指标（如 BMI、腰围和腰高比（WHtR））之间的关系。我们在印度尼西亚棉兰的 10 所小学进行了一项病例对照研究。病例组为肥胖儿童，对照组为 BMI 正常的儿童。使用 ELISA 法测量所有受试者的瘦素和 sOB-R 水平。采用逻辑回归分析确定哪些因素是肥胖的预测变量。共有 202 名 6 至 12 岁的儿童参与了这项研究。肥胖儿童的瘦素水平和 FLI 显著较高，而 sOB-R 水平显著较低（p<0.05）。本研究中 WHtR 的截断值为 0.499（灵敏度 90%，特异性 92.5%）。根据 BMI、腰围和 WHtR 值，瘦素水平较高的儿童肥胖的风险更高。
