Lahlou N, Landais P, De Boissieu D, Bougnères P F
INSERM U342 and Pediatric Endocrinology, Saint Vincent de Paul, Paris, France.
Diabetes. 1997 Jun;46(6):989-93. doi: 10.2337/diab.46.6.989.
In 112 obese compared with 42 lean children, we found that serum leptin is elevated early in the evolution of childhood-onset obesity (28.4 +/- 1.4 vs. 4.5 +/- 0.4 ng/ml in lean children, P < 0.0001) and correlates with adiposity. Obese children also had higher serum leptin normalized to fat mass. Despite high serum leptin, obese children ingested 2-3 times more calories than did lean control subjects (P < 0.0001) and gained weight rapidly (10.2 +/- 0.3 vs. 2.9 +/- 0.1 kg/year in control subjects, P < 0.0001). Girls had higher leptin levels than did boys, in obese as well as in nonobese children, and showed a closer correlation between adiposity and serum leptin. Elevation of serum leptin was comparable before and after puberty in obese boys, but puberty further increased leptin levels in obese girls (36 +/- 3 ng/ml), resulting in a clear sexual dimorphism with pubertal obese boys (22 +/- 5 ng/ml, P < 0.005). In conclusion, increased serum leptin reflects but does not halt fat deposition in childhood obesity. After normalization to body adiposity, leptin was found to be increased independently by obesity status, female sex, and female sexual maturation.
在112名肥胖儿童与42名瘦儿童的对比中，我们发现血清瘦素在儿童期肥胖发展早期即升高（瘦儿童为4.5±0.4 ng/ml，肥胖儿童为28.4±1.4 ng/ml，P<0.0001），且与肥胖程度相关。肥胖儿童经脂肪量标准化后的血清瘦素也更高。尽管血清瘦素水平高，但肥胖儿童摄入的热量比瘦对照受试者多2 - 3倍（P<0.0001），且体重快速增加（对照受试者为2.9±0.1 kg/年，肥胖儿童为10.2±0.3 kg/年，P<0.0001）。在肥胖和非肥胖儿童中，女孩的瘦素水平均高于男孩，且肥胖程度与血清瘦素的相关性更强。肥胖男孩青春期前后血清瘦素升高程度相当，但青春期使肥胖女孩的瘦素水平进一步升高（36±3 ng/ml），导致青春期肥胖男孩（22±5 ng/ml）出现明显的性别差异（P<0.005）。总之，血清瘦素升高反映但并未阻止儿童肥胖中的脂肪沉积。经身体肥胖程度标准化后，发现瘦素因肥胖状态、女性性别及女性性成熟而独立升高。
