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Clin Chem Lab Med 2010;48(5):707711  2010 by Walter de Gruyter Berlin New York. DOI 10.1515/CCLM.2010.142

Leptin and adiponectin levels in pubertal children:


relationship with anthropometric variables and body
composition1)

Stefanie Schoppen, Pa Riestra, Alicia GarcaAnguita, Laura Lopez-Simon, Beatriz Cano, Iria de
Oya, Manuel de Oya and Carmen Garces*
Lipid Research Laboratory, Fundacion Jimenez Daz,
Universidad Autonoma de Madrid, Madrid, Spain

Abstract
Background: Adipocytokines play an important role in controlling energy homeostasis, and in various metabolic processes related to obesity. The aim of this study was to
describe serum leptin and adiponectin concentrations in a
sample of pubertal Spanish children and to evaluate their
association with anthropometric parameters and body
composition.
Methods: The study included 833 pubertal boys and girls.
Serum leptin and adiponectin concentrations were determined by ELISA.
Results: Leptin concentrations were significantly higher
(p-0.0001) in obese or overweight (OW) children compared
with children with normal weight (NW). Adiponectin was
significantly lower (p-0.01) in obese or OW girls compared
with girls of NW, although these findings were not the same
for boys. Weight, body mass index (BMI), waist circumference (WC), hip circumference (HC), and waist to hip ratio
were significantly correlated (p-0.01) with leptin concentrations in both genders. Correlation of leptin with fat mass
and % fat mass was strong, particularly in boys. The association of adiponectin concentrations with anthropometric
variables was weaker in both genders. No significant correlations were found between adiponectin concentrations and
fat mass or % fat mass.
Conclusions: In summary, our study showed that, in pubertal
children, leptin is related to weight, BMI, WC and HC and
correlates even more strongly with % fat mass. However,
adiponectin was weakly related to anthropometric variables
and was not correlated with body fat.
Clin Chem Lab Med 2010;48:70711.
1)

Dedicated to Prof. Manuel de Oya, as the warmest homage to his


memory.
*Corresponding author: Dr. Carmen Garces, Lipid Laboratory,
Fundacion Jimenez Daz, Avda. Reyes Catolicos, 2,
28040 Madrid, Spain
Phone/Fax: q34-91-5432880, E-mail: cgarces@fjd.es
Received November 20, 2009; accepted January 13, 2010

Keywords: adiponectin; anthropometric data; body composition; leptin; pubertal children.

Introduction
Obesity is a complex disorder resulting from an imbalance
between food intake and energy expenditure. A substantial
increase in the prevalence of obesity has been paralleled by
an increase in the study of the mechanisms underlying the
regulation of energy balance (1). Adipose tissue-derived adipocytokines, including leptin and adiponectin, play an important role in controlling energy homeostasis and in various
metabolic processes related to obesity (2).
Leptin functions by transmitting signals to the brain that
regulate energy homeostasis by reducing food intake and
increasing energy expenditure (3). Increased leptin concentrations have been observed in obese adults (4). Furthermore,
leptin concentrations have been shown to be directly proportional to the amount of body fat (3, 5).
Adiponectin enhances fatty acid oxidation and insulin sensitivity, in addition to increasing energy expenditure and lipid
catabolism (6). In contrast to most other adipocytokines that
increase with the excess of body fat mass, concentrations of
adiponectin are lower in obese adults (79).
The association of these cytokines with obesity has also
been studied in children. Obesity has been linked with higher
leptin concentrations in different populations of children
(1013), and also with lower adiponectin values in several
populations including Pima Indian children (14), as well as
Taiwanese (15), Japanese (12) and Caucasian (16, 17) children. However, with the exception of the data produced by
The Taipei Childrens Heart Study, the results of these studies
are not derived from population-based samples, but rather
from either relatively small population samples, or studies
including a broader range of age groups. Observational studies in Caucasian pubertal children are scarce, particularly
those which include measurement of adiponectin, and the
relationship between adiponectin and body composition has
largely been overlooked.
It is well known that adipocytokines related to increases
in body weight at the transition to puberty may have substantial influence over the onset of puberty. Thus, the aim of
our study was to examine leptin and adiponectin concentrations according to gender in Spanish pubertal children
between the ages of 12 and 16 years, and to analyze the
relationship of leptin and adiponectin with anthropometric

2010/621

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708 Schoppen et al.: Leptin, adiponectin and obesity in children

measurements and body composition in a large populationbased sample of healthy children.

Materials and methods

in kg/height in m2) was calculated. We considered children to be


overweight (OW) or obese if their BMI exceeded the age- and gender-specific cut-off points proposed for children by Cole et al. (18)
based on a synthesis of international studies.

Biochemical data

Subjects
Children included in this study were part of a cross-sectional study
examining cardiovascular risk factors in Spain. Children were
selected by means of random cluster-sampling in schools, and stratified by gender. Sampling was carried out in two stages: first,
schools were selected from lists made available by the Regional
Educational Authorities; and second, class rooms and pupils were
selected. The sample population was comprised of 397 male and
436 female children, 1216 years of age. The study protocol complied with the Helsinki Declaration guidelines and Spanish legal
provisions governing clinical research on humans, and was
approved by the Clinical Research Ethics Committee of the Fundacion Jimenez Diaz.

Data collection and study variables


The study was formally presented to the board of each of the participating schools. Following this, a letter was circulated to the parents of all the children invited to join the study, outlining the study
goals and procedures. Parents were required to sign a written consent form allowing their children to participate. All children were
reported by their parents to be suffering from metabolic syndrome,
endocrine, liver or kidney disorders, were excluded from the study
to rule out any possible alteration in the values of the variables of
interest.

Fasting (12 h) venous blood samples were obtained by venipuncture


and collected in vacutainer tubes. Samples were kept on ice and
sent to the laboratory for analysis. Following centrifugation, fractions were separated and frozen at 708C. Serum leptin and adiponectin concentrations were measured by ELISA using commercially available kits (Leptin EIA-2395, DRG Instruments
GmbH, Marburg, Germany, and Adiponectin E-09, Mediagnost
Reutlingen, Germany, respectively).

Statistical analysis
Statistical analyses were performed using the SPSS software package, version 9.0 (SPSS, Inc., Chicago, IL, USA). Results were
expressed in mean"SD. Gender differences in the variables being
studied were assessed using the t-test. Differences in variables by
age and weight category in boys and girls were evaluated by onefactor ANOVA. A two-way ANOVA was used to evaluate the contribution of the interaction between gender and obesity status to
variations in leptin and adiponectin concentrations. Pearson correlation analysis was performed to evaluate the relationships between
leptin and adiponectin concentrations and both anthropometric
variables and body composition. Given that serum leptin did not
show a normal distribution, the data were log transformed prior to
statistical analysis.

Results

Anthropometric variables
Measurements were taken with children wearing light clothing and
no shoes. Weight was determined to the nearest 0.1 kg using a
standardized electronic digital scale. Height was measured to the
nearest 0.1 cm using a portable stadiometer. Waist circumference
(WC) was measured at the narrowest point between the lowest rib
and the uppermost lateral border of the right iliac crest. Hip circumference (HC) was measured at the widest point of the hips with the
subject standing with both feet together. The waist to hip ratio was
calculated from these two circumference values. In a subgroup of
children (163 boys and 165 girls), body composition wexpressed as
fat mass (kg), lean mass (kg) and percent of body fatx was assessed
using a Tanita (Arlington Heights, IL, USA) TBF-300MA impedance body composition analyzer. Body mass index (BMI; weight

Serum leptin and adiponectin concentrations were significantly higher (p-0.0001) in girls than in boys, with the
exception of adiponectin concentrations in 12-year-old children. Thus, all the results are presented separately for girls
and boys. Even though leptin concentrations appear to progressively decrease with age in boys, no significant differences were found in leptin or adiponectin concentrations
with respect to age in boys or girls.
Serum leptin and adiponectin concentrations in normal
weight (NW), OW and obese pubertal boys and girls are
shown in Table 1. Serum leptin concentrations were significantly higher (p-0.0001) in obese or OW boys and girls

Table 1 Plasma leptin and adiponectin concentrations in normal weight (NW), overweight (OW) and obese pubertal boys and girls.

Boys
Leptin, ng/mL
Adiponectin, ng/mL

Girls
Leptin, ng/mL
Adiponectin, ng/mL

Total, ns397

NW, ns264

OW, ns104

Obese, ns29

ANOVA

6.1"8.1
11.3"6.7

3.1"4.2a
11.8"6.8

10.1"9.0b
10.6"6.8

20.4"11.0c
8.6"5.1

F0.0001
0.072

Total, ns436

NW, ns330

OW, ns88

Obese, ns18

ANOVA

16.0"10.0
15.4"8.0

13.0"7.7a
16.1"7.9a

24.1"9.9b
13.3"8.2b

36.4"8.9c
11.6"6.9b

F0.0001
F0.01

Data are presented as mean"SD. Different superscript letters (abc) represent significant differences between NW, OW and obese groups.

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Schoppen et al.: Leptin, adiponectin and obesity in children 709

Table 2 Pearsons correlation analysis between leptin and adiponectin concentrations, anthropometric data and body composition in
1216-year-old boys and girls.
Leptin

Weight, kg
Height, m
BMI, kg/m2
Waist circumference, cm
Hip circumference, cm
Waist to hip ratio
Fat mass, %
Fat mass, kg
Lean body mass, kg

Adiponectin

Boys

Girls

Boys

Girls

0.457b
0.076
0.643b
0.642b
0.531b
0.385b
0.828b
0.815
0.158

0.645b
0.096a
0.685b
0.651b
0.655b
0.251b
0.650b
0.680b
0.443b

0.179b
0.139b
0.141b
0.165b
0.146b
0.086
0.061
0.058
0.134

0.116a
0.037
0.149b
0.151b
0.063
0.160b
0.024
0.066
0.025

p-0.05; bp-0.01.

compared with NW subjects. Serum adiponectin concentrations were significantly lower (p-0.01) in obese or OW girls
than in NW girls (Table 1). Differences in adiponectin concentrations in boys were not statistically significant (Table
1). A two-way ANOVA showed that the interaction between
gender and obesity status was statistically significant for
adiponectin (p-0.01).
Pearson correlation analysis showed highly significant
positive correlation between leptin concentrations and all
anthropometrical variables with the exception of height, and
an even higher correlation with fat mass and percentage of
fat mass in boys and girls (Table 2). Negative correlation
between adiponectin concentrations and anthropometric
variables were weaker in both genders, with no correlation
existing between adiponectin and body composition data
(Table 2).

Discussion
For adults, there are an important number of studies whose
findings on different populations demonstrate the positive
association of leptin and the negative association of adiponectin with obesity and obesity-related phenotypes (4, 5, 8,
19, 20). However, data obtained from children during puberty, when subjects experience weight gain rather than maintaining body weight are scarce. To our knowledge, this is the
first study that presents data on leptin and adiponectin concentrations from a large population of Spanish pubertal children for a defined period of time (between 12 and 16 years).
An added strength of our study is that, in addition to analyzing the relationships of leptin and adiponectin concentrations with anthropometric variables, we analyzed the
association between these values and percentage of fat mass,
an aspect rarely addressed in previous population-based
studies.
As previously reported in other populations of children
(1017), our study found that leptin concentrations were
higher in OW and obese boys and girls and adiponectin concentrations were lower in OW and obese girls than in NW

children. We observed a strong effect of gender on leptin


concentrations in our children, with higher values in girls
compared with boys. This has been widely described in the
literature for obese and non-obese adults and children
(2123). Some studies suggest that there are important gender-based differences in the regulation and action of leptin
in humans (24). It has been suggested that the higher serum
leptin concentration in females is, at least partially, the result
of higher body fat content compared with males (25). In fact,
in our study we observed important differences in body composition between boys and girls, with significantly higher fat
mass and fat mass percentage in girls than in boys. Adiponectin concentrations in our study are also greater in girls
than in boys, as in other studies (16). Leptin concentrations
in boys and girls seem higher, and adiponectin levels lower,
than values reported for Taiwanese children of the exact
same ages (10, 15). However, the variability of the assays
used to determine adipocytokines, especially adiponectin,
makes it difficult to compare results between different studies.
In this population-based study, we found that leptin was
correlated positively with anthropometric variables and body
composition in boys and girls, which is consistent with previously reported results (10, 11, 16, 2630), showing higher
correlations with fat mass or percentage of fat mass than with
BMI itself. Our results also showed significant correlation
with WC, a measure of central adiposity, in girls and boys.
The association between leptin and WC has also been reported in previous studies on adults (31) and children (16, 30).
However, there was a weak inverse correlation between
adiponectin and BMI or WC, and no correlation with total
fat mass or percent fat mass. In this regard, our study differs
from previous findings in adults that reported adiponectin
concentrations to be correlated with adiposity assessed by
either BMI or percent body fat (20, 27, 28, 32). However,
most of those studies include a wide age range among the
participants, 1894 years in the study published by Goropashnaya et al. (20). This can account for the large variations
in BMI or fat mass composition among participants. A negative correlation between adiponectin and BMI has also been
reported by some studies in children (1416, 33). However,
these studies, while significant, also support the idea that
the correlation between adiponectin and anthropometric
variables is not as strong as the one between leptin and adiposity. In the same population, adiponectin was more highly
correlated with BMI than with the percentage of body fat in
5-year-old children, but adiponectin was more highly correlated with percentage of body fat in 10-year-old children
(14). These data suggest that leptin and adiponectin regulation and action in humans may vary with different age or
Tanner stage (34, 35). While the lack of information on Tanner stage in our children appears to be an important limitation of our study, we did not find any significant differences
in leptin and adiponectin concentrations with respect to age.
In conclusion, in addition to describing leptin and adiponectin concentrations in pubertal Spanish children between
the ages of 12 and 16 years, our study confirmed the association of leptin concentrations with anthropometric variables
and also described a strong positive correlation between lep-

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710 Schoppen et al.: Leptin, adiponectin and obesity in children

tin and body composition independently of gender. On the


contrary, adiponectin concentrations were weakly associated
with anthropometric variables and were unrelated to body
composition.

Acknowledgements
We thank Oliver Shaw for his revision of our manuscript.

Conflict of interest statement


Authors conflict of interest disclosure: The authors stated that
there are no conflicts of interest regarding the publication of this
article. Research funding played no role in the study design; in the
collection, analysis, and interpretation of data; in the writing of the
report; or in the decision to submit the report for publication.
Research funding: This study was supported by grants from the
Fondo de Investigacion Sanitaria (FIS 08/1189) and the Fundacion
de Investigacion Medica Mutua Madrilena. The contract of
C. Garces is co-financed by the Fondo de Investigacion Sanitaria.
Employment or leadership: Pa Riestra is a fellow of the Conchita
Rabago Foundation.
Honorarium: None declared.

References
1. Flier JS. Obesity wars: molecular progress confronts an expanding epidemic. Cell 2004;116:33750.
2. Badman MK, Flier JS. The adipocyte as an active participant
in energy balance and metabolism. Gastroenterology 2004;132:
210315.
3. Crowley VE. Overview of human obesity and central mechanisms regulating energy homeostasis. Ann Clin Biochem
2008;45:24555.
4. Klok MD, Jakobsdottir S, Drent ML. The role of leptin and
ghrelin in the regulation of food intake and body weight in
humans: a review. Obes Rev 2007;8:2134.
5. Friedman JM, Halaas JL. Leptin and the regulation of body
weight in mammals. Nature 1998;395:76370.
6. Ahima RS, Qi Y, Singhal NS, Jackson MB, Scherer PE. Brain
adipocytokine action and metabolic regulation. Diabetes
2006;55:S14554.
7. Yang WS, Lee WJ, Funahashi T, Tanaka S, Matsuzawa Y, Chao
CL, et al. Plasma adiponectin levels in overweight and obese
Asians. Obes Res 2002;10:110410.
8. Hara T, Fujiwara H, Shoji T, Mimura T, Nakao H, Fujimoto S.
Decreased plasma adiponectin levels in young obese males. J
Atheroscler Thromb 2003;10:2348.
9. Kadowaki T, Yamauchi T, Kubota N, Hara K, Ueki K, Tobe K.
Adiponectin and adiponectin receptors in insulin resistance,
diabetes, and the metabolic syndrome. J Clin Invest 2006;116:
178492.
10. Chu NF, Wang DJ, Shieh SM. Obesity, leptin and blood pressure among children in Taiwan: the Taipei childrens heart
study. Am J Hypertens 2001;14:13540.
11. Pilcova R, Sulcova J, Hill M, Blaha P, Lisa L. Leptin levels in
obese children: effects of gender, weight reduction and androgens. Physiol Res 2003;52:5360.

12. Nishimura R, Sano H, Matsudaira T, Miyashita Y, Morimoto


A, Shirasawa T, et al. Childhood obesity and its relation to
serum adiponectin and leptin: a report from a population-based
study. Diabetes Res Clin Pr 2007;76:24550.
13. Jin H, Jiang B, Tang J, Lu W, Wang W, Zhou L, et al. Serum
visfatin concentrations in obese adolescents and its correlation
with age and high-density lipoprotein cholesterol. Diabetes Res
Clin Pr 2008;79:4128.
14. Stefan N, Bunt JC, Salbe AD, Funahashi T, Matsuzawa Y, Tataranni PA. Plasma adiponectin concentrations in children: relationships with obesity and insulinemia. J Clin Endocrinol
Metab 2002;87:46526.
15. Chu NF, Shen MH, Wu DM, Lai CJ. Relationship between
plasma adiponectin levels and metabolic risk profiles in Taiwanese children. Obes Res 2005;13:201420.
16. Bottner A, Kratzsch J, Muller G, Kapellen TM, Bluher S, Keller E, et al. Gender differences of adiponectin levels develop
during the progression of puberty and are related to serum
androgen levels. J Clin Endocrinol Metab 2004;89:405361.
17. Panagopoulou P, Galli-Tsinopoulou A, Fleva, A, PavlitouTsiontsi, E, Vavatsi-Christaki N, Nousia-Arvanitakis S. Adiponectin and insulin resistance in childhood obesity. J Pediatr
Gastroenterol Nutr 2008;47:35662.
18. Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a
standard definition for child overweight and obesity worldwide:
international survey. Br Med J 2000;320:12403.
19. Silha JV, Krsek M, Skrha JV, Sucharda P, Nyomba BL, Murphy
LJ. Plasma resistin, adiponectin and leptin levels in lean and
obese subjects: correlations with insulin resistance. Eur J Endocrinol 2003;149:3315.
20. Goropashnaya AV, Herron J, Sexton M, Havel PJ, Stanhope KL,
Plaetke R, et al. Relationships between plasma adiponectin and
body fat distribution, insulin sensitivity, and plasma lipoproteins in Alaskan Yupik Eskimos: the Center for Alaska Native
Health Research study. Metabolism 2009;58:229.
21. Chan JL, Bluher S, Yiannakouris N. Regulation of circulating
soluble leptin receptor levels by gender, adiposity, sex steroids,
and leptin: observational and interventional studies in humans.
Diabetes 2002;51:210512.
22. Gomez JM. Serum leptin, insulin-like growth factor-I components and sex-hormone binding globulin. Relationship with sex,
age and body composition in healthy population. Protein Pept
Lett 2007;14:70811.
23. Huang KC, Lin RC, Kormas N, Lee LT, Chen CY, Gill TP,
et al. Plasma leptin is associated with insulin resistance independent of age, body mass index, fat mass, lipids, and pubertal
development in non diabetic adolescents. Int J Obes 2004;
28:4705.
24. Martin LJ, Mahaney MC, Almasy L, MacCluer JW, Blangero
J, Jaquish CE, et al. Leptins sexual dimorphism results from
genotype by sex interactions mediated by testosterone. Obes
Res 2002;10:1421.
25. Marshall JA, Grunwald GK, Donahoo WT, Scarbro S, Shetterly
SM. Percent body fat and lean mass explain the gender difference in leptin: analysis and interpretation of leptin in hispanic
and non-hispanic white adults. Obes Res 2000;8:54352.
26. Blum WF, Englaro P, Hanitsch S, Juul A, Hertel NT, Muller J,
et al. Plasma leptin levels in healthy children and adolescents:
dependence on body mass index, body fat mass, gender, pubertal stage and testosterone. J Clin Endocrinol Metab 1997;82:
290410.
27. Taniguchi A, Fukushima M, Ohya M, Nakay Y, Yoshii S, Nagasaka S. Interleukin 6, adiponectin, leptin, and insulin resistance

Article in press - uncorrected proof


Schoppen et al.: Leptin, adiponectin and obesity in children 711

28.

29.

30.
31.

32.

in non-obese Japanese type 2 diabetic patients. Metabolism


2006;55:25862.
Park KG, Park KS, Kim MJ, Kim HS, Suh YS, Ahn JD. Relationship between serum adiponectin and leptin concentrations
and body fat distribution, Diabetes Res Clin Pract 2004;63:
13542.
Dencker M, Thorsson O, Karlsson MK, Linden C, Wollmer P,
Ahren B. Leptin is closely related to body fat in prepubertal
children aged 811 years. Acta Pediatr 2006;95:9759.
Antunes H, Santos C, Carvalho S. Serum leptin levels in overweight children and adolescents. Br J Nutr 2009;101:12626.
Smith J, Al-Amri M, Sniderman A, Cianflone K. Leptin and
adiponectin in relation to body fat percentage, waist to hip ratio
and the apoB/apoA1 ratio in Asian Indian and Caucasian men
and women. Nutr Metab (Lond) 2006;10:318.
Cnop PJ, Havel PJ, Utzschneider KM, Carr DB, Sinha MK,

Boyko EJ. Relationship of adiponectin to body fat distribution,


insulin sensitivity and plasma lipoproteins: evidence for independent roles of age and sex. Diabetologia 2003;46:45969.
33. Hung YJ, Chu NF, Wang SC, Hsieh CH, He CT, Lee CH, et
al. Correlation of plasma leptin and adiponectin with insulin
sensitivity and beta-cell function in children the Taipei children heart study. Int J Clin Pract 2006;60:15827.
34. Nishimura R, Sano H, Matsudaira T, Morimoto A, Miyashita
Y, Shirasawa T, et al. Changes in body mass index, leptin and
adiponectin in Japanese children during a three-year follow-up
period: a population-based cohort study. Cardiovasc Diabetol
2009;39:830.
35. Carlsson B, Ankarberg C, Rosberg S, Norjavaara E, AlbertssonWikland K, Carlsson LM. Serum leptin concentrations in relation to pubertal development. Arch Dis Child 1997;77:396
400.

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