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