title: Plasma leptin, fatty acids, and tumor necrosis factor-receptor and insulin resistance in children.
abstract: OBJECTIVE
  To evaluate the effect of plasma leptin, nonsterified fatty acids (NEFAs), and tumor necrosis factor-receptor 1 (TNFR1) on plasma insulin and insulin-resistance status in children.
  
  
  METHODS
  One thousand thirty-two children (521 boys and 511 girls) were included in this study. We measured plasma insulin and leptin levels by radioimmunoassay, plasma NEFA levels by enzymatic acyl-coenzyme A synthase-acyl-coenzyme A oxidase spectrophotometric methods, and TNFR1 levels by enzyme-linked immunosorbent assay. We calculated insulin resistance index (IRI) using homeostasis model assessment and calculated insulin-resistance syndrome summary score (IRS) by adding the quartile ranks from the distribution of systolic blood pressure (BP), serum triglyceride, high-density lipoprotein-cholesterol (inverse), and insulin levels.
  
  
  RESULTS
  Overweight children had higher BP, plasma leptin, and insulin levels and higher IRI and IRS than normal-weight children. Plasma leptin and TNFR1 were positively correlated with insulin levels, IRI, and IRS. The correlation coefficients of leptin and TNFR1 in IRI were 0.53 and 0.12, respectively, for boys and 0.25 and 0.18, respectively, for girls. In multivariate regression analyses, TNFR1 was positively associated with insulin level and IRI in girls; NEFA was positively associated only with IRS. Plasma leptin levels were significantly positively associated with insulin levels, IRI, and IRS, even after adjusting for BMI and other potential confounders.
  
  
  CONCLUSIONS
  Overweight children had higher BP, plasma insulin, and leptin levels and adverse insulin-resistance status than normal-weight children. Plasma leptin levels, rather than NEFA and TNFR1, may play a significant role in the development of hyperinsulinemia and insulin resistance in children.
authors.affiliation: Department of Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC. chuepi@ndmctsgh.edu.tw
authors.forename: Nain-Feng
authors.initials: NF
authors.lastname: Chu
authors.forename: Jin-Biou
authors.initials: JB
authors.lastname: Chang
authors.forename: Shih-Ming
authors.initials: SM
authors.lastname: Shieh
mesh_terms: D000293:Adolescent; D015703:Antigens, CD / Q000097:blood*; D001794:Blood Pressure; D015992:Body Mass Index; D002648:Child; D008076:Cholesterol, HDL / Q000097:blood; D003430:Cross-Sectional Studies; D005230:Fatty Acids, Nonesterified / Q000097:blood*; D005260:Female; D006706:Homeostasis; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D020738:Leptin / Q000097:blood*; D008297:Male; D024821:Metabolic Syndrome; D054411:Receptors, Leptin; D018124:Receptors, Tumor Necrosis Factor / Q000097:blood*; D047888:Receptors, Tumor Necrosis Factor, Type I; D012044:Regression Analysis; D014280:Triglycerides / Q000097:blood
chemical_list: D015703:Antigens, CD; D008076:Cholesterol, HDL; D005230:Fatty Acids, Nonesterified; D007328:Insulin; C515448:LEPR protein, human; D020738:Leptin; D054411:Receptors, Leptin; D018124:Receptors, Tumor Necrosis Factor; D047888:Receptors, Tumor Necrosis Factor, Type I; D014280:Triglycerides