Influence of nutritional recovery on the leptin axis in severely malnourished children.
BACKGROUND
Leptin might be more important as a starvation hormone than as a satiety signal. The role of the soluble leptin receptor (sOB-R) and its regulation in children with protein energy malnutrition (PEM) is poorly understood.


METHODS
We elucidated the effect of intensive nutritional support on the leptin axis in 26 severely malnourished toddlers who received infant milk-based formula for 2 wk via continuous enteral tube feeding followed by 2 wk ad libitum feeding. Serum levels of leptin, sOB-R, IGF-I, and IGF-binding protein-3 as well as anthropometric measurements were determined at the beginning of the study and at 2-wk intervals. The control group consisted of 13 well-nourished children.


RESULTS
The following were changes in the PEM toddlers after the nutritional support. Leptin increased significantly (P < 0.001), reaching 166% of levels observed in control group. sOB-R decreased significantly (P < 0.001), and a 142-fold molar excess of sOB-R over leptin was found. There were significant correlations between leptin and IGF-I after 2 wk and IGF-binding protein-3 during the whole study. sOB-R was not correlated with any anthropometric data, whereas IGF-I was a predictor of sOB-R variance in the PEM toddlers (19.9%, P = 0.022).


CONCLUSIONS
It can be concluded that sOB-R has a modulatory effect on leptin in PEM children during nutritional recovery and participates in their adaptive survival mechanisms. Leptin and the molar excess of sOB-R over leptin are better biomarkers of nutritional status than IGF-I in PEM children during nutritional recovery.
Stein
Katja
K
Institute of Nutrition, Friedrich Schiller University, Dornburger Strasse 24, D-07743 Jena, Germany.
Vasquez-Garibay
Edgar
E
Kratzsch
Juergen
J
Romero-Velarde
Enrique
E
Jahreis
Gerhard
G
D000818:Animals; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007225:Infant Food; D018972:Insulin-Like Growth Factor Binding Protein 3 / Q000097:blood; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D020738:Leptin / Q000097:blood*; D044342:Malnutrition / Q000097:blood / Q000628:therapy*; D008892:Milk; D009747:Nutritional Physiological Phenomena / Q000502:physiology*; D011956:Receptors, Cell Surface / Q000097:blood*; D054411:Receptors, Leptin; D012016:Reference Values
D018972:Insulin-Like Growth Factor Binding Protein 3; C515448:LEPR protein, human; D020738:Leptin; D011956:Receptors, Cell Surface; D054411:Receptors, Leptin; D007334:Insulin-Like Growth Factor I