title: Influence of nutritional recovery on the leptin axis in severely malnourished children.
abstract: 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.
authors.affiliation: Institute of Nutrition, Friedrich Schiller University, Dornburger Strasse 24, D-07743 Jena, Germany.
authors.forename: Katja
authors.initials: K
authors.lastname: Stein
authors.forename: Edgar
authors.initials: E
authors.lastname: Vasquez-Garibay
authors.forename: Juergen
authors.initials: J
authors.lastname: Kratzsch
authors.forename: Enrique
authors.initials: E
authors.lastname: Romero-Velarde
authors.forename: Gerhard
authors.initials: G
authors.lastname: Jahreis
mesh_terms: 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
chemical_list: 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