Hyperleptinemia and hypoadiponectinemia in extreme pediatric obesity.
BACKGROUND
Adiponectin and leptin, adipokines associated with metabolic syndrome, type 2 diabetes, and cardiovascular disease, have not been well characterized in extreme pediatric obesity. Therefore, levels were compared in youth that were extremely obese (EO) to normal weight (NW), overweight (OW), and obese (OB) youth.


METHODS
Leptin, adiponectin, body mass index (BMI), blood pressure, fasting glucose, insulin, and lipids were obtained in 277 children and adolescents (age 13.4±2.6 years; 152 boys). Participants were classified into four BMI groups (NW, OW, OB, EO). Variables were compared across groups using analysis of covariance (ANCOVA) adjusted for gender, age, and race.


RESULTS
Risk factors generally worsened across BMI groups. EO had significantly higher levels of leptin than OB (P<0.0001), OW (P<0.0001), and NW (P<0.0001). Leptin was higher in OB compared to OW (P<0.005) and NW (P<0.0001) and higher in OW compared to NW (P<0.0001). Adiponectin levels in EO did not significantly differ from OB or OW but were significantly lower than NW (P<0.0001). Adiponectin was not significantly different among the OB, OW, and NW groups.


CONCLUSIONS
Leptin was markedly elevated in EO children and adolescents, suggesting that this subset of obese youth may be at particularly high risk of future weight gain and potentially reduced response to weight-loss interventions.
Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota 55455, USA. kelly105@umn.edu
Aaron S
AS
Kelly
Andrea M
AM
Metzig
Sarah Jane
SJ
Schwarzenberg
Anne L
AL
Norris
Claudia K
CK
Fox
Julia
J
Steinberger
D054392:Adipokines / Q000097:blood; D052242:Adiponectin / Q000032:analysis / Q000097:blood*; D000293:Adolescent; D017668:Age of Onset; D015992:Body Mass Index; D002648:Child; D003430:Cross-Sectional Studies; D015536:Down-Regulation; D005260:Female; D006801:Humans; D020738:Leptin / Q000032:analysis / Q000097:blood*; D008297:Male; D009767:Obesity, Morbid / Q000097:blood* / Q000150:complications / Q000453:epidemiology; D050177:Overweight / Q000097:blood / Q000453:epidemiology; D015854:Up-Regulation
C499918:ADIPOQ protein, human; D054392:Adipokines; D052242:Adiponectin; D020738:Leptin