title: Relationship between changes in plasma leptin concentrations and plasminogen activator inhibitor-1 in obese prepubertal children after nine months of treatment.
abstract: OBJECTIVE
  The metabolic syndrome (MS) is associated with insulin resistance (IR), inappropriate fibrinolysis and high plasma leptin concentrations. The aim of this study was to quantify fibrinolysis and MS-related variables in obese prepubertal children and to evaluate changes in these variables as a result of improved body mass index (BMI), IR and leptin levels following 9 months of treatment.
  
  
  METHODS
  The homeostasis model assessment for insulin resistance (HOMA-IR), leptin, plasminogen activator inhibitor-1 (PAI-1) and lipid profile were studied at baseline in obese (n = 50) and nonobese children (n = 50), and after 9 months of treatment in obese children.
  
  
  RESULTS
  In the cross-sectional study the mean values for insulin, HOMA-IR, triglycerides, leptin and PAI-1 were significantly higher in obese children than in controls. High-density lipoprotein cholesterol (HDLc) and apolipoprotein A-1 were significantly lower. In the longitudinal study, after 9 months, children with lowered BMI standard deviation score displayed a significant decrease in insulin, HOMA-IR, PAI-1, leptin and triglyceride levels, and an increase in HDLc. Only leptin proved to be an independent predictive factor for changes in PAI-1 (p = 0.010).
  
  
  CONCLUSIONS
  Obesity-linked disorders appear in obese children prior to puberty; these disorders can be improved by decreasing BMI. Changes in leptin levels were found to independently predict changes in PAI-1 in obese children and can help to diagnose complications associated with the obesity.
authors.affiliation: Clinical Laboratory Department, Valle de los Pedroches Hospital, Pozoblanco, Córdoba, Spain.
authors.forename: Miguel
authors.initials: M
authors.lastname: Valle Jiménez
authors.forename: Rosario
authors.initials: R
authors.lastname: Martos
authors.forename: Rosario M
authors.initials: RM
authors.lastname: Morales
authors.forename: Rosario
authors.initials: R
authors.lastname: Valle
authors.forename: María Dolores
authors.initials: MD
authors.lastname: Cañete
authors.forename: M Mar
authors.initials: MM
authors.lastname: Urbano
authors.forename: Francisco
authors.initials: F
authors.lastname: Bermudo
authors.forename: Ramón
authors.initials: R
authors.lastname: Cañete
mesh_terms: D016632:Apolipoprotein A-I / Q000097:blood; D015992:Body Mass Index; D002648:Child; D008076:Cholesterol, HDL / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D020738:Leptin / Q000097:blood*; D008137:Longitudinal Studies; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000150:complications / Q000628:therapy; D009765:Obesity / Q000097:blood* / Q000150:complications / Q000628:therapy*; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood*; D014280:Triglycerides / Q000097:blood
chemical_list: D016632:Apolipoprotein A-I; D008076:Cholesterol, HDL; D007328:Insulin; D020738:Leptin; D017395:Plasminogen Activator Inhibitor 1; D014280:Triglycerides