Pre-treatment circulating leptin/ghrelin ratio as a non-invasive marker to identify patients likely to regain the lost weight after an energy restriction treatment.
BACKGROUND
Leptin and ghrelin appear to play a role in weight regain after a successful weight loss. The pre-treatment plasma levels of leptin/ghrelin ratio (L/G) could have power to predict this clinically relevant issue in the obesity treatment.


OBJECTIVE
To evaluate the ability of the L/G as a non-invasive tool for the early discrimination of obese patients who are more likely to regain weight after an energy restriction program (regainers) from those who maintain the lost weight (non-regainers).


METHODS
Fasting leptin and ghrelin levels were evaluated in 88 overweight/obese patients who followed an 8-week hypocaloric diet program and were categorized as regainers (≥10 % weight-lost regain) and non-regainers (<10 % weight-lost regain) 6 months (32 weeks) after finishing the dietary treatment. A receiver operating characteristic (ROC) curve analysis was employed to evaluate the diagnostic value of the L/G ratio and to establish a cut-off point to differentiate regainers from non-regainers.


RESULTS
Regainers showed a statistically higher baseline (week 0) and after treatment (week 8) L/G ratio than non-regainers. The baseline L/G ratio was associated with an increased risk for weight regain (odds ratio 1.051; p = 0.008). Using the area under the ROC curve (AUC), the L/G ratio significantly identified female (AUC = 0.69; p = 0.040) and male regainers (AUC = 0.68; p = 0.030). The maximum combination of sensitivity and specificity was shown at the cut-off point of 26.0 for women and 9.5 for men.


CONCLUSIONS
The pre-intervention fasting leptin/ghrelin ratio could be a useful non-invasive approach to personalize obesity therapy and avoid unsuccessful treatment outcomes.
Laboratory of Molecular and Cellular Endocrinology, Instituto de Investigación Sanitaria, Complejo Hospitalario Universitario de Santiago (CHUS) and Santiago de Compostela University (USC), C/Choupana, s/n, 15706, Santiago de Compostela, Spain, anabelencrujeiras@hotmail.com.
A B
AB
Crujeiras
A
A
Díaz-Lagares
I
I
Abete
E
E
Goyenechea
M
M
Amil
J A
JA
Martínez
F F
FF
Casanueva
D000328:Adult; D015415:Biomarkers / Q000097:blood; D031204:Caloric Restriction; D004038:Diet, Reducing; D005260:Female; D054439:Ghrelin / Q000097:blood*; D006801:Humans; D020738:Leptin / Q000097:blood*; D008297:Male; D009765:Obesity / Q000097:blood / Q000175:diagnosis* / Q000178:diet therapy*; D050177:Overweight / Q000097:blood / Q000175:diagnosis* / Q000178:diet therapy*; D011379:Prognosis; D017211:Treatment Failure; D015430:Weight Gain
D015415:Biomarkers; D054439:Ghrelin; D020738:Leptin