Circulating soluble leptin receptor, leptin, and insulin resistance before and after weight loss in obese children

Reinehr, T.; Kratzsch, J.; Kiess, W.; Andler, W.
October 2005
International Journal of Obesity;Oct2005, Vol. 29 Issue 10, p1230
Academic Journal
journal article
OBJECTIVE:To study the relationships between leptin, soluble leptin receptor (sOB-R), and insulin resistance in obese children before and after weight reduction.METHODS:We determined fasting serum leptin, sOB-R, and insulin resistance index (Homeostasis model assessment (HOMA)) in 36 obese children at baseline and 1 y later and compared them to 72 lean children matched for age, gender, and pubertal stage. The changes of leptin (Δleptin) and sOB-R (ΔsOB-R) over the 1 y period were correlated to the changes of HOMA (ΔHOMA), the changes of weight status, and the changes of percentage body fat (Δ%BF) based on skinfold measurements. Multiple linear regression analyses were conducted for the dependent variables Δleptin and ΔsOB-R, including ΔBMI and ΔHOMA as independent variables adjusted for age, gender, and pubertal stage. Changes of leptin and sOB-R levels were analyzed in 11 obese children after they had lost weight substantially (decrease SDS-BMI>0.5) and compared to 11 obese children without substantial weight loss matched for age, gender, and pubertal stage.RESULTS:Obese children showed significantly (P<0.001) higher leptin and lower sOB-R levels. Δleptin correlated significantly to ΔSDS-BMI (r=0.28, P<0.05), Δ%BF (r=0.44, P<0.05), and ΔHOMA (r=0.42, P<0.01), while ΔsOB-R correlated significantly to ΔSDS-BMI (r=−0.42, P<0.01) and Δ%BF (r=−0.47, P<0.01), but not to ΔHOMA. In contrast to ΔsOB-R, Δleptin correlated significantly to ΔHOMA (P=0.02) in multiple linear regression analysis. Substantial weight loss led to a significant increase in sOB-R (P=0.02) and to a decrease in HOMA (P=0.02). In children without substantial weight loss, there were no changes in sOB-R, while HOMA (P=0.04) and leptin (P=0.02) increased significantly.CONCLUSIONS:The decrease of sOB-R and the increase of leptin levels in obese children normalized after weight loss. Therefore, these changes are consequences rather than the cause of overweight. In contrast to sOB-R, leptin levels are associated with insulin resistance.International Journal of Obesity (2005) 29, 1230–1235. doi:10.1038/sj.ijo.0803027; published online 5 July 2005


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