ESPE Yearbook of Paediatric Endocrinology

Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island, USAcatherine.buck@yale.edu Obesity (Silver Spring). 2021 Jun;29(6):1036–1045. doi: 10.1002/oby.23160. https://pubmed.ncbi.nlm.nih.gov/34029449/

Brief Summary: This longitudinal study assessed the association between changes in leptin and adiponectin levels from birth to 12 years of age with level of adiposity and cardiometabolic risk in adolescence in a prospective birth cohort study (HOME Study, n=166). They observed that compared to adolescents with decreasing leptin z-scores, adolescents with stable or increasing leptin z-scores from birth onwards had higher adiposity and worse cardiometabolic risk scores in adolescence. Adolescents with increasing or stable adiponectin-to-leptin ratio had lower adiposity and more favorable cardiometabolic risk scores than adolescents with a decreasing adiponectin-to-leptin ratio.

It has been reported that changing leptin concentrations over time are related to higher waist circumference and BMI in midchildhood [1] as well as higher metabolic risk scores in adolescents [2]. Therefore, this paper is important because it supports previous findings and highlights a subgroup of adolescents with a specific leptin course from birth onwards, characterized by a worse cardiometabolic risk score and higher adiposity in adolescence. Leptin levels at birth and at 12 years of age were moderately positively correlated, whereas adiponectin levels did not correlate between birth and adolescence. An interesting finding was that the authors identified children with increasing, decreasing or stable leptin z-score (age- and sex-standardized), or adiponectin-to-leptin ratio from birth up to 12 years of age.

The pathophysiological mechanism behind this observation is unclear. It is possible that changing leptin concentrations over time may present the development of leptin resistance, which is associated with insulin resistance, central and visceral adiposity or it represents a partial leptin deficiency that is compensated by excess leptin production during the course. Regardless of this question, studies like this help to identify subgroups that can then be characterized subsequently, and which can thereby contribute to a better understanding of the pathophysiology of development of adiposity.

References: 1. Volberg V, Heggeseth B, Harley K, Huen K, Yousefi P, Dave V, et al. Adiponectin and leptin trajectories in Mexican-American children from birth to 9 years of age. PloS One 2013;8:e77964. doi: 10.1371/journal.pone.0077964. 2. Li LJ, Rifas-Shiman SL, Aris IM, Mantzoros C, Hivert MF, Oken E. Leptin trajectories from birth to mid-childhood and cardio-metabolic health in early adolescence. Metabolism 2019;91:30–38. doi: 10.1016/j.metabol.2018.11.003.