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The role of leptin, soluble leptin receptor, resistin, and insulin secretory dynamics in the pathogenesis of hypothalamic obesity in children

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Abstract

Introduction

In this study, we have investigated the role of leptin, soluble leptin receptor(sOb-R), resistin, and insulin secretory dynamics in the development of hypothalamic obesity.

Materials and methods

Children who had hypothalamo-pituitary tumor were divided into two groups. First group included obese-overweight (hypothalamic obese = HOB group, n = 23) and second group included non-obese children (hypothalamic non-obese = HNOB group, n = 16). Exogenously obese-overweight children (OB group, n = 22) were included as controls. Basal and second-hour serum glucose and insulin in oral glucose tolerance test (OGTT), basal serum leptin, sOb-R, resistin levels, and homeostasis model assessment (HOMA) indexes were compared between the groups.

Results

Age, sex, and pubertal status were similar in study groups. Median and interquartile ranges of body mass index (BMI) z scores were similar in HOB and OB groups (2.0 (1.5–2.1) and 2.1 (1.8–2.3), respectively). Serum leptin levels corrected for BMI were highest and total leptin/sOb-R ratios (free leptin index (FLI)) tended to be higher in HOB than HNOB and OB groups, indicating leptin resistance (leptin/BMI, 4.0 (1.6–5.2), 1.5 (0.8–3.1), and 2.5 (1.8–3.5); FLI, 2.0 (0.8–3.5), 0.6 (0.3–1.2), and 1.5 (1–2.3) in HOB, HNOB, and OB groups; respectively). Serum resistin levels were similar in groups (2.6 (1.9–3.1), 2.8 (1.7–3.4), and 3.0 (2.2–3.5) ng/ml in HOB, HNOB, and OB groups, respectively). Basal serum glucose, basal and second-hour insulin levels in OGTT, and HOMA index were higher in OB group than the HOB and HNOB groups, indicating insulin resistance in simple obesity; however, increment of insulin to same glycemic load in OGTT was highest in the HOB group indicating insulin dysregulation (p < 0.05).

Conclusion

Hypothalamic obesity seems to be related to both dysregulated afferent (leptin) and efferent (insulin) neural outputs through the autonomic nervous system resulting in energy storage as fat.

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Abbreviations

sOb-R:

soluble leptin receptor

HOB:

Hypothalamic obese

HNOB:

Hypothalamic non-obese

OB:

Obese

OGTT:

Oral glucose tolerance test

BMI:

Body mass index

FLI:

Free leptin index

HOMA-IR:

Homeostasis model assessment for insulin resistance index

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Acknowledgment

The authors would like to thank pediatric dietician Sabiha Keskin for caloric analyses of the children and SERONO Company who provided the commercial kits for serum leptin, soluble leptin receptor, and resistin.

Author information

Authors and Affiliations

  1. Pediatric Endocrinology, Marmara University, Istanbul, Turkey

    Tulay Guran, Serap Turan, Abdullah Bereket & Teoman Akcay

  2. Marmara University, Istanbul, Turkey

    Goksenin Unluguzel & Goncagul Haklar

  3. Istanbul Medical Faculty, Pediatric Endocrinology, Istanbul University, Istanbul, Turkey

    Firdevs Bas, Hulya Gunoz, Nurcin Saka, Ruveyde Bundak & Feyza Darendeliler

  4. Pediatric Endocrinology, Goztepe Education and Research Hospital, Istanbul, Turkey

    Pinar Isguven & Metin Yildiz

  5. Pediatric Endocrinology, Bakirkoy Maternity and Child Hospital, Istanbul, Turkey

    Erdal Adal, Sevil Sarikaya & Leyla Akin Baygin

  6. Pediatric Endocrinology, Sisli Etfal Education and Research Hospital, Istanbul, Turkey

    Nihal Memioglu

  7. Cerrahpasa Medical Faculty, Pediatric Endocrinology, Istanbul University, Istanbul, Turkey

    Hasan Onal & Oya Ercan

  8. Marmara Universitesi Hastanesi, Cocuk Saglıgı ve Hastalıkları ABD. No 13/15, 81190, Uskudar-Istanbul, Turkey

    Abdullah Bereket

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  1. Tulay Guran
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  2. Serap Turan
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Corresponding author

Correspondence to Abdullah Bereket.

Additional information

This work has been presented in part in the free communication session of ESPE 2007 meeting (Helsinki-Finland, 2007).

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Guran, T., Turan, S., Bereket, A. et al. The role of leptin, soluble leptin receptor, resistin, and insulin secretory dynamics in the pathogenesis of hypothalamic obesity in children. Eur J Pediatr 168, 1043–1048 (2009). https://doi.org/10.1007/s00431-008-0876-x

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  • DOI: https://doi.org/10.1007/s00431-008-0876-x

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