Background: Adipose tissue secretes multiple adipokines that exhibit essential roles in metabolic regulation. Of these adipokines are leptin and adiponectin, which regulate body weight and energy expenditure. Since leptin and adiponectin change inversely in relation to BMI, their ratio -the leptin/adiponectin (L/A ratio) - has been suggested as a more sensitive marker of metabolic syndrome than their serum concentrations individually.
Aim of the work: evaluate the prognostic value of serum concentrations of the adipokines (leptin, adiponectin, the L/A ratio) in children and adolescents with simple obesity under a nutritional management program and their role in developing cardio-metabolic complications.
Patients and Methods: This study was conducted on 90 children and adolescents (age: 6-18 years) with simple obesity recruited from the Obesity Clinic, Children's Hospital, Ain Shams University. All patients were subjected to the following initially and after 6 months of nutritional management: anthropometric measurements, analysis of body composition, 24-hour diet recall and laboratory investigations including: lipid profile, serum leptin, serum adiponectin and HOMA-IR.
Results: revealed higher values of serum leptin and L/A ratio in the Cardio-Metabolic risk group before and after dietary management than Non-Cardio-Metabolic risk group. After diet control, significant lower adiponectin levels were found in CM risk group. Before management, ROC curve showed that best cut off point for L/A ratio to differentiate between CM risk and non-CM risk groups was found >7.72 with sensitivity of 63.16%, specificity of 78.57% and AUC 71.7%.
Conclusion: Identifying serum leptin /Adiponectin (L/A) ratio would be beneficial tool for the optimum assessment of obesity and its severity.