Leptin/adiponectin ratio as a prognostic factor for increased weight gain in girls with central precocious puberty

Jessie Nallely Zurita-Cruz; Miguel Angel Villasís-Keever; Leticia Manuel-Apolinar; Leticia Damasio-Santana; Eulalia Garrido-Magaña; Aleida de Jesús Rivera-Hernández

doi:10.3389/fendo.2023.1101399

Leptin/adiponectin ratio as a prognostic factor for increased weight gain in girls with central precocious puberty

Front Endocrinol (Lausanne). 2023 Mar 10:14:1101399. doi: 10.3389/fendo.2023.1101399. eCollection 2023.

Authors

Jessie Nallely Zurita-Cruz¹, Miguel Angel Villasís-Keever², Leticia Manuel-Apolinar³, Leticia Damasio-Santana³, Eulalia Garrido-Magaña⁴, Aleida de Jesús Rivera-Hernández⁴

Affiliations

¹ Medicine Faculty of Autonomous National University, Clinical Research Department, Hospital Infantil de México Federico Gómez, Ciudad de Mexico, Mexico.
² Unit of Analysis and Synthesis of the Evidence, National Medical Center XXI Century, Instituto Mexicano del Seguro Social, Ciudad de Mexico, Mexico.
³ Department of Endocrinology Research, Hospital of Medical Specialties, National Medical Center XXI Century, Instituto Mexicano del Seguro Social, Ciudad de Mexico, Mexico.
⁴ Department of Pediatric Endocrinology, Children's Hospital, National Medical Center XXI Century, Instituto Mexicano del Seguro Social, Ciudad de Mexico, Mexico.

Abstract

Objective: To determine if the leptin, adiponectin, and leptin/adiponectin ratio (LAR) can predict weight gain at the end of GnRH analogs (GnRHa) treatment in girls with central precocious puberty (CPP).

Material and methods: Study design: prospective cohort. Serum levels of leptin and adiponectin were determined at diagnosis of CPP. Anthropometry was performed at diagnosis of CPP and every six-months, until treatment with GnRHa was discontinued and they presented menarche. Patients were divided according to BMI<94 and BMI>95 percentile at diagnosis of CPP. The outcome was the increased in weight gain (e.g., from normal weight to overweight) at the end of follow-up. Statistical analysis: repeated measures ANOVA test and Student's t-test were used to compare groups. Logistic regression analysis was used to evaluate the association of leptin and adiponectin levels, as well as LAR values with increased weight gain.

Results: Fifty-six CPP patients were studied, 18 had BMI >95 percentile and 38 BMI <94 percentile. Of the 18 patients who initially had BMI >95^th, two patients went from obesity to overweight, while among the 38 patients who started with BMI <94^th, 21 (55.2%) increased their weight gain at the end of follow-up. This last group had higher leptin levels (8.99 ± 0.6 vs 6.14 ± 0.8, p=0.005) and higher LAR values compared to those who remained in the same weight (1.3 ± 0.5 vs 0.96 ± 0.56, p=0.01). In the logistic regression analysis, it was found that higher leptin levels and higher LAR values were associated with increased weight gain (RR 1.31, 95%CI 1.03-1.66, RR 4.86, 95%CI 1.10-21.51, respectively), regardless of birth weight, pubertal stage, age, and bone/chronological age ratio.

Conclusions: In patients with CPP, leptin levels and higher LAR values appear to be associated with significantly greater weight gain during GhRHa treatment, particularly in girls starting with BMI < 94 percentile.

Keywords: adiponectin; leptin; nutrition status; obesity; precocious puberty; prognosis; weight gain.

MeSH terms

Adiponectin
Body Mass Index
Female
Humans
Leptin*
Overweight / complications
Prognosis
Prospective Studies
Puberty, Precocious* / complications
Weight Gain

Substances

Leptin
Adiponectin