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01-09-2009 | Original Paper

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

Authors: Tulay Guran, Serap Turan, Abdullah Bereket, Teoman Akcay, Goksenin Unluguzel, Firdevs Bas, Hulya Gunoz, Nurcin Saka, Ruveyde Bundak, Feyza Darendeliler, Pinar Isguven, Metin Yildiz, Erdal Adal, Sevil Sarikaya, Leyla Akin Baygin, Nihal Memioglu, Hasan Onal, Oya Ercan, Goncagul Haklar

Published in: European Journal of Pediatrics | Issue 9/2009

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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Title: The role of leptin, soluble leptin receptor, resistin, and insulin secretory dynamics in the pathogenesis of hypothalamic obesity in children
Authors: Tulay Guran
Serap Turan
Abdullah Bereket
Teoman Akcay
Goksenin Unluguzel
Firdevs Bas
Hulya Gunoz
Nurcin Saka
Ruveyde Bundak
Feyza Darendeliler
Pinar Isguven
Metin Yildiz
Erdal Adal
Sevil Sarikaya
Leyla Akin Baygin
Nihal Memioglu
Hasan Onal
Oya Ercan
Goncagul Haklar
Publication date: 01-09-2009
Publisher: Springer-Verlag
Published in: European Journal of Pediatrics / Issue 9/2009
Print ISSN: 0340-6199
Electronic ISSN: 1432-1076
DOI: https://doi.org/10.1007/s00431-008-0876-x

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

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

Abstract

Introduction

Materials and methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Materials and methods

Results

Conclusion

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