G. Di Stefano et al., Leptin serum concentrations predict the responsiveness of obese children and adolescents to weight excess reduction program, INT J OBES, 24(12), 2000, pp. 1586-1591
BACKGROUND: A role for leptin to predict weight gain is still controversial
.
OBJECTIVE AND DESIGN: To determine the relationship between baseline serum
leptin values and responsiveness to an educational-based weight excess redu
ction program (WERP), 418 (241 males and 185 females) obese subjects, aged
9 -15 y, were recruited. WERP required 2 y of follow-up. Body mass index (B
MI) was evaluated at baseline and at each semester of follow-up. The obese
subjects were subdivided into responsives and non-responsives, according to
reduction or not of their BMI Z-scores during the WERP. Leptin concentrati
ons were assayed at baseline and were included together with other independ
ent variables in statistical multiple regression analysis.
RESULTS: At a preliminary multiple regression analysis, a significant posit
ive correlation between leptin values and BMI Z-score reduction at the seco
nd, third and fourth semester of follow-up was registered. To determine the
odds ratio of the subjects who were responsive or non-responsive at the va
rious semesters of WERP follow-up, a stepwise logistic regression was used
incorporating the same predictors, with the serum leptin values subdivided
into quintiles and responsiveness and non-responsiveness as a binary outcom
e variable. The model offered a satisfying goodness of fit as shown by the
sensitivity and specificity. The odds ratio of being responsive were signif
icantly increased by greater quintiles of leptin serum concentrations. Furt
hermore, such odds ratios were much higher in pubertal than in prepubertal
subjects.
CONCLUSIONS: These findings support a significant role for serum leptin con
centration in predicting BMI changes as a response to an educational excess
weight reduction program.